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After the scabs have fallen off, if they gradually detach starting from the hands, and the resulting scars are bright, smooth, and lustrous, without any redness or blackness, nor any concavities or convexities, with the facial appearance restored to normal, this is a highly favorable outcome. If after the scabs fall, the five organs exhibit numbness or dysfunction, the four limbs are disabled, hair falls out completely, and the physical appearance is drastically altered, this indicates survival amidst critical danger. For dark and dirty scars on the face, Miecan San (Scar-Removing Powder) must be used; mix it with honey water before sleep and apply it, then wash it off with water at dawn, so that it will naturally become white, bright, and lustrous. Further care should be taken to avoid exposure to wind and sunlight too early. If the scars protrude, it indicates that heat-toxin has not been fully cleared; Jiedu Fangfeng Tang (Detoxifying and Saposhnikovia Decoction) is appropriate. If the scars are depressed, it indicates Spleen and Stomach deficiency failing to nourish muscles; Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) added with Huangqi (Astragali Radix) should be used. If the scabs do not detach, apply Baihua Gao (Hundred Flowers Ointment) to moisten them for rapid detachment; delay may cause them to penetrate deep into the muscle and form permanent keloids. If they remain for a long time, it is due to Blood deficiency generating heat in the Lung (which governs skin and hair) and Spleen (which governs muscles); internally, use formulas to tonify Blood and cool Ying (Nutritive Qi), and externally, apply Sesame Oil and Honey. The scabs will detach naturally when moistened. Do not forcibly peel them off, as this may damage the skin, causing ulcers or transforming into acne-like lesions (Dou Lai).

For cases where the entire body's scar marks are dark after smallpox recovery, one should not immediately assume there is no issue, even if recalling that pus formation was insufficient previously and the resolution phase seemed to relate to the Kidney. Careful differentiation is required. If there is high fever, poor appetite, extreme thirst, restlessness, confusion, drowsiness, and irregular bowel movements (either loose or constipated), this is true "Dao Ye Gui Shen" (Inverted Resolution Retreating to the Kidney), a critical condition. If the body feels warm and comfortable, and bowel movements and diet are regular, this is merely the natural color of the scars, requiring no worry. If the scars are white, it indicates Qi and Blood deficiency; urgently use major Qi and Blood tonics. If resolution is delayed and scabs are hard to fall, and the person is lethargic and sleepy without other suffering, it is because although pathogenic factors have receded, Zheng Qi (Upright Qi) remains weak due to Spleen and Stomach deficiency. Use Baoyuan Anshen (Protect Vitality and Calm Spirit) methods, regulating slowly; once Qi and Blood stabilize, clarity will return. However, when scabs first fall, the new muscle tissue is tender; bathing is inappropriate, and clothing adjustments should be cautious because Biao Qi (Defensive Qi) is weak, making the Six Evils (Wind, Cold, Summerheat, Dampness, Dryness, Fire) prone to attack. Additionally, internal Qi is weakened by lingering toxin, and the Intestines and Stomach are fragile; cold drinks and irregular eating habits should be avoided. Illness during the smallpox course is difficult to treat later; rather than enduring lifelong illness, it is better to exercise caution for one hundred days. Red and itchy scars indicate Blood deficiency with Heat; use Mudanpi (Moutan Cortex) and Digupi (Cortex Lycii). Red and painful scars indicate residual toxin; use Lianqiao (Forsythiae Fructus) and Niubangzi (Arctii Fructus). White scars indicate Qi deficiency and Blood decline; focus on consolidating Yuan Qi (Original Qi). White, itchy, and thirsty scars indicate dual Qi and Blood deficiency; major tonification of Qi and Blood is especially indicated. Fever with normal stools indicates Spleen-Stomach Deficient Heat; fever with constipation indicates Intestine-Stomach Excess Heat. Reduced milk/food intake and limb fatigue indicate Middle Qi deficiency. If treatment leads to immediate recovery and scars turn red and vibrant, it is auspicious. If the color does not change, diarrhea and dysentery leading to death may occur even years later. If Qi and Blood tonification fails over a long period, one should instead tonify the root of Qi and Blood. The root of Qi is True Yang in the Kidney; the root of Blood is True Yin in the Kidney. Tonifying from these roots will invariably restore deficient Qi and Blood.

If scars protrude again after falling, forming new pustules and re-scabbing, it is likely due to overly rapid resolution leaving incomplete toxin, or misusing warming and tonifying herbs, consuming excessive bland, fatty, and sweet foods, drinking alcohol, indulging in spicy foods, ignoring fried/greasy items, or early exposure to wind causing stagnation of Ying and Wei (Nutritive and Defensive Qi). All these can cause recurrence. However, since this pathogenic toxin disperses outward, severe suffering is unlikely, though muscle emptiness may lead to chronic ulcerative conditions. Another scenario involves scabs falling but hard,成片 (patchy) formations appearing on the face, hands, or feet; although the surface is scorched, pus accumulates inside. This occurs because the initial eruption was too dense, merging into a mass without distinct granules, trapping toxin internally preventing thorough expulsion, thus delaying resolution. Now, with diminished Qi and Blood, toxic pus reforms. Apply Miecan San mixed with honey; wait for pus to resolve and scabs to fall for natural healing. In cases where wrist and knee lesions form connected chains, creating large masses of liquid pus like sacs, where the skin remains intact and fluid persists for a long time, this indicates the underlying muscle has healed, but only the outer scar skin remains. Puncture with a needle to drain the fluid, allowing it to dry and detach naturally.