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Ask the Expert
There is not a great deal of evidence that acupuncture has been used successfully for treating this condition. This becomes very clear when you undertake any searches for evidence. There is a single paper for the use of acupuncture and hypnotherapy ('hypnopuncture')
which is cited over and over again without any further additions, a certain sign that there is no other evidence. We are sure that there are probably a large number of trials which have been undertaken in China, but the great majority of these have not been translated and are often regarded in the West as methodologically flawed.
However, skin diseases are as old as mankind, and the systems of Chinese medicine do have ways of interpreting the signs and symptoms of diseases like prurigo within its framework. These often use terms like 'invasions' of 'heat', 'wind' or 'damp' which sound alien to the western ear but describe the effects of climate (as experienced by a largely agrarian population) on the flow of energy, called 'qi', especially where this disrupted the flow, rhythm and balance near the skin surface. Everyone is aware of the short term effects of exposure to extremes of climate, and from a Chinese medicine perspective, whether this is the primary cause of a problem, or whether there is an underlying weakness which makes particular people vulnerable, the skill of the practitioner lies in assessing the overall balance as well as the presenting symptoms, and attempting to restore balance.
The best advice that we can give you is that you visit a BAcC member local to you for a brief face to face assessment of the problem. Crucial to this assessment will be whether the problem is local or widespread. In broad terms, the more localised, the more treatment options there are. We would also recommend that you might want to see advice from someone who also does Chinese herbal medicine. The majority of the members of the Register of Chinese Herbal Medicine are also BAcC members. We say this because herbal medicine has developed a very good reputation over the years for treating skin conditions, the daily dose of herbs helping to maintain a treatment momentum. It may be that a combination of acupuncture and herbal medicine may prove a more potent force in helping your problem, but to what extent would depend on a more thorough assessment than we can give here.
Q: What is the VAT status of treatments made by an acupuncturist? Exempt or standard rated?
A: There are no exemptions from VAT for acupuncture treatment because we are a healthcare profession. This only applies to the statutorily regulated professions like osteopathy. The full list, taken from the HMRC site, is:
Item 1 of Group 7 of Schedule 9 to the VAT Act 1994 exempts:
The supply of services by a person registered or enrolled in any of the following –
(a) the register of medical practitioners or the register of medical practitioners with limited registration;
(b) either of the registers of ophthalmic opticians or the register of dispensing opticians kept under the Opticians Act 1989 or either of the lists kept under section 9 of that Act of bodies corporate carrying on business as ophthalmic opticians or as dispensing opticians;
(c) the register kept under the Health Professions Order 2001;
(ca) the register of osteopaths maintained in accordance with the provisions of the Osteopaths Act 1993;
(cb) the register of chiropractors maintained in accordance with the provisions of the Chiropractors Act 1994;
(d) the register of qualified nurses and midwives maintained under article 5 of the Nursing and Midwifery Order 2001;
(e) the register of dispensers of hearing aids or the register of persons employing such dispensers maintained under section 2 of the Hearing Aid Council Act 1968
Health Professions Order 2001
Professions which have registers kept under the Health Professions Order 2001 are:
podiatrists and chiropodists (Chiropody: the examination, diagnosis, treatment and prevention of diseases and malfunctions of the foot and its related structures);
dieticians (Dietetics: the application of nutritional science to the maintenance or restoration of health);
occupational therapists (Occupational therapy: treatment aimed at enabling people disabled by physical illness or a serious accident to relearn muscular control and co-ordination, to cope with everyday tasks, such as dressing, and when possible to resume employment);
orthoptists (Orthoptics: a technique used to measure and evaluate squint, mainly in children. It includes assessment of monocular and binocular vision, eye exercises and measures to combat lazy eye);
physiotherapists (Physiotherapy: treatment of disorders or injuries with physical methods or agents);
prosthetists and orthoptists;
radiographers (Radiography: the use of radiation to obtain images of parts of the body. Radiotherapists are included in this register);
speech and language therapists; and
operating department practitioners
You may find a number of American sites such as this one
Please click here
which give some very clear and unequivocal advice about the treatment of hair loss. You may also have seen some of the high street shops with lurid photos of 'before' and 'after' treatment.
The reality is that there is very little research evidence to suggest that acupuncture can reverse hair loss if that is a stand-alone problem. This is becoming an increasing problem for men especially in modern times, and there are a number of theories, from stress to electro-magnetic radiation to increases in background hormone levels in drinking water, as to why this might be. However, there is no conclusive evidence for any of these, and no evidence that acupuncture can treat hair loss as a specific symptom.
However, hair loss can be associated with other conditions like Polycystic Ovary Syndroe (PCOS) in women and systemic lupus erythematosus (SLE) in both sexes, and if this is the case, there are approaches in both conventional and Chinese medicine which may prove beneficial. Clearly the Chinese medicine ones will be looking at the symptom in the context of other symptoms which someone may have, and also in the context of understanding the body as a system of energy, or 'qi', whose flow, rhythms and balance have been disturbed. There are a number of functional elements understood from this perspective which contribute to the health and quantity of the hair, as well as its 'vitality', and if a diagnosis can make sense of the hair loss within this wider context, then there is some sense that acupuncture treatment may help.
However, progress, even if good, is likely to be slow, and there are, sad to say, professionals (not BAcC members, we are pleased to note) who make the kinds of claims for hair growth and recovery which we do not believe are underpinned by evidence, either research or anecdotal, so we recommend great caution.
Q: Have wondered if acupuncture would help with hay fever. I have been given steroidal nasal spray (by doctor) for severe running eyes and nose. Don`t want to keep the steroids up. Tablets (anti-histamine) make me very drowsy, although they advertise that they shouldn't. I also seem to be alergic to dust etc.
A: Hay fever is usually grouped under the generci term 'allergic rhinitis', and as the BAcC fact sheet shows
Please click here
it has been a frequently researched condition over the years because the diagnosis is easy to make from the cluster of symptoms and willing patients are plentiful. Unfortunately a great deal of the research is on too small a scale or methodologically flawed, so the results are often inconclusive, encouraging but some way short of saying that acupuncture is guaranteed to deliver. There are a number of reasons for this to do with the level of evidence required in the West, the randomised control trial, which is not the best way to assess traditional acupuncture, but even allowing for that, our clinical experience is that there are patients for whom treatment makes not a jot of difference.
That said, allergic rhinitis is not a new phenomenon, and Chinese medicine, which developed in treating people whose lives were mainly spent outdoors, has a number of ways of understanding how the symptoms present in terms of the systems of Chinese medicine and also how this can derive from a number of systemic weaknesses. This latter enterprise has been the subject of a great deal of debate amongst modern practitioners as the number of environmental factors which can create similar symptoms has escalated alarmingly. In short, Chinese medicine has a number of strategies for dealing with the various presentations of the condition, and also a way of looking at the overall health of the patient as a potential underlying factor which predisposes someone to the problem. This means that in many cases treatment is aimed at the person, not the symptoms, a strategy which underpinned a great deal of the practice of the ancients.
The received wisdom inside the modern profession is that it is better to commence treatment before the time that the condition, if it is seasonal, would norally present, and our clinical experience has been that once the condition has kicked in, a reduction in the severity of the symptoms is the best that one can hope for. If the condition is always present, it can sometimes be a long haul to bring the system back to a point where the symptoms are minor and bearable.
Each sufferer is unique and different, however, and the best thing you can do is to find a BAcC member local to you and arrange for a brief chat so that he or she can establish whether acupuncture treatment might be of benefit to you.
Provision of acupuncture on the NHS is fairly limited. There are about 2000 doctors and 6000 physios who belong to special interest groups within their professions, but most use acupuncture only as another tool in the toolbox. They are also severely limited by only being able to offer treatment for conditions which have an accepted evidence base. These are few, not because there aren't any but because the standard test applied, the randomised control trial, was designed for drugs, not therapies like acupuncture, and the practice of acupuncture does not lend itself to such a design. There are hundreds of thousands of studies, mainly from China, which underpin the World Health Organisation's list of conditions which acupuncture can treat.
A small number of BAcC members have managed to secure funding to provide acupuncture within the NHS, but these projects are few and far between. In theory GPs are allowed to use their practice funds as they wish, and could refer patients for treatment within their budgets, but in practice this does not happen. There is immense pressure on funding right now, especially with the Commissioning Groups taking over from the Primary Care Trusts, and with savings being sought everywhere possible, there is less chance of either individual provision or the funding of units or projects.
The BAcC is keenly aware that with the average cost of a treatment being between £30 and £50, depending where you live, this puts treatment beyond the reach of many people. However, there are a growing number of innovative ways in which BAcC members are trying to reach people who otherwise could not afford acupuncture, and most members are willing to discuss reductions in fees if a small discount enables someone to have treatment. Ask your local BAcC members for advice.