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Ask an expert - body - skin conditions
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.
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: I am not sure if acupuncture would have any chance of helping with this, but I suffer from bad acne around my chin area - and I'm pretty sure this is related to hormones. I am 29 years of age, and female.
A: There is some evidence that acupuncture can help acne, as out factsheet shows:
Please click here
However, we are interested that you think there is a hormonal connection because in someone your age acne is very often a symptom of polycystic ovary syndrome, for which there is some, if conflicting, evidence about the value of acupuncture treatment, as our factsheet shows
Please click here
There is every reason to seek further conventional medical assessment to establish whether this is the case, because it can add to the understanding of the condition from a Chinese medicine perspective. Any accumulations of fluid in the body have significance from a Chinese point of view, and if there are other linked symptoms this will suggest possibilities for treatment.
If the problem is simply a local one, we believe that there may be some value in seeking acupuncture treatment, but we would also probbaly recommend that a prospective patient visit someone who is also trained in Chinese herbal medicine. Using herbal medicines can often offer daily treatment of a problem which in the case of skin problems seems to provide a better chance of 'breaking through' the pattern. Mist members of the RCHM are also members of the BAcC, so finding someone who uses acupuncture and herbs is not difficult.
However, any of the BAcC members local to you will be able to offer you honest advice and a brief face to face assessment of your problem to make a more informed recommendation than we can make remotely.
Q: I wondered whether acupuncture is able to treat rosacea. I was diagnosed by my GP about one year ago. I have since tried creams and medications as suggested by my GP. Although I have seen some improvement in the condition it still remains present, largely on my head.
A: It's always a good indicator how well something responds to acupuncture to type the condition and 'acupuncture' into google and see what comes back. We have trawled the databases for evidence that there have been trials which have looked at how successful acupuncture treatment was for this condition, but there are very few in English. This does not mean that there are none at all; the Chinese conduct many thousands of trials each year, the vast majority of which are never translated. Where there are good ones, they tend to emerge quickly. Many suffer from methodological weaknesses, however; the Chinese know acupuncture works and want to assess what works better, whereas in the West we are still fixated on whether it works at all. This requires a much more rigorous level of trial with standards which many Chinese studies fail to meet.
However, the fact that there are no relevant trials does not mean that Chinese medicine cannot help. There is a vast difference between the way that conventional medicine and Chinese medicine address their patients, and while symptoms are the primary focus of conventional medicine, in Chinese medicine these are mainly relevant as indicators of deeper underlying imbalances which affect the whole system. Chinese medicine primarily treats the patient, not the disease. This may mean that a practitioner can, in your case, identify areas of weakness or imbalance which might be contributing to the symptoms which you have. Many people, indeed, turn to Chinese herbal medicine, which affords the possibility of daily treatment, something which can really help in bringing a stubborn long-term condition under control.
However, much research is stimulated by anecdotal evidence, and there isn't a great deal to be found on the internet suggesting that acupuncture is the treatment of choice of this condition. We think that you may well benefit from seeking the advice of a BAcC member local to you. This will at least alert you to the background against which your condition has developed, and may offer some useful suggestions about how best to avoid making the condition worse. If you did decide to give treatment a try, we recommend that you ensure that you set measurable targets and also review dates; long term chronic conditions can easily become a money pit unless one is very careful.
There may be some merit in finding a BAcC member who also uses Chinese medical herbs, not that difficult since the majority of RCHM members are also members of the BAcC, but we cannot give you an individual recommendation, we are afraid to say. From our perspective all BAcC members are equally well equipped in Chinese medicine skills to address any patient, and this means you can contact any with confidence that you will be getting an honest and informed assessment of how acupuncture may benefit you.
Q: can acupuncture help alopecia areata I do not have a lot of money and am scared of going on a wild goose chase please be honest
A: We have been asked this question a couple of times and embedded the answer to the first occasion in the answer to the second, which read as follows:
How many acupuncture treatments required for alopecia areata?
Q: My daughter has had 3 courses of acupunture with 14 sessions for each course. She has alopecia areata and has had for the last year. She now has small blond hairs growing on the bald patch which covers the whole of the top of the head. Her acupuncturist advises that she needs another course of treatment - 14 more sessions. I am concerned he is treating for the sake of treatment and dare I say payment although he seems to be a reputable acupuncturist.
Can you please advise if the course should continue further or has the treatment reached its full potential in your opinion after so many sessions?
A: This is a very difficult question to answer without sight of the patient and the notes. Each practitioner works in their own tried and tested way, and it is not for us to pass comment on practice methods which they have developed over the course of their career. At the same time there are going to be occasions when a question such as yours reveals something which warrants further investigation, and we have to tread carefully so that we do not prejudice the outcome of any more serious investigation.
Alopecia is a difficult condition to treat. We were asked for a view some while ago and our answer was:
Allopecia treated with acupuncture
Q: I´m a family doctor who recently graduated in acupuncture with the masters from our Medical Council in Barcelona. I have a friend who is suffering from a alopecia associated with stress the last 2 years, having also skin problems since his childhood (hipercrhomia and vitiligo). Does anyone has experience or a good literature source about alopecia treated with acupuncture?
A: There is not a great deal of literature to assist you, we're sorry to say. We tend to undertake the same sorts of literature searches which you might do using the 'ncbi' resource to access most of the Pubmed resource, mainly because we are constrained under UK advertising law to be very clear about the existing evidence for the treatment of specific conditions and extremely clear about what level of certainty this generates. Given that traditional acupuncture and randomised control trials are not a happy mix, the evidence is generally scant. In the case of the acupuncture treatment of alopecia there are only two or three articles in English and these date back to the 1980s and 1990s. There are undoubtedly hundreds in Chinese but we do not have the resources to translate them and assess them carefully for their methodological soundness.
There are a number of articles available in the traditional acupuncture press, such as
but if your training is in medical or western acupuncture, as we suspect it might be, then much of what these articles say will be largely incomprensible.
Certainly from an eastern or traditional acupuncture perspective we would be likely to see what else was happening in the patient's system which might place the symptom of alopecia in a wider and more informative context. Although the problem might be a local one the chances are that there are wider patterns of disharmony and imbalance, and correcting or addressing these patterns might offer the best chance of sustainable improvement. That said, there are a number of treatments which do involve the insertion of a number of needles both within and on the margins of the affected area. From an eastern perspective this is seen as encouraging the local flow of 'qi', and from a western perspective is understood in neurophysiologial and segmental terms, and there is an outside chance that this may help to reduce or reverse the condition. Our experience, however, is that alopecia is not very easy to treat, and we tend to ensure that patient expectations are as realistic as possible.
The fact that your daughter has shown some improvement over the last year is itself very encouraging, although we would be the last people to apply the 'post hoc, propter hoc' argument, that simply because improvement happened while someone has acupuncture does not in and of itself mean that it happened because of the treatment. Alopecia can spontaneously resolve of its own accord.
There are a number of conditions for which treatment can continue for a very long period of time, and we would expect, if this were the case, for there to be underlying patterns in the patient's energetic balance which warranted further treatment and which the practitioner could explain. Otherwise that would reduce what we do to the simple treatment of a symptom in itself, and someone could reasonably challenge the basis on which the treatment was continued if the symptom appeared to be responding well. It would certainly be reasonable to ask for a more in-depth rationale for continuing, even if you do have to end up on the receiving end of a lesson in Chinese medicine.
We are a little concerned about the 'course of fourteen treatments.' We tend to take a much more conservative view in our advice through these pages, and often suggest that four or five sessions constitute a good review period at which one can question whether the treatment is working and with what frequency it should continue. The aim of most practitioners is to reduce the frequency of treatment where the natural healing processes start to kick in, and many of us use the analogy of watering plants to explain this, that where you might need to water frequently to begin with the need decreases as the plant becomes healthy again. We're not suggesting that there is over-watering going on here but we would feel a little uneasy about a straightforward commitment to so many sessions without a good underlying reason. This was one of the most frequent complaints we had to deal with when people came to us for help in dealing with high street shops, where paying for ten sessions up front regardless of prognosis was often the norm.
Our advice to you is to raise this with the practitioner directly, both in terms of the need to book a course of treatments, and the frequency with which treatment needs to take place. If you are not happy with the response there are a number of options. It is always possible to seek treatment from another practitioner with whom you could discuss your concerns. Alternatively you can raise the matter with our Ethics Department if you feel that the practitioner's financial well-being is taking precedence over your daughter's needs.
We can understand your concern, and hope that better communication will resolve the issue. This is the most frequent reason for matters to get adversarial. However, if you are not satisfied with the outcome of any future exchanges we would urge you to let us know and to enable us to follow up. It is always a matter of concern to us if any of our members falls below the standards to which we all aspire.