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Ask an expert - body - skin conditions

47 questions

A:  As our factsheet shows

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/acne.html

the evidence for the use of acupuncture, while limited, is fairly good. In particular there is a systematic review from 2009 which combines the data from several studies which appears to be very positive. As always, though, there is not enough research for us to be able to give an unequivocal recommendation.

That said, acne can present in many areas of the body and to varying degrees of severity, so it is quite difficult to give an all-purpose response like this. Someone who has had the condition for thirty years and tried every medication under the sun is going to be a different proposition from someone who has a small but recent outbreak. In all cases the advice we usually give is that someone visits a BAcC member local to them for a short face to face assessment which many members offer without charge. This will enable them to give you a slightly more balanced view of what might be possible for your specific case.

We often suggest that a prospective patient considers adding Chinese herbal medicine to the mix. There is a considerable amount of anecdotal evidence in the profession that herbal medicine can greatly add to the treatment of skin conditions, possibly because the daily regimen based on the same diagnostics principles adds weight to the treatment. Members of the Register of Chinese Herbal Medicine are very often also members of the BAcC, and members of the Association of Traditional Chinese Medicine often use both modalities as a matter of course, so it may well taking this into account as you look for a practitioner.

Q:  How long will it take for treatment of keloids with acupuncture? I have keloids on my chest. 

A:  There isn't a great deal of information about the time scales for trying to help keloid scar tissue on the body, and more to the point there isn't a great deal of formal research which would enable us to make a specific claim that acupuncture works. Most of us have treated people with keloid scarring, and there are many anecdotal reports of considerable help and improvement. There are equally as many reports of trying to help and having no effect at all, as this expert has found on a number of occasions. There are also cases where the scarring remains but the blockages which they can create in the flow of energy, or qi as we call it, are helped considerably by the use of acupuncture treatment. We find this particularly in the case of horizontal scarring after a C-section or hysterectomy, and in the rarer cases of heart surgery or emergency surgery leaving large vertical scars in the midline.

There are occasionally short studies published about specific individual cases, and one such is

 http://aim.bmj.com/content/29/1/2.full

with some interesting photographs for what is deemed to be a good outcome. There are a number of others, but these are probably the exception rather than the rule.

The bottom line, though, is that a great deal depends both on the nature of the scarring (why it is there, how long it has been there, whether it has changes at all) and also the underlying reasons for it. If these are post-operative scars, for example, the condition which required surgery may itself be fairly serious and need to be factored in to any estimates of whether acupuncture might be able to help.

The only advice which we can give is to visit a BAcC member local to you for a brief assessment based on a sight of the scarring and the causes of it of whether they think that acupuncture treatment might be beneficial.

Q:  I have, in the past had localised alapeisha. I believe  this was caused by stress, which unfortunately my character is prone to. However,  new responsibilities at work have lead to better pay and I am reasonably happy with my 'lot'. Just wondering whether acupucture could be beneficial to me?

A: The evidence for the treatment of alopecia with acupuncture is a bit thin. We were asked by a Portuguese doctor some time ago about treating alopecia as a primary condition, and the answer we gave her was:

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 alopecial 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
 
http://www.jcm.co.uk/product/catalog/product/view/6412/the-treatment-of-alopecia-with-acupuncture-and-related-techniques/
 
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 you can track your alopecia to stress, however, suggests that treatment may well be of benefit. We have a great many more studies for the use of acupuncture with anxiety and stress, and the factsheet on anxiety


http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/anxiety.html

while falling a long way short of conclusive is certainly very encouraging.

As always, we believe that you are best served by arranging to see a BAcC member local to you for a brief chat and face to face assessment of the potential benefit. Most members do this  without charge,  and this  also gives you a chance to meet them and see where they work.

Q:  I have lots of scars on my skin which causes my skin to have a lot of discolouration. Especially on my arm my butt and legs. Currently my butt has
goosebump like bumps and sort of acne scarring. I've been looking for many treatments and have also used home remedies like lemon but the results are disappointing.

A:  We are not rally sure what to advise in cases like yours. Our first thought would be that we would need a great deal more information about how the scarring arose, and what the discolouration was, i.e whether it was the scar tissue which was causing the skin to be discoloured or whether the skin around the scar tissue was also discoloured. Scar tissue itself is not that easy to remove or modify, but there are occasions when it can be affecting the flow of energy in the surrounding area, and this can in turn lead to secondary problems. If the scarring itself is the result of a body-wide problem like acne, then there may be something which treatment of the system as a whole can do.

Generally speaking the advice we give to most enquirers is that a visit to a BAcC member local to them is probably their best option to get a brief face to face assessment of what acupuncture treatment may be able to offer, especially when the person has a problem for which there may be far too many possible causes and solutions for us to go through here. 

The received wisdom inside the profession is that skin problems are often amenable to a mixture of acupuncture and Chinese herbal medicine, and it may be worthwhile finding someone who practises both. Most of the members of the Register of Chinese Herbal Medicine (RCHM) are also BAcC members, so this may be the best route for you to pursue to get a more detailed view of what may be possible. 

A:  As you can imagine, we have been asked similar questions on several occasions, and a typical answer is:

Can acupuncture help eczema?

A:  The use of acupuncture for skin conditions is not particularly well researched, as our fact sheet shows:

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/eczema-and-psoriasis.html

There may be a number of reasons for this, one of which is that skin conditions form a 'fuzzy' set where the definition and location are not always precise enough to be testing like with like, a pre-condition of the randomised double blind control trial much loved by western science.

That said, there is a considerable amount of anecdotal evidence within the profession about good reactions to treatment, especially a reduction in the amount of itching and discomfort. One has to be cautious, however; a very common effect of initial treatment is a radical improvement followed by a settling back to nearly the same state as before. We have seen a number of people become even more disheartened when this has happened, even though we have said that short-term results are unlikely and if they appear usually unsustainable.

It has to be said, though, that the collective view inside the BAcC is that skin problems are usually best treated with a combination of Chinese herbal medicine and acupuncture. There is something about the precision with which the formulae are designed and the daily routine of treatment which clearly seems to evince powerful changes in the system. Most members of the Register of Chinese Herbal Medicine are also BAcC acupuncturists, and finding someone in your area who practises both may be a very good way forward. 

Our best advice to you is to see if there are BAcC members local to you who also use Chinese Herbal medicine, and to see if they can offer you a brief face to face assessment of whether they believe tahat acupuncture and herbal treatment can help you.

We think that this remains the best advice that we can give. The only caveat which we sometimes add is that acupuncture is often used as a last resort, and before someone comes to us they have taken a large number of medications which can had added layer upon layer of secondary effects on the initial problem. The overall clinical picture can sometimes be a little more complex than one would hope to see. However, acupuncture treatment treats the person, not the condition, and the treatment is tailored to the needs of the individual to help their system restore its own balance and healing ability. The oldest forms of Chinese medicine were often asymptomatic, driven by the simple belief that a system in balance corrected symptoms. In clinical practice, an experienced practitioner can both treat the underlying cause and the symptoms at the same time to facilitate recovery.

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