Ask an expert - body - skin conditions

53 questions

Q:  My husband has been diagnosed with senile pruritus ( he is 75) - nothing he has tried in the way of creams and lotions gives him any relief. Otherwise he is fit and healthy but this is really affecting his quality of life. Is acupuncture likely to give help him?

 

A: A great deal depends on the health background from a Chinese medicine perspective against which the condition sits. Pruritus is often associated with dry skin, and within the diagnostic systems of Chinese medicine there area number of ways in which dryness of the skin can be explained and understood. A symptom seen in isolation is rarely the basis for effective treatment; the practitioner will want to see how the symptom fits into the wider patterns of a patient's health in order to tailor the treatment to their needs. The same symptom could be a feature of a dozen different diagnostic patterns, and the skill of the practitioner lies in ensuring that the most appropriate treatment is used. Otherwise, the treatment may give short term benefits which are not sustained.
 
In broader terms the kind of secondary problems which drive the condition along, such as the agitated state and the fixed focus on the problem, also fall within the work of the skilled practitioner. A key word in Chinese medicine is 'appropriate', and there is a sense in which any pattern that persists beyond its reasonable limit is a sign that the system is not as balanced as it could be. While this is much easier to recognise in the kinds of long term worry and anxiety with which practitioners routinely deal, it is nonetheless a component of physical complaints which start to dominate a life. Since part of the treatment involves breaking the 'itch-scratch-itch' cycle, there may be a benefit from treatment on this level too. There are one or two acupuncture points which are cited as 'first aid' points for itching, but these are very much short term treatments to buy some peace and quiet, not a proper solution.  
 
Our best advice to you is to see if your husband can visit a BAcC member local to you for a brief face to face assessment of whether acupuncture treatment may be of benefit to him. In the case of some skin problems we often recommend that someone sees a member who is also trained as a Chinese herbal medicine practitioner, anf there is no doubt that many people with skin problems find herbal medicine very effective because of the daily treatment which it offers at a systemic level. However, we have heard several anecdotal accounts of acupuncture alone being of benefit, and if the member you see says that he or she thinks it may be worthwhle, this would be the first option to follow, with herbal medicine in reserve if it acupuncture did not provide sufficient sustainable gains.

 

 

 

 

 

As far as research is concerned there is little or no research to make a positive recommendation for acupuncture treatment. In cases like this we often say that people might want to consider Chinese herbal medicine as a treatment strategy. There are a great many skin conditions for which herbal medicine appears to be a very effective option, and it may well be that the regularity of treatment with daily prescriptions contributes to its effects. The majority of the members of the RCHM (Register of Chinese Herbal Medicine) are also BAcC members, and this really gives a patient a good and wide range of options.
 
However, in our experience this condition can often be linked with a more complex underlying pattern which may involve emotional factors and several other minor functional disturbances. A practitioner of Chinese medicine might well be able to make sense of the condition in its wider context, and by working within the principles of Chinese medicine, balancing the energies of the body and reinstating flow where there has been blockage, might be able to achieve an overall improvement which might in turn help the prurigo. However, even if this were to be the case it may well take a considerable time to clear, and if you decided to have treatment you would need to set very clear and measurable outcomes with regular review periods to ensure that the treatment was worth continuing.
 
The best advice is to visit a BAcC practitioner local to you and seek a face to face assessment. Most BAcC members are happy to give up a little time without charge or commitment to see whether acupuncture treatment would be an appropriate option for the prospective patient. 
 

This question is difficult to answer succinctly because it is very broad in scope. There are many different forms of connective tissue disorders, many of which are linked to auto-immune problems, and such research as does exist is very patchy. There is no broad-ranging research into connective tissue disorders and acupuncture treatment because this would go against the grain of conventional research which aims to narrow the field of variables to a minimum.
 
We have from time to time had questions on specific connective tissue disorders, and here, for example, is what we replied when asked about Ehlers Danlos syndrome:
 

Ehlers-Danlos Syndrome is one of a number of genetic connective tissue disorders which manifest in a wide array of symptoms and as congenital degenerative conditions are not likely to change or improve. In these circumstances the best that one could hope to achieve with acupuncture would be to relieve some of the symptoms which are manifesting your particular case, and perhaps to slow down the progressive deterioration.

 

There have been attempts to use acupuncture as part of a package of measures to help people deal with the condition, but no research on the use of acupuncture with conventional treatment in contrast to conventional treatment alone which would allow us to make specfic claims. From a Chinese medicine perspective, however, there are a number of ways in which treatment is pitched at systemic problems rather than unique symptoms themselves, and sometimes ways of making sense of a collection of disparate symptoms in a way which Western medicine might not recognise. There may well be some merit in asking the advice of a practitioner local to you about whether the way in which EDS presents in your particular case makes sense from a different medical perspective.

 

One caution for possible treatment, however, would be the tendency to bruise and the effect on wound healing. Acupuncture is a remarkably gentle treatment, with especially fine needles being used at relatively shallow levels, and only in severe cases of blood thinning through illness and medication is it contra-indicated. Any practitioner worth their salt will always treat conservatively in cases like yours to gauge how well the body responds to the physical process of treatment.

 
In reviewing this answer several months on we would perhaps now emphasise the fact that traditional Chinese acupuncture treatment aims to address the system as a whole, and can on occasion offer possibilities for treatment, based on the concepts of Chinese medicine of the flow of energy and its balance, which would not make a great deal of sense within conventional medical thought. It is far from being a universal panacea, though; as we said above, the best one can often hope for in these situations is some relief from the symptoms. Anyone promising more than this should be treated with suspicion.
 
You may find it worthwhile to have a short chat with a BAcC near you to seek their advice on whether the specific presentation of connective tissue order about which you are concerned may be amenable to treatment.  
 
 
 

The answer is 'generally not'. Although you will see internet stories and even techniques for treating scars by the direct insertion of needles into scar tissue, most BAcC members try to avoid needling directly into scar tissue. There are very few acupuncture points on the body whose actions cannot be replicated by using needles in other locations, sometimes using the equivalent points on the opposite limb and occasionally on the equivalent position on the lower/upper limb. This means that there is no reason that a practitioner cannot do their work effectively because of local scarring.
 
Sometimes the scar tissue can itself be a problem, and we hear many anecdotal accounts of people needling on both sides of scar tissue, especially the thicker kind of keloid scar tissue, in order to reinstate a flow of 'qi', or energy, through the affected area. The Chinese sometimes had a very literal understanding of the concept of blockage, and where thick scar tissue was seen to cut across the flow of energy in the meridians or along the line of a meridian it was always believed that this could undermine the integrity of the subtle flow of qi. When you consider that many scars from operations run horizontally across the body and limbs, you can see how this could have a profound effect.
 
We wouldn't want to underplay the problems that we have found, however. In cases where people have had very serious injuries where the scarring is not a simple straight line but a whole patch, or where people have suffered from serious burns which have left a whole area transformed, or in cases of self-harm where the scars are multiple and cover the whole surface of a limb, there are likely to be concerns about proper healing and cross infection. If this is the case, and the practitioner cannot easily use equivalent points elsewhere on the body, it is possible that they may want to speak to someone's GP to seek advice or confirmation that piercing the skin is safe. There are one or two conditions where we advise members not to needle affected areas, and severe trauma to a part of the body may warrant additional care or even a prohibition on needle insertions.
 
You can rest assured that if you decide to have acupuncture treatment your practitioner will discuss this very carefully with you, looking not only how safe it is to needle near scars but also how comfortable you may be having needles in areas which may have become sensitised and painful because of the scarring. 
 

Q: My daughter-in law suffers from Scleroderma with Raynauds syndrome. She has chronic Raynauds and has to have the heating on even in summer and wear gloves indoors and out. She has constant joint pain and many other very uncomfortable symptoms. Would acupuncture be of any benefit to her.

A: Your daughter-on-law's situations, where the Raynauds syndrome is set against the wider clinical picture of scleroderma, is not an easy one on which to give advice. Raynaud's itself is not something for which there is a great deal of proven evidence from research. As our fact sheet shows please click here
 
there have been very few trials, and these have generated conflicting results. However, many people do turn to acupuncture for help with Raynauds, and there are a number of clearly defined syndromes and patterns of imbalance in Chinese medicine where the symptoms of Raynaud's feature appear and for which there are recognised treatment protocols.
 
However, Chinese medicine works from an entirely different conceptual basis, and acupuncture is not simply another tool in the toolbox for addressing a western-named and defined condition. The Chinese medicine practitioner has a functional understanding of the body based on a theory of the flow of energy, called 'qi', and its balance, flow or blockage within the system. The fact that the extremities become cold could be understood as a functional disturbance in a number of areas of the system, and the practitioner would use his or her skills to determine which areas were under-performing and try to correct them. Every person is unique and different, so there are no formula treatments for conditions.
 
However, scleroderma is a much more complex condition, and as an auto-immune disorder is rather more difficult to make sense of in Chinese medicine. The symptoms do not necessarily point to specific functional distress, and a practitioner may have to rely on the basics of diagnosis, taking the pulse at the wrist and looking at the tongue, the 'twin pillars' of Chinese diagnosis, as well as other observed signs to determine how to proceed. The more classical, older systems of acupuncture have a nunber of treatments which reflect the kind of overall disharmony which auto-immune conditions appear to represent, but here again there are no clear correspondences.
 
In cases like this nothing can really substitute for a short face to face discussion with a practitioner, and your daughter-in-law's best option is to visit a BAcC member local to her and seek an assessment of whether acupuncture may be of benefit. It will be the spedific presentation of her scleroderma, together with the main Chinese diagnostic tools, which enable the practitioner to offer a balanced view.
 
 
  

 

 

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