Acupuncture and Acupressure for Eczema
Eczema is a challenging and complex condition which can cause significant discomfort and decreased quality of life. The symptoms, such as itchiness, are not only uncomfortable, but also cause further inflammation and disrupt sleep. Children and adults often live in a cycle of worsening symptoms which cause a flare in the condition, and then the flare further worsens the symptoms. The instability of eczema can lead individuals to live restricted lives, avoiding enjoyable events and social situations.
While pharmaceutical treatments including topical steroids, oral antihistamines, and biologic injections such as dupilumab, are often used to manage the disease, the condition may be refractory, and these drugs are often expensive. Mind-body treatments, such as acupuncture, can help to break the cycle of the symptoms and inflammation, which is an important step for healing.
Acupuncture is a holistic therapy able to address both physical and psychological symptoms in eczema such as itch, inflammation, allergic response, as well as depression and anxiety.1–4 Acupuncture was developed over 2500 years ago in China as a part of Traditional Chinese Medicine (TCM). This long clinical history has provided generations of experience in the treatment of many skin and medical conditions.
What Is Acupuncture Like?
Acupuncture is a therapy that uses very thin needles to stimulate areas on the body known as acupuncture points. Each acupuncture point has a specific healing effect. Some acupuncture points have been found to reduce itching, even with just the use of massage.
For teenagers and adults
The acupuncture needles are placed in specific healing areas, acupoints, and retained for 20-30 minutes. The acupuncture points are selected based both on your symptoms and the TCM imbalances that may be underlying the condition. The needles are very gently inserted into the acupuncture points. Sometimes patients can feel a small prick, but most often people feel nothing upon insertion. Common feelings during acupuncture are warmth and tingling sensations. Often a small amount of electrical stimulation will be placed on the needles, or they will be manipulated in rhythmic motions. This enhances the anti-itch and antihistamine response of the treatment. Most people leave the therapy feeling refreshed and relaxed and often fall asleep during the treatment.
For infants and children
For infants and children, the acupuncture points are usually gently stimulated and massaged, which is called acupressure, or stimulated with dull instruments. This avoids any discomfort and aversion by the children to the therapy.
How Does Acupuncture Work for Eczema?
Acupuncture helps to break the cycle of itching and inflammation to bring comfort to the patient and speed the healing process. Acupuncture can do this in both specific ways to reduce discomfort with eczema and by encouraging overall wellness.
Acupuncture reduces itch
Itch is often the primary and most distressing symptom of eczema. Acupuncture has been shown to reduce itching in those with eczema through multiple mechanisms.5 A study found that acupuncture reduces itching by changing the itch response in the brain and central nervous system (CNS).6 Acupuncture may also reduce itch by reducing activation of basophils, a type of white blood cell (WBC) involved in the inflammatory and itch responses in eczema.7 In addition, acupuncture has been shown to cause degranulation of mast cells, a type of WBC that are abundant in acupoints, causing an increased pain threshold on nearby nerve fibers and producing analgesic effects.8,9 Acupuncture has also been shown to prevent histamine induced itch.10
Not only does acupuncture reduce itching, but acupressure is also helpful. Acupressure is the massage and application of pressure at acupuncture points which is great because it is something patients can do to themselves. One small study showed that self-administered acupressure at the acupuncture point QuChi (LI 11)—located at the lateral aspect of the elbow crease—reduced itching.11 Additionally, stimulation of LI 11 has also been shown to reduce scratching in animal studies.11
Acupuncture Treats the Whole Person
One of the challenges with eczema is that it can disrupt sleep, making the patient feel tired and generally fatigued.12 One of the great things about acupuncture is that it helps the patient feel relaxed and improves wellness.13 In addition, acupuncture is well known to reduce anxiety, improve sleep, and provide more energy helping improve overall mind body wellness.14
Acupuncture is also individualized for each patient based on the eczema symptoms and overall physical wellbeing. For example, if the patient has insomnia and anxiety, the acupuncturist may add the points An Shen (Quiet Spirit) and Shen Men (Spirit Gate) to help the patient sleep and calm their mind. If the patient has digestive symptoms such as constipation, the acupuncturist may add the acupuncture point Tian Shi (Stomach 25) and Zu San Li (Stomach 36).
Acupuncture is a very safe therapy and has only minor uncommon adverse effects, such as superficial bleeding and pain with needle insertion.15
Table 1. Summary of the Use of Acupuncture for Ezcema
Mechanism of Action
- Insertion of acupuncture needles in acupoints
- Small electrical stimulation or manual manipulation
- Changes itch response in the brain and CNS
- Modulation of peripheral nerves
- Reduces activation of basophils
- Degranulation of mast cells
- Reduces itch
- Reduces pain
- Prevents histamine induced itch
- Reduces anxiety
- Improves sleep and energy
- Minor superficial bleeding
- Pain with needle insertion
- Feng S, Han M, Fan Y, et al. Acupuncture for the treatment of allergic rhinitis: a systematic review and meta-analysis. Am J Rhinol Allergy. 2015;29(1):57-62. doi:10.2500/ajra.2015.29.4116
- Choi SM, Park JE, Li SS, et al. A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis. Allergy. 2013;68(3):365-374. doi:10.1111/all.12053
- Yu C, Zhang P, Lv ZT, et al. Efficacy of Acupuncture in Itch: A Systematic Review and Meta-Analysis of Clinical Randomized Controlled Trials. Evid-Based Complement Altern Med ECAM. 2015;2015:208690. doi:10.1155/2015/208690
- Chan YY, Lo WY, Yang SN, Chen YH, Lin JG. The benefit of combined acupuncture and antidepressant medication for depression: A systematic review and meta-analysis. J Affect Disord. 2015;176:106-117. doi:10.1016/j.jad.2015.01.048
- Pfab F, Athanasiadis GI, Huss-Marp J, et al. Effect of acupuncture on allergen-induced basophil activation in patients with atopic eczema:a pilot trial. J Altern Complement Med N Y N. 2011;17(4):309-314. doi:10.1089/acm.2009.0684
- Napadow V, Li A, Loggia ML, et al. The brain circuitry mediating antipruritic effects of acupuncture. Cereb Cortex N Y N 1991. 2014;24(4):873-882. doi:10.1093/cercor/bhs363
- Pfab F, Kirchner MT, Huss-Marp J, et al. Acupuncture compared to oral antihistamine for type I hypersensitivity itch and skin response in adults with atopic dermatitis – a patient and examiner blinded, randomized, placebo-controlled, crossover trial. Allergy. 2012;67(4):566-573. doi:10.1111/j.1398-9995.2012.02789.x
- Yin N, Yang H, Yao W, Xia Y, Ding G. Mast Cells and Nerve Signal Conduction in Acupuncture. Evid-Based Complement Altern Med ECAM. 2018;2018:3524279. doi:10.1155/2018/3524279
- Yao W, Yang H, Yin N, Ding G. Mast Cell-Nerve Cell Interaction at Acupoint: Modeling Mechanotransduction Pathway Induced by Acupuncture. Int J Biol Sci. 2014;10(5):511-519. doi:10.7150/ijbs.8631
- Pfab F, Hammes M, Bäcker M, et al. Preventive effect of acupuncture on histamine-induced itch: a blinded, randomized, placebo-controlled, crossover trial. J Allergy Clin Immunol. 2005;116(6):1386-1388. doi:10.1016/j.jaci.2005.08.055
- Lee KC, Keyes A, Hensley JR, et al. Effectiveness of acupressure on pruritus and lichenification associated with atopic dermatitis: a pilot trial. Acupunct Med J Br Med Acupunct Soc. 2012;30(1):8-11. doi:10.1136/acupmed-2011-010088
- Lewis-Jones S. Quality of life and childhood atopic dermatitis: the misery of living with childhood eczema. Int J Clin Pract. 2006;60(8):984-992. doi:10.1111/j.1742-1241.2006.01047.x
- Gould A, MacPherson H. Patient perspectives on outcomes after treatment with acupuncture. J Altern Complement Med N Y N. 2001;7(3):261-268. doi:10.1089/107555301300328133
- Pilkington K. Acupuncture therapy for psychiatric illness. Int Rev Neurobiol. 2013;111:197-216. doi:10.1016/B978-0-12-411545-3.00010-9
- Yang C, Hao Z, Zhang LL, Guo Q. Efficacy and safety of acupuncture in children: an overview of systematic reviews. Pediatr Res. 2015;78(2):112-119. doi:10.1038/pr.2015.91