Alternate Routes: Acupuncture, Acupressure and Eczema

May 14, 2012

Kachiu C. Lee, MD and Peter A. Lio, MD

Judging from the increasing media coverage, acupuncture (and its closely-related but needleless cousin, acupressure) has grown in popularity over the past decade (Ernst, 2006). Actress Gwyneth Paltrow (Lantin, 2004) proudly blogs about it on her popular personal website, while Kate Moss openly admits to using acupuncture to assist with smoking cessation (BBC, 2006). But is acupuncture actually effective? Or is it a passing fad? What is the evidence behind acupuncture as a treatment for eczema?

Basis of acupuncture

Acupuncture, as described by its own practitioners, is based on a system of meridians, or paths of energy, which flows throughout the body. When points in this path become blocked or weakened, the body responds by producing symptoms of illness, such as the symptoms of eczema, or the chronic pain of fibromyalgia.  In order to restore the flow of energy, acupuncture uses the insertion of fine needles at specific points along the meridians. Eastern medicine practitioners have used this therapy for centuries (perhaps even millennia), to treat a variety of illnesses. In contrast to the fine needles of acupuncture, acupressure uses fingertips or small pellets applied to the surface of the skin. Although the skin is not punctured, the pressure is applied to predefined acupuncture points, thereby stimulating known meridian pathways.

A New Study

Our research group, based out of Northwestern University’s Department of Dermatology, conducted a small study of 15 adults with moderate-to-severe eczema at baseline (Lee, 2011). Approximately half of the subjects were randomized into the experimental group, and the other half into the control group. Experimental group participants were instructed to apply pressure at the large intestine 11 (LI11) acupuncture point using a small titanium pellet resembling a tiny BB. This acupuncture point is located approximately at the end of the elbow crease, and is a point that is frequently used in red, itchy skin conditions.  Subjects in the control group were instructed not to use acupressure or acupuncture during this time. Both groups were encouraged to continue their normal regimen of eczema treatments: baths, soaps, moisturizers and all their topical and oral medications.

After 4 weeks, participants in this study were asked to return for follow-up examination. Individuals in the acupressure group reported significantly decreased sensation of itch, as well as improvement in skin findings of their eczema. In contrast, control subjects who did not use acupressure had no change in their symptoms or disease severity. No adverse side effects were noted by any participant during the trial.

Support for Alternatives

Due to the small size of this study, further research needs to be conducted before any definitive conclusions can be drawn on the effectiveness of acupressure in reducing itch. However, this study shows promise for the use of acupressure as an additional or adjuvant therapy to conventional medications.  What we especially like is that acupressure does not require puncturing the skin with needles, does not require visits to an acupuncturist.  It also appears very safe and is inexpensive. By using a tiny metal pellet that can easily be applied at home by the patient, many of the barriers to receiving treatment are removed.  This study only examined the use of acupressure in adults, so no conclusions can be drawn regarding use of this therapy in children with eczema, but this is another area we are actively interested in.

Similar to our study on acupressure, other studies on acupuncture have also supported a role for this therapy in treatment of eczema and related symptoms.  One pilot trial of 10 individuals found physiological changes in the way the immune system responds to itch-inducing allergens after receiving acupuncture (Pfab, 2011). In a larger study by the same German group, researchers found that acupuncture at the LI11 point decreased itch sensation in a population of participants with eczema.  In contrast, those who received acupuncture at “sham” points away from the meridian lines did not demonstrate any improvement in itch. Similarly, those that did not receive any acupuncture showed no improvement in itch (Pfab, 2010).

Bottom line

While the repeated success of acupuncture for eczema in evidence-based studies is encouraging, this therapy may not be suited for everyone. Firstly, regular visits to a licensed acupuncturist are required, making it both expensive and time-consuming for people to receive regular therapy. Secondly, some individuals may balk at the idea of puncturing the skin with needles, which forms the basis of acupuncture therapy.  Therefore, the success of acupressure is encouraging.  This therapy uses pressure without puncturing the skin, and can be self-administered at home.  The success of our pilot study is promising for those who seek the benefits of acupuncture but are limited from seeking out a licensed therapist.  Above all, our hope is that clinicians and patients continue to consider and evaluate alternative and complementary forms of medicine, and that studies like this one help further that cause.

References:

Ernst E, Pittler MN. Celebrity-based medicine. Med J Aust. 2006;185(11-12):680-1.

Lantin, B. Don’t let pain needle you. Jan 9, 2004.  (accessed on 12/30/2011)

BBC News. Can acupuncture beat addiction? Mar 9, 2006. (accessed on 12/30/2011)

Lee KC, Keyes A, Gordon JG, et al. Effectiveness of acupuressure on pruritus and lichenification associated with atopic dermatitis: a pilot trial. Acupunct Med. Epub 2011 Dec 28.

Pfab F, Huss-Marp J, Gatti A, et al. Influence of acupuncture on type I hypersensitivity itch and the wheal and flare response in adults with atopic eczema – a blinded, randomized, placebo-controlled, crossover trial. Allergy. 2010;65(7):903-10.

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. 2011 17(4):309-14.

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