What is Alopecia Areata?
Alopecia Areata (AA) is a type of alopecia characterised by non scarring hair loss. Non scarring alopecia usually results from inflammation to the hair follicles that leaves the hair follicles able to regrow if the inflammation subsides.8 The condition is found in 0.1–0.2% of the general population.1–3
The cause of AA appears to be related to the disturbance of autoimmune functioning, physical and emotional stress, genetic factors and poor microcirculation.1 2
AA could cause significant psychological problems, result in reduced self-esteem and negatively affect the quality of life.1 2
What is Acupuncture?
Acupuncture is one of the most frequently used forms of complementary medicine.4 Acupuncture involves the insertion of needles into the skin and underlying tissues at acupuncture points for a therapeutic purpose.
Acupuncture points (body, ear, head or tongue) could be stimulated with several types of acupuncture needles, electricity, laser, pressure or heat. The procedure is frequently used in dermatology for treating a number of skin disorders.5 6 In addition, the most frequently used acupuncture technique for skin disorders is Plum Blossom Acupuncture (PBA), in which the skin should appear flushed, with bleeding.7 8
Acupuncture has also been shown to help with stress, anxiety and insomnia. A meta-analysis study performed in 2012 included 33 studies, where different forms of acupuncture were used to treat insomnia disorder and indicated that Auricular Acupuncture may ameliorate sleep quality compared to a placebo comparison.13
While there is no definitive answer as to the underlying cause of Alopecia Areata in both Western Biomedical Medicine and Complementary Medicine, studies have shown from a Complementary Medicine perspective, acupuncture can help to reduce hair loss by reducing inflammatory attacks on the hair bulb.
A recent study in 2013, showed that electroacupuncture reduces inflammation or degranulation of the mast cells in the dermis10 that is reported to be a possible cause of pathological changes causing Alopecia Areata. By reducing follicle inflammation, acupuncture can help to create a healthy environment in which hair can grow.
In addition, acupuncture may also stimulate the hair follicles, warm the local collaterals and activate blood circulation.8 This will also help to stimulate hair growth via the increase in blood flow and nutrient delivery. Reduction in stress and anxiety levels will also benefit in the growth process.
Is there any scientific evidence to show that Acupuncture can treat Alopecia Areata?
Although scientific research into Alopecia Areata is still in its early stages, there have been several studies to show how acupuncture can help to reduce hair loss.
A recent study reported in 2015 and published in the Journal of Clinical Acupuncture and Moxibustion, consisted of 60 patients with Alopecia Areata.10
According to the study, 60 patients were randomized into 2 groups with 30 patients undergoing Plum Blossom Acupuncture (PBA) in addition to standard acupuncture (Treatment Group) and the other 30 patients receiving Western treatment consisting of Minoxidil plus multivitamins (Control Group).
The acupuncture group (Treatment Group) was treated by plum blossom needle by means of local skin flushing with mild bleeding, once every other day and body acupuncture once a day for 20 minute session. Treatment course duration was 1 month.
The Western medicine group (Control Group) was given 5% Minoxidil Tincture applied to the lesion, 1 ml each time and applied two times per day. In addition, oral vitamins with mineral tablets were also administered. Treatment course was also 1 month.
The results of this study showed that alopecia patients who received acupuncture therapy (Treatment Group), achieved a total effective rate of 90% compared to the patients who received drug therapy (Control Group), achieving a 60% total effective rate. In addition, 3 months after the completion of treatment, the acupuncture group reported only 3 cases of relapse (10% relapse rate) and the drug therapy group reported 11 cases (36.67% relapse rate).
The authors of this research study concluded that “Acupuncture treatment for Alopecia Areata has an obvious curative effect and can significantly improve the immunological indexes in patients; which is probably one of the therapeutic mechanisms”.10
Another study performed in 2011 and published in the Journal of Acupuncture and Tuina Science, consisted of 78 patients with Alopecia Areata.11
According to the study, 43 patients (Treatment Group) were randomized and treated with acupuncture while the remaining 35 patients (Control Group) were randomized and treated with a combination of Cystine, Vitamin B1, and Minoxidil Solution. Treatment was continued for four months.
At the end of the treatment cycle, the Treatment Group patients who received acupuncture as a form of treatment had a 97.7% total effective rate while the Control Group patients treated with the combination Cystine, Vitamin B1, and Minoxidil Solution had a less, 77.1% total effective rate.
The results of this study showed that acupuncture was more effective at treating hair loss than other common treatment options with the authors stating that “Acupuncture is better than medications in the treatment of Alopecia Areata”.11
A similar case study can be found in the Journal of Chinese Medicine.8 According to Jiang and Liu, a 36-year-old male presenting with occipital alopecia received acupuncture in three separate courses. Following the first course, thin and fluffy hair had begun to grow.
After the second course, fluffy hair had spread throughout the entire bald area. And finally, after the third course, healthy hair growth was observed.
Another recent study in 2014 and published in the Shanghai Journal of Acupuncture and Moxibustion, concluded that by administering acupuncture with the Qi Xing (Seven Star) or Plum Blossom Acupuncture (PBA) needle (see picture below), increases the rate of positive patient outcomes.12
This study consisted of 65 patients with alopecia due to a Traditional Chinese Medical (TCM) differential diagnostic pattern of Spleen and Stomach Damp-Heat. In TCM, the pathology of heat and dampness may lead to the obstruction of the channels. This can therefore impede qi and blood circulation to the scalp, leading to hair follicle malnutrition and nutrients not being delivered to the hair roots.
The authors note that scalp acupuncture and Qi Xing or PBA needling, stimulates neurohumoral and endocrine system responses, thereby initiating the restoration of sebaceous gland functioning for general hair health. Additionally, the investigators cite research demonstrating that skin surface temperature is related to local blood circulation. Based on that data, skin temperature was employed as a marker to quantify blood circulation changes to the scalp. The Qi Xing acupuncture protocol induced a 2.62℃ rise in scalp temperature.
The study reported a total of 65 patients with alopecia due to Damp-Heat in the Spleen and Stomach. Patients were randomly split into 2 groups: 33 patients in the Treatment Group and 32 patients in the Control Group. The control group received standard acupuncture therapy and traditional Chinese herbal medicine. The treatment group received the same treatments with the addition of Qi Xing needle acupuncture. Treatment was conducted twice a week by an acupuncturist and self-administered by patients once per week. One full treatment course was comprised of 12 weeks of patient care.
The results of this study concluded that patients receiving only standard acupuncture and Chinese herbal medicine had an 84.4% total effective rate. However, adding the Qi Xing needle protocol increased the total effective rate to 90.9%. Moreover, patients receiving Qi Xing acupuncture had a 2.62℃ increase in temperature of the scalp. The results were measured at the end of the full treatment course. The researchers note that the application of acupuncture and herbs “can efficiently control hair loss and promote hair growth.” 12
Currently, it appears that definitive research is limited, but the research that is currently available on acupuncture and hair loss is valuable as described above. While further research would illustrate the exact mechanism behind acupuncture’s effectiveness at treating hair loss, the current research does show a pattern of effectiveness and the good news is that ongoing research is continually progressing in this field.
This is great for hair loss sufferers who are looking for a natural treatment with minimal or no long-term side effects.
Are There Side Effects Associated with Acupuncture?
When practiced by an experienced and properly trained professional, acupuncture is generally considered to be a safe alternative to modern medical treatments and medications.
Be aware, however, that everyone responds differently to acupuncture, and you may experience a few adverse reactions in individual cases. Fortunately, such reactions are temporary and generally mild, though you should speak with your doctor if symptoms persist or seem to worsen with each session.
References
1. Gilhar, A., Etzioni, A., Paus, R. (2012). Alopecia areata. N Engl J Med, 366:1515–25.
2. Harries, M.J., Sun, J., Paus, R., et al. (2010). Management of alopecia areata. BMJ, 341:c3671.
3. Sperling, L. C., Sinclair, R.D., Shabrawi-Caelen, L.E. (2012). Alopecias. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. London: Saunders, 1093–114.
4. Ernst, E. (2006). Acupuncture—a critical analysis. J Intern Med, 259:125–37.
5. Nelson, J.L., Badreshia-Bansal, S. (2011). An overview of complementary and alternative medicine. In: Taylor SC, Gathers RC, Callender VD, et al, eds. Treatments for skin of color, NY: Saunders, 351–74.
6. Van Den Biggelaar, F.J., Smolders, J., Jansen, J.F. (2010). Complementary and alternative medicine in alopecia areata. Am J Clin Dermatol, 11:11–20.
7. Dou, W. (2009). Research progress of acupuncture for treatment of alopecia areata in recent ten years. World J Acupunct Moxibustion, 19:55–9.
8. Jiang, W., Liu, W. (2006). The treatment of alopecia with acupuncture and related techniques. J Chin Med, 82:32–5.
9. Maeda, T., Taniguchi, M., Matsuzaki , S., et al. (2013). Anti-inflammatory effect of electroacupuncture in the C3H/HeJ mouse model of alopecia areata. Acupunct Med, 31:117–9.
10. Xu, K. (2015). Clinical observation on acupuncture treatment for alopecia areata. Journal of Clinical Acupuncture and Moxibustion. 31(2).
11. Zhu, Q., Wu, F. (2011). Clinical observation on acupuncture treatment of alopecia areata. J Acupuncture and Tuina Science, 9(3):162–164.
12. Lin, K. R., Yun, A.S. & Jiang, Y.F. (2014). Therapeutic observation of seven-star needle plus acupuncture-medication for alopecia due to heat and dampness in spleen and stomach. Shanghai Journal of Acupuncture and Moxibustion. 33(9).
13. Cheuk, D.K.L., Yeung, W-F., Chung, K.F., Wong, V. (2012). Acupuncture for insomnia, Cochrane Database of Systematic Reviews, no. 9, Article ID CD005472.
