What Does the Current Research tell us about Acupuncture for Hair Loss and Hair Regrowth?

Hair loss can be classified as scarring or non-scarring depending on scar formation or hair follicle destruction, respectively. Unfortunately, scarring hair loss permanently damages the hair follicles and treatment will not be feasible. The good news is that non-scarring hair loss can be treated. 1

Examples of non-scarring hair loss include Androgenic Alopecia (AGA), Alopecia Areata (AA), Seborrhoeic Alopecia (SA) and Telogen Effluvium (TE).2, 6 Western medications such as Oral Finasteride, topical Minoxidil (MXD) and Systemic Corticosteroids have been typically used for hair loss. However, it is not feasible for some patients to be treated using these drugs, and the risk of side effects such as erectile dysfunction, dermatitis, and immunosuppression cannot be excluded. 3

What is the Current Evidence Base to show that Acupuncture can help with Hair Loss?

The current evidence base for treating hair loss and regrowth using acupuncture is very much in its early stages. It has been estimated there is a 17-year time lag in translating clinical research into clinical practice. 4

On a positive note, there is current ongoing research and studies showing how acupuncture can help with hair loss and regrowth.

Acupuncture using Plum Blossom Needling to help with Hair Loss?

A recent study conducted in 2020 and published in Annals of Palliative Medicine, consisted of 87 patients with Seborrheic Alopecia (SA). 5 Seborrheic Alopecia (SA) is also called androgenic alopecia. SA is an androgen-dependent polygenic hereditary hair loss disease. 6

According to the study, the 87 patients were randomly divided into a Chinese Medicine (44 patients) group using Plum-Blossom Acupuncture (PBA) with qi-invigorating superficies-consolidating therapy (Chinese Herbal Medicine) and a Western Medicine (43 patients) group using conventional western medicine consisting of oral Cystine tablets and Vitamin B6 tablets.

Plum-Blossom Acupuncture (PBA), which uses seven needles arranged in the shape of a flower, is used to treat a number of dermatologic diseases. 7

The results of the study showed the difference in total effective rate between the Chinese Medicine group and Western Medicine group was (95.45% vs 81.40%) indicating the Chinese Medicine treatment was overall more effective. The study concluded that Plum Blossom Acupuncture combined with qi-invigorating superficies-consolidating therapy (Chinese Herbal Medicine) is significantly effective for treating patients with Seborrheic Alopecia. 6 

Another study reported in 2015 and published in the Journal of Clinical Acupuncture and Moxibustion, consisted of 60 patients with Alopecia Areata. 8

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 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.8

A Qualitative Evidence Synthesis on the add-on effect of Plum-blossom needling for Alopecia Areata conducted in 2021 and published in the Annals of Palliative Medicine, consisted of searching 4 online databases with analysis of results following the Cochrane Handbook for Systematic Reviews of Interventions. The purpose of this analysis was to critically evaluate the add-on effect of plum-blossom needling in AA compared to conventional treatment. 9

The meta-analysis search found eleven articles involving 1192 patients (632 cases in the plum-blossom needling group and 560 in the conventional control group). The results of the studies showed the application of plum-blossom needling add-on therapy had consistent beneficial effects in any form of hair regrowth and no significantly increased risk of adverse events.

The study concluded that the combination of plum-blossom needling provided moderate positive add-on effects in Alopecia Areata patients. 9

Acupuncture using Microneedle Therapy to help with Hair Loss?

A Literature Review of the Microneedle Therapy System for Hair Loss conducted in 2020 and published in the Journal of Acupuncture Research, consisted of searching 9 online databases, with the analysis of 13 studies. The purpose of the review was to investigate the effects of Microneedle Therapy System (MTS) on alopecia in experimental and clinical studies. The MTS is acupuncture needling therapy delivered by a roller. 1

According to the results, most studies showed that the MTS was effective when used in combination with other treatments. There were no reported side effects, however, further studies need to be conducted. 1

Another study conducted in 2019 and published in the Journal of Cosmetic Dermatology, researched the preliminary results of scalp microneedling in different types of Alopecia. 10

The study contained 36 females, 29 with AGA and 7 with TE and 14 males with AGA, treating them with 3 sessions of microneedling over a 6 month period.

The results showed no serious adverse side effects and all patients reported a partial or complete reduction in hair loss, associated to the perception of improvement of hair density and thickening of the hair shaft diameter, confirmed by iconography and trichoscopy. 10

Other Acupuncture Studies to help with Hair Loss?

A 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 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

Finally, a case report in 2021 published in Medicine used a combination of Acupuncture, Herbal Medicine and Plum Blossom needle stimulation for recurrent Alopecia Areata. 12

The study documented a 34-year-old male with a history of childhood asthma and presented with a sudden hair loss patch at the top of his head, without any preceding symptoms. After undergoing topical immunotherapy via a dermatologist, the patient noticed an exacerbation of the hair lesion. The patient then received 2 herbal formulas in combination with acupuncture. When relapse occurred, the patient used self-administered plum blossom needling with herbal formula.

The result of the intervention showed the patient achieved complete remission for 5 months, however, another stressful event induced multiple Alopecia Areata lesions. Plum blossom needling was then initiated, resulting in faster resolution with the recovery rate at 50% after 3 months, and 75% after 4 months and a long lasting response without relapse was obtained for at least 3 years.

The researchers concluded that a combination of multimodal traditional therapies, including herbal formulas, acupuncture and plum blossom stimulation, represents an effective integrative treatment for patients with Alopecia Areata.12

Currently, it appears that definitive research is limited, but the research that is currently available on acupuncture and hair loss is valuable and ongoing 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.

References

  1. Kim, J. H., Shim, S. E., Kim, J. Y., Kim, H. N., Hwang, J. M., Park, K. J., Jo, M. G., Jang, J. Y., Kim,J. H., Goo, B., Park, Y. C., Seo, B., K., Baek, Y. H., & Nam, S. S. (2020). A Literature Review of the Microneedle Therapy System for Hair Loss. Journal of Acupuncture Research37(4), 203–208. https://doi.org/10.13045/jar.2020.00234
  2. Lee, S. W., Lee, S. Y., Lee, M. H., Kim, Y. J., Lee, S.H., & Yoo, S. Y. (2008). A case study of beevenom effect on alopecia universalis started from alopecia areata. Journal of Acupuncture Research, 25(6), 163–173.
  3. Yoon, H. J. (2014). A case study of androgenetic alopecia in woman improved by pharmacopuncture therapy and needle-embedding therapy. Journal Korean Med Ophthalmol Otolaryngol Dermatol, 27:162-170.
  4. Morris, Z. S., Wooding. S. & Grant. J. (2011). The answer is 17 years, what is the question: understanding time lags in translational research. J R Soc Med. 104(12):510-20.
  5. Li, Q., Xie, Y., & Zha, X. (2020). The clinical effect of plum blossom needle acupuncture with qi-invigorating superficies-consolidating therapy on seborrheic alopecia. Annals of Palliative Medicine9(3), 1030–1036. https://doi.org/10.21037/apm-20-909
  6. Chen, Q., Tao, Y., Wang, L., Zhang, J., Sun, B., & Yang, X. (2020). A randomized controlled clinical study of acupuncture therapy for Seborrheic alopecia in young and middle ages Study protocol clinical trial (SPIRIT compliant). Medicine (Baltimore)99(17), e19842–e19842. https://doi.org/10.1097/MD.0000000000019842
  7. Tan, E. K., Millington, G. W. M., & Levell, N. J. (2009) Acupuncture in dermatology: an historical perspective. International Journal of Dermatology, 48, 648–652.
  8. Xu, K. (2015). Clinical observation on acupuncture treatment for alopecia areata. Journal of Clinical Acupuncture and Moxibustion. 31(2).
  9. Dai, T., Song, N., & Li, B. (2021). Add-on effect of plum-blossom needling in alopecia areata: a qualitative evidence synthesis. Annals of Palliative Medicine10(3), 3000–3008. https://doi.org/10.21037/apm-20-1969
  10. Starace, M., Alessandrini, A., Brandi, N., & Piraccini, B. M. (2020). Preliminary results of the use of scalp microneedling in different types of alopecia. Journal of Cosmetic Dermatology19(3), 646–650. https://doi.org/10.1111/jocd.13061
  11. Zhu, Q. & Wu, F. (2011). Clinical observation on acupuncture treatment of alopecia areata. Journal of Acupuncture and Tuina Science9(3), 162–164. https://doi.org/10.1007/s11726-011-0500-x
  12. Kawashima, N., Hu, X., Ishikawa, N., Matsuhisa, T., & Sato, J. (2021). A combination of herbal formulas, acupuncture, and novel pine-needle stimulation for recurrent alopecia areata. Medicine (Baltimore)100(20), e26084–e26084. https://doi.org/10.1097/MD.0000000000026084