Home›Infectious Disease› Acupuncture therapies show varying efficacy and safety profiles in chronic spontaneous urticaria management
Acupuncture therapies show varying efficacy and safety profiles in chronic spontaneous urticaria managementAcupuncture therapies show promise for chronic spontaneous urticaria
Frontiers in MedicinePublished October 4, 2026Study authors: Mingde Chang, Linna Wu, Zhao Wang, Yurou Wang, Shuihan Zhou, Rong Zhao, Mingling ChenDOI ↗Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease
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Key Takeaway
Consider acupuncture as a viable, safe option for CSU, with specific modalities potentially tailored to patient symptoms.
This network meta-analysis evaluated the clinical efficacy and safety of various acupuncture therapies, including combinations with autohemotherapy, moxibustion, and cupping, for the treatment of chronic spontaneous urticaria (CSU). The analysis included a total of 7,746 patients and compared these interventions against antihistamines.
Key findings indicate that acupuncture combined with autohemotherapy ranked first for overall efficacy (SUCRA = 92.79%, RR = 1.46, 95% CrI: 1.19, 1.84). Specific outcomes showed varying top-ranked interventions: moxibustion was most effective for improving Dermatology Life Quality Index (DLQI) scores (MD = -9.45, 95% CrI: -12.48, -6.44), while acupuncture combined with moxibustion was most effective for reducing pruritus severity (MD = -1.03, 95% CrI: -1.15, -0.91). For laboratory markers, autohemotherapy combined with moxibustion ranked first for reducing IgE levels (MD = -36.23, 95% CrI: -55.33, -17.33).
Regarding safety and relapse, acupuncture combined with cupping therapy ranked first in reducing adverse reactions (RR = 0.04, 95% CrI: 0.04, 0.24) and reducing relapse rates (RR = 0.02, 95% CrI: 0, 0.09). However, no significant differences were found between most acupuncture therapies and antihistamines regarding wheal counts. The authors note that findings should be interpreted cautiously and require validation in larger, higher-quality trials. Clinically, acupuncture therapies appear to offer a viable option for CSU, with specific modalities potentially tailored to patient symptoms and immune profiles.
How this fits prior evidence
This meta-analysis addresses a gap in the management of chronic spontaneous urticaria by evaluating various acupuncture modalities. While previous evidence suggests that viral infections may lead to persistent and chronic urticaria in up to 9.5% of cases, this study provides specific data on non-pharmacological interventions. It also provides a nuanced look at managing pruritus, a symptom previously noted in patients with primary biliary cholangitis.
Living with chronic spontaneous urticaria means dealing with persistent hives and intense itching. While antihistamines are a common way to manage these symptoms, some patients look for additional ways to find relief and improve their daily quality of life.
A large review of data from over 7,700 patients looked at various acupuncture methods. The study found that different types of acupuncture performed differently depending on what was being measured. For example, acupuncture combined with autohemotherapy showed strong results for overall efficacy, while moxibustion was noted for improving quality of life scores. Other combinations, like acupuncture with cupping, were noted for reducing the rate of relapse.
It is important to note that while these results are encouraging, the evidence is still early. The study noted that these findings should be interpreted cautiously because more large, high-quality trials are needed to confirm these results. Doctors suggest that the best treatment depends on a person's specific symptoms and how well they tolerate different therapies.
What this means for you:
Different acupuncture methods show varying success in treating hives and itching, but more high-quality trials are needed.
Common questions
Can acupuncture help with the itching of chronic urticaria?
Yes, the study found that acupuncture combined with moxibustion was ranked first for reducing the severity of pruritus, which is the medical term for itching. However, the study noted that most acupuncture therapies did not show a statistical difference in wheal counts compared to standard antihistamines.
Is acupuncture safe for treating skin conditions?
The study suggests acupuncture therapies have good safety profiles. Specifically, acupuncture combined with cupping therapy ranked first for reducing the incidence of adverse reactions. Because results vary based on individual symptoms, you should talk to your doctor about which method is safest for you.
How does acupuncture compare to antihistamines?
The study compared several acupuncture combinations against antihistamines. While some acupuncture methods showed better results for specific markers like immune levels or relapse rates, many did not show a significant difference over antihistamines when measuring the actual number of wheals on the skin.
Chronic spontaneous urticaria (CSU) is a common refractory skin disorder impairing quality of life. This study systematically evaluated the clinical efficacy and safety of acupuncture therapies for CSU, providing evidence for clinical decision-making.
Eight databases—CNKI, VIP, WanFang, SinoMed, PubMed, Embase, Cochrane Library, and Web of Science—were searched from their inception to 31 July 2025, for randomized controlled trials (RCTs) investigating various acupuncture therapies for CSU. The quality of the included studies was assessed using the Risk of Bias 2 tool. Data analysis was performed using R4.4.2 and Stata 18. This study was registered in PROSPERO (https://www.crd.york.ac.uk/PROSPERO/view/CRD42024608056).
Ninety-three RCTs involving 7,746 patients were included. Based on surface under the cumulative ranking curve (SUCRA) analysis, acupuncture combined with autohemotherapy ranked first in improving efficacy [SUCRA = 92.79%, relative risk (RR) = 1.46, 95% credible interval (CrI): 1.19, 1.84]. Moxibustion ranked first in reducing the Dermatology Life Quality Index (DLQI) score [SUCRA = 99.94%, mean difference (MD) = −9.45, 95% CrI: −12.48, −6.44]. In terms of wheal count, most pairwise comparisons among interventions showed no significant differences, and none of the acupuncture therapies demonstrated statistical superiority over antihistamines. Acupuncture combined with moxibustion ranked first in reducing the severity of pruritus (SUCRA = 96.27%, MD = −1.03, 95% CrI: −1.15, −0.91). Autohemotherapy combined with moxibustion ranked first in reducing the levels of immunoglobulin E (IgE) (SUCRA = 93.05%, MD = −36.23, 95% CrI: −55.33, −17.33). The combination of acupuncture, bloodletting puncture and cupping (BLP-C), and antihistamine ranked first in both reducing interleukin-4 (SUCRA = 97.95%, MD = −194.39, 95% CrI: −317.68, −71.10) and increasing IFN-γ (SUCRA = 99.78%, MD = 32.36, 95% CrI: 19.00, 46.49). Acupuncture combined with cupping therapy ranked first in reducing the incidence of adverse reactions (SUCRA = 91.69%, RR = 0.04, 95% CrI: 0.04, 0.24) and relapse rate (SUCRA = 91.79%, RR = 0.02, 95% CrI: 0, 0.09).
Acupuncture therapies demonstrate good efficacy and safety in treating CSU. Nevertheless, optimal interventions should be selected based on the characteristics of symptoms, immune profiles, and patient tolerability. These findings should be interpreted cautiously and validated in larger, higher-quality trials due to study limitations.
