Although fire needle therapy used alone or in combination with other treatments is effective for moderate to severe acne, additional large-scale, more rigorously designed trials should be conducted to confirm these findings, according to a study published in Complementary Therapies in Medicine.
First-line therapy for moderate to severe acne involves antibiotics and isotretinoin, but these medications have serious side effects. Fire needle therapy — a treatment widely utilized in China — has shown good clinical efficacy with fewer side effects, which indicates that it can be used as a primary treatment as an alternative to pharmaceuticals or combined with pharmaceuticals.
The current systematic review and meta-analysis searched a number of databases, including Embase, PubMed, Cochrane Central Register of Controlled Trials, China Science and Technology Journal Database (CQVIP), China Biomedical Literature Service System (SinoMed), China Network Knowledge Infrastructure (CNKI), and Wanfang Data Knowledge Service Platform, from their inception to November 22, 2018. The researchers only included randomized, controlled trials comparing the efficacy, recurrence, and adverse events associated with the use of fire needle therapy alone or in combination with Chinese herbs or conventional pharmaceutical acne therapies with trials using only pharmaceutical therapy. RevMan 5.3 software was used to calculate the risk ratio (RR) with a 95% confidence interval (CI). Ten trials were selected (N=904).
Meta-analyses indicated that fire needle treatment with oral isotretinoin or clindamycin treatment had more advantages compared with pharmaceutical therapies alone (RR = 2.18, 95% CI, 1.19-3.99; P =.03 random model; I2 = 72%). Furthermore, fire needle treatment alone was more effective than pharmaceutical treatment, irrespective of the medication used (RR = 2.32, 95% CI, 1.77-3.03; P <.00001 random model; I2 = 59%). There was no significant difference in the rate of recurrence between fire needle therapy and pharmaceutical treatments (RR = 0.78, 95% CI, 0.54-1.14; P =.20 fixed-effect model; I2 = 0%). Fire needle therapy was also associated with fewer adverse reactions (primarily burning and tingling), and these reactions were transient.
Study investigators concluded, “Although the evidence for the effectiveness of fire needle therapy for the treatment of moderate-severe acne is encouraging, it is not conclusive due to the low methodological quality of the available RCTs [randomized controlled trials]. Therefore, more high-quality RCTs, with low risk of bias and adequate sample sizes are required to demonstrate its effectiveness.”
Xing M, Yan X, Sun X, et al. Fire needle therapy for moderate-severe acne: A PRISMA systematic review and meta-analysis of randomized controlled trials [published online April 28, 2019]. Complement Ther Med. doi: 10.1016/j.ctim.2019.04.009