Cupping for Acne

Cupping, a favorite of mine, is highly effective for cystic acne. In Traditional Chinese Medicine acne is often caused by heat, dampness, and stagnation, and cupping is effective at reducing heat and moving stagnation. Cupping is performed by depressurizing the inside of the cup with a flame or a vacuum, so it then lifts up the skin below it. Traditionally cupping works to increase circulation and remove heat from the body, and is used for a wide range of conditions including stress, muscle pain, arthritis, chest colds and fevers, and even some skin conditions.

Plastic and glass are the most common materials used today. Cupping therapy types can be classified into four main categories.

1. Technical Types

• Dry
• Wet
• Massage
• Flash Cupping

2. Power of Suction

• Light
• Medium
• Strong 

3. Method of Suction

• Fire
• Manual Suction
• Electrical suction 

4. Materials Inside Cups

• Herbal
• Water
• Ozone
• Needle 
• Magnetic cupping

Cups may range in size from 1 to 3 inches in diameter.

Dry cupping commonly involves creating a small area of low air pressure next to the skin. The low air pressure required may be created by heating the cup or the air inside it with an open flame or a bath in hot scented oils, then placing it against the skin. As the air inside the cup cools, it contracts and draws the skin slightly inside. More recently, vacuum is created with a mechanical suction pump acting through a valve located at the top of the cup.

Fire cupping, my favorite (pictured), involves soaking a cotton ball in alcohol, then clamping it by a pair of forceps, setting it on fire and, in one motion, placing into the cup and quickly removing. Then, the cup is placed on the skin. Fire heats the inside of the cup and a small amount of suction is created by the air cooling down and contracting. Massage oil may be applied to create a better seal as well as allow the cups to glide over muscle groups in an act called "moving cupping". Immediately after, dark circles will appear where the cups were placed because of rupture of the capillaries just under the skin. 

Wet cupping, or Hijama, is performed by letting the area under the cup fill with “bad” dark blood. The cups are applied to the skin using the fire or suction method, and left to cling to the skin for a few minutes, then it is lifted off and several very small incisions are made in the skin. The cup is then put back as it was before until the flow of blood subsides. Hijama is considered a form of energy medicine because it has been claimed to "unclog" purported meridians in the body.

When treating inflammatory conditions, such as acne, the goal is to remove heat and toxins. This is generally done through cupping on the back, even if the acne is on the face or chest.

There are a number of small studies and reports for cupping alone or in combination with other therapies that have been successful for treating acne, particularly for inflammatory and cystic acne. In TCM, it is very common to combine cupping with other modalities such as acupuncture or herbal medicine. 

A meta-analysis of cupping concluded that cupping alone or in combination with herbal interventions is more effective than herbal interventions alone, and cupping combined with acupuncture was found to have a trend toward being more effective than acupuncture alone. A study that examined cupping found that 10 out of 11 people with acne had improvement in their symptoms. In these patients, cupping also reduced inflammatory chemicals circulating in the blood.