Whether you accept it, avoid it or live somewhere in between, insurance coverage has become a defining issue for our profession. Patients increasingly expect to use their benefits, practitioners want to be compensated fairly for their time and expertise, and the system itself remains – at best – fragmented. The encouraging news is that coverage has expanded in meaningful ways. The challenging news is that reimbursement, across the board, remains inadequate.
Atopic Dermatitis: Reducing the Itch With Acupuncture
Atopic dermatitis, the most common form of eczema, affects nearly 10 million children and more than 16 million adults in the U.S. Itchy skin is one of the hallmark symptoms of this frustrating, often-chronic condition. Topical anti-inflammatories are the standard of care; but what about acupuncture?
A randomized, three-armed, controlled clinical trial published in Clinical and Experimental Dermatology (full text here) divided patients into three groups: acupuncture, osteopathic care or no intervention. All patients (ages 18-65) had "average reported itching severity of the skin between 40 and 80 mm on a visual analogue scale" at baseline (100 mm = maximum imaginable itching) – as well as an Alzheimer's disease diagnosis. (Dermatitis in dementia patients been associated in previous studies.)
Acupuncture patients "received eight semistandardized treatments of 30 minutes at one- to two-week intervals. The obligatory ACU points large intestine channels 4 and 11 (bilaterally) and spleen channels 6 and 10 (uni- or bilaterally) were supplemented by optional points, including ear acupuncture."
Osteopathic medicine patients received five 45-minute semistandardized sessions (at approximately two-week intervals), with obligatory treatment locations including the cervical and thoracic columns, ribs, diaphragm, lungs, intestines, cranial bones and cranial fasciae.
Patients in all three comparison groups were able to supplement their care as necessary with topical corticosteroids and emollients.
Acupuncture achieved a clinically relevant improvement in itching severity at 12 weeks compared to both osteopathic intervention and no intervention: VAS 27.9 mm vs. 35.0 mm vs. 42.3 mm, respectively; as well as topical corticosteroid use compared to controls (2.3 vs. 4.3; 1.9 in the osteopathic medicine group).