There’s some limited research to suggest that acupuncture can treat urticaria (hives), but more evidence is needed before drawing any conclusions.

Hives, medically known as urticaria, are itchy, red, and inflamed areas of skin that typically occur due to allergic reactions to foods, drugs, stress, or infections.

Most of the time, doctors recommend treating hives with either over-the-counter (OTC) or prescription antihistamines. Though the evidence is still limited, some research suggests that acupuncture may also be an effective treatment for both acute and chronic urticaria, either as a stand-alone treatment or in addition to medication.

Here’s what to know about the connection.

Acupuncture is a Traditional Chinese medicine (TCM) technique that involves the insertion of thin needles into specific pressure points. The aim is to balance the energy or life force in the body (known as Qi) in order to heal it. It’s been around for at least 2,000 years, but it became popular globally in the 1970s.

Experts still aren’t sure exactly how acupuncture works, but some research suggests that it affects nervous system function. It also seems to have a direct impact on the tissues where the needles are placed.

Others believe it functions purely at an energetic level. According to the National Center for Complementary and Integrative Health (NIH), acupuncture often seems to have a “nonspecific” effect — meaning impacts that seem incidental to the mode of treatment.

Researchers note this outcome could be impacted by the patient’s belief in the treatment and other factors like the patient-practitioner relationship. That said, studies show that acupuncture is still more effective than placebo or sham treatments.

Acupuncture may help reduce stress, ease chronic pain, and treat a number of conditions, including many dermatologic diseases such as dermatitis.

There’s some evidence to suggest that acupuncture is an effective treatment for hives.

In a 2016 review of 6 studies with 406 participants, researchers found acupuncture to significantly improve hive symptoms, both when compared to medication and when done as a complementary treatment. That said, they noted that the overall risk of bias in the studies was high due to limitations, including a lack of control groups.

Due to the low level evidence, they concluded that acupuncture might be effective for treating symptoms of chronic hives. Higher quality studies need to be done in the future before making further claims.

In a 2020 case study, researchers followed one 26-year-old with severe and sudden hives (acute urticaria). There were no hives medication available, so he underwent a 30-minute acupuncture treatment. Researchers noted that after 5 minutes, the itching sensation stopped. After 30 minutes, the hives were almost completely faded.

Though researchers can’t draw any conclusions based on the experience of just one person, they noted that acupuncture may be a promising alternative therapy for hives.

In a 2023 study that followed over 43,500 patients with hives for a decade, researchers found that acupuncture significantly reduced the risk of hypertension.

Since those with chronic spontaneous urticaria (CSU) have a higher risk of developing high blood pressure, researchers wanted to know whether acupuncture could help ease this side effect.

They concluded that acupuncture does indeed reduce the risk of hypertension. However, they noted that those who received medication combined with acupuncture had the lowest risk.

Even though this study only analyzed hypertension and acupuncture, it may be encouraging for those with hives who want to minimize the risk of blood pressure issues.

According to 2018 research, the most common region to place acupuncture points for hives include:

  • Urinary bladder meridian: Runs along either side of the spine and down the backs of the legs.
  • The “governor vessel”: Runs from the bottom of the spine up to the top of the head, over the forehead to the mouth.
  • The “conception vessel:” Runs up the center of the body from the reproductive organs up to the mouth.
  • The large intestine meridian: Starts from the tip of the index finger and runs up the wrist, elbow, shoulder, neck, and along the side of the face.
  • The spleen meridian: Starts from the big toe and travels up to the side of the ribs.
  • The stomach meridian: Runs from the upper cheek, curves around the mouth, jaw, and ears, and descends down the neck, clavicle, and stomach to the tip of the second toe.

Ultimately, there are many acupuncture points that may be utilized depending on where the hives are located and other factors at the discretion of the practitioner.

According to current evidence, acupuncture is safe for treating urticaria.

So, even if more studies are needed, there’s minimal risk in trying the alternative therapy out for yourself.

What are the risk factors for acupuncture?

According to the NIH, there are few reported complications from using acupuncture. The main risk factor lies in the use of nonsterile needles or the improper placement of the needles.

When not done safely or hygienically, acupuncture may cause adverse outcomes such as:

  • infections
  • wounded organs
  • central nervous system injuries

Due to the potential risks, the Food and Drug Administration (FDA) considers acupuncture needles medical devices and regulates them as such. They must be sterile and only used once. The acupuncturist must also be fully licensed.

There’s limited evidence that suggests that acupuncture is an effective treatment for hives, but more studies are needed to know for sure. It also appears to reduce the risk of hypertension in patients, which is otherwise elevated in those with hives.

Traditionally, both acute and chronic hives are treated with antihistamines. But since acupuncture is a low risk treatment, it may be worth a try as a complementary approach.