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| CASE REPORT |
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| Year : 2016 | Volume
: 12
| Issue : 1 | Page : 26-27 |
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Cupping therapy burn in an African
Afieharo I Michael1, Temilola O Akande2
1 Department of Plastic, Reconstructive and Aesthetic Surgery, University College Hospital, Ibadan, Oyo State, Nigeria
2 Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
| Date of Web Publication | 10-Nov-2016 |
Correspondence Address:
Afieharo I Michael
Department of Plastic, Reconstructive and Aesthetic Surgery, University College Hospital, P.M.B. 1156, Ibadan, Oyo State
Nigeria
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0794-9316.193740
Cupping therapy is an ancient alternative medicine practice with origins in the Middle East. It involves mobilization of blood flow to promote healing through either heat or suction. It is rare in Sub-Saharan Africa. The authors present an 80-year-old known diabetic Nigerian female with 2% burns to the left shoulder from cupping therapy for back pain. The methods of cupping therapy and the potential adverse events from a Plastic Surgery perspective are discussed. Keywords: Burn, cupping, Nigeria
How to cite this article:
Michael AI, Akande TO. Cupping therapy burn in an African. Nigerian J Plast Surg 2016;12:26-7 |
| Introduction | |  |
Cupping therapy is an ancient alternative medicine practice with origins in the Middle East. [1] It is reported to have been in existence since 1550 BC as recorded in the Ebers Papyrus as an Egyptian practice. [2] There are myths surrounding its efficacy with as yet no concrete scientific evidence base. [3],[4] Despite this, it is a routine alternative medical practice in Asia and has been adopted in other parts of the world. [1],[5],[6] Cupping therapy involves the creation of a negative pressure inside a cup that can be of glass, wood, or silicon. [1] This negative pressure results when burning alcohol or cotton within the cup rarefies the air. Immediate application of the cup to a well-lubricated skin results in sucking up of the skin. The heat produced results in vasodilatation erythema, ecchymosis, and edema. [5] The negative pressure could be created with a suction valve. Dry cupping and wet cupping are the two types in practice. Superficial incisions on the skin to allow for bleeding are characteristic of the wet cupping. [1],[2] Adoption of cupping therapy is still quite new in sub-Saharan Africa and Asians typically are the practitioners where they exist. There have been no reports of cupping therapy burn from this region.
| Case report | | |
An 80-year-old woman presented 5 days following cupping therapy burn to her left shoulder. She was a known diabetic of 10 years duration and had sought cupping therapy for chronic back pain. She received dry cupping but was unable to describe exactly how the burn occurred. It was her first experience with the therapy. On examination, she had 15 cm × 20 cm largely superficial partial thickness burn on the posterior surface of her left shoulder [Figure 1]a. There were hyperpigmented circles on the rest of the upper back which are tell-tale signs of the procedure [Figure 1]b. A diagnosis of 2.5% majorly superficial partial thickness cupping therapy burn was made. She had conservative management and most of the wounds healed in 3 weeks while a 0.5% area healed in 6 weeks. | Figure 1: (a) Patient with burns on the right shoulder from cupping therapy, (b) cupping therapy burn on right shoulder and hyperpigmented circles on rest of upper back
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| Discussion | | |
Cupping therapy though in practice over the centuries still has no concrete scientific basis to its efficacy. [3],[4] Nevertheless, it is still being sought and recommended by those who believe in its effectiveness. Its side effects include Burns, Anaemia, pigmentary changes, epidural abscess, and iatrogenic bullae. [2],[3],[5] Those who advocate it usually would not inform the intending patient of these side effects. Our patient believed that it was a simple form of massage. All reported cases of cupping therapy burns in the English literature have been in patients with at most Fitzpatrick IV skin type. [1],[2],[3],[4],[5],[6] Our patient is the first reported case in Fitzpatrick skin type VI. In the case series of 14 patients seen with cupping therapy burn over a 4-year period, the oldest patient was 61 years. [2] Our patient may be the oldest reported case. The burn wounds in Jing-Chun et al.'s series ranged from 1% to 6% and the time to healing from 3 to 23 days. The superficial partial thickness wound healed in 3 weeks while focal 2 cm × 4 cm deep dermal areas took 6 weeks to heal. This may not be unconnected with the age of the patient and the presence of diabetes. Hypopigmentation and hypertrophic scarring are the reported post burn sequelae. [2],[3] Hyperpigmentation, as seen in our patient, hypertrophic scarring and keloid formation, are more probable post burn sequelae in Fitzpatrick IV to VI skin types. As the adoption of this method of alternative medical practice increases in sub-Saharan Africa, the need for awareness on its possible side effects would be justified.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Kose AA, Karabagli Y, Cetin C. An unusual cause of burns due to cupping: Complication of a folk medicine remedy. Burns 2006;32:126-7.  |
| 2. | Jing-Chun Z, Jia-Ao Y, Chun-Jing X, Kai S, Lai-Jin L. Burns induced by cupping therapy in a burn center in Northeast China. Wounds 2014;26:214-20. |
| 3. | Iblher N, Stark B. Cupping treatment and associated burn risk: A plastic surgeon′s perspective. J Burn Care Res 2007;28:355-8. |
| 4. | AlBedah A, Khalil M, Elolemy A, Hussein AA, AlQaed M, Al Mudaiheem A, et al. The use of wet cupping for persistent nonspecific low back pain: Randomized controlled clinical trial. J Altern Complement Med 2015;21:504-8. |
| 5. | Sagi A, Ben-Meir P, Bibi C. Burn hazard from cupping - An ancient universal medication still in practice. Burns Incl Therm Inj 1988;14:323-5. |
| 6. | Kulahci Y, Sever C, Sahin C, Evinc R. Burn caused by cupping therapy. J Burn Care Res 2011;32:e31. |
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