c700x420
I keep thinking, “Now I’ve seen everything,” and I am constantly being proven wrong. I recently came across the new fad of facial cupping. After I stopped laughing, I went on to an amazed appreciation of the extent of human creativity and entrepreneurship.

Cupping is a traditional Chinese medicine (TCM) treatment often applied over acupuncture points. Traditionally, the air in a glass bulb is heated, and when it is applied to the skin and the air cools, it creates a vacuum, sucking up a blob of skin. It leaves unsightly bruises (remember the pictures of Michael Phelps at the Olympics and of actress Gwyneth Paltrow?) Sometimes the skin is incised, and blood is drawn up into the bulb. The new fad of facial cupping is kinder and gentler. Less suction is involved, and no visible marks are left on the skin.

You can see facial cupping in action on videos like this one. The cups are made of silicone and are of various sizes; the smallest ones are used around the eyes. You squeeze gently before you apply it to the skin, and when you release the squeeze, it creates a vacuum that sucks a bit of skin up into the device. You can treat a single spot or sweep the device across an area without breaking the suction. It doesn’t leave scars, but it can produce a transient redness. In the video, the patient is being treated at a spa, but cupping kits are being marketed for people to use on themselves at home.

One product description says:

What is Cupping? Cupping therapy is a form of alternative medicine in which cups are placed on the skin to create suction in order to increase blood flow, reduce inflammation and activate lymphatic drainage. Cupping therapy dates back to ancient Egypt, Asia and Middle East. Cupping brings fresh blood to the area, improves circulation and is widely used to treat pain, digestive problems, release toxins, improve appearance of cellulite and much more! When can I expect to see results? Impress me! In many cases, results are visible after only a few cupping treatments, though you will start feeling and looking better instantly! With regular use, you will experience muscle tension relaxation, rejuvenation, increased energy, firmness and a more toned, healthier physique. Reduced stress, improved circulation and pain relief are just some of the many benefits you can see and feel. Remember, results are cumulative. To be effective, use regularly until optimal results are reached, follow a healthy diet, exercise and drink plenty of water!

Even if all that were true (which it probably isn’t), it might only apply to the original kind of cupping, the kind with strong enough suction to leave large welts on the skin

For advocates of “natural” treatments, I don’t see anything “natural” about cupping. But there is a “natural” alternative: hickeys or love bites. Is anyone advocating those?

So, some genius had the brainstorm that if you reduced the suction to where no visible lesions were produced, cupping would be more acceptable and you could make a lot of money selling weak suction devices. I wonder if this should be called “pseudo-cupping”? It’s homeopathic thinking, analogous to what Hahnemann did. He came to believe that all effective drugs produce symptoms in healthy individuals similar to those of the diseases that they treat, then he kept diluting his remedies until they no longer produced those symptoms (nor did they do anything else!).

Another website sells both the old and new types of cup. It claims therapeutic benefits of gentle facial cupping for patients with sinus infections, headaches, facial paralysis, earaches, and temporomandibular joint pain (TMJ). It claims to help patients suffering from these conditions “without the need for more extensive treatments.” It is illegal for them to make such disease-specific claims, and could be dangerous if patients are discouraged from effective treatments for these conditions.

On another page, they list the top 7 benefits of cupping:

  1. Relief from pain
  2. Promote relaxation
  3. Promote healing from injuries
  4. Clear, flawless skin
  5. Better digestion
  6. Relief from respiratory issues
  7. Detoxification

And a sidebar claims benefits for tonsillitis, angina pectoris, osteoarthritis, gout, endometriosis, infertility, urinary incontinence, high blood pressure, heartburn, neuralgia, and diabetes!

But wait! There’s more! Anemia, hemophilia, wrinkles, mental problems, varicose veins, weight loss, diarrhea, conjunctivitis, frozen shoulder, fever, herpes, cervical spondylosis, and “scaring” (a typo, but cupping does scare me.) And “anti-aging” claims are common.

Amazon sells them. One customer reports using them to pop pimples. One said she is hoping to reduce cellulite. One reports a large decrease in dimpling in her legs. One said “Painful, but seems to be helping [helping for what?]” One said, “Hard to use.” One said, “Not sure if it works but it doesn’t provide good suction and feels like a deep massage.” One said, “Didn’t work.”

I got a kick out of two 2-star customer reviews. The first said she used the cups about six times and they no longer suction. The second asked, “What to do when an item sucks because it doesn’t suck?”

Evidence?

Is there evidence for any kind of cupping? According to the American Cancer Society, “There is no scientific evidence that cupping leads to any health benefits….No research or clinical studies have been done on cupping. Any reports of successful treatment with cupping are anecdotal. There is no scientific evidence that cupping can cure cancer or any other disease.”

Edzard Ernst employed cupping himself 40 years ago before he started looking for scientific evidence. He says cupping has a significant placebo effect, and the most plausible mode of action is counter-irritation (analogous to hitting your thumb with a hammer to distract you from the pain of a headache). He mentions recent research but characterizes it as “flimsy” at best. It is impossible to do blinded studies, and most of the positive studies are out of China, where negative studies are never published.

The bottom line: there is no credible evidence for the original form of cupping, and there is even less evidence for the newer, kinder, gentler version.

Suggestion?

An article in Vogue, “Cupping Works Even Better on Your Face,” inadvertently provides insight into the psychological mechanisms behind customer satisfaction and glowing testimonials:

My skin was tighter, pinker, plumper; my jawline lifted. The irksome fine lines on my forehead had taken leave, and my eyebrows even appeared slightly higher. I’d been skeptical, but it was as if I’d just awakened from a five-year nap [I can’t help wondering how she knows this. How many five-year naps has she had?] “Look at those cheekbones,” Goldstein said admiringly.

Having barely sacrificed any extra time (her sessions, with their added skin-treatment component, run 30 minutes), I returned triumphantly to the office, where a colleague complimented me on my unusually rested appearance. Later that night, I told my boyfriend what had happened. He narrowed his eyes. “You know, maybe your face does look a bit thinner and more angular,” he surmised. Two days later, apropos of nothing, he revised his opinion. “I don’t know why,” he said, “but you look more beautiful this week than you ever have.

Suggestion is very powerful. Especially without controlled observations.

Conclusion: It sucks

Facial cupping sucks. In more than one sense.

As I see it, it offers two benefits: a mostly harmless sort of masturbatory pastime for self-absorbed and self-indulgent users, and a source of amusement for skeptics.

Posted by Harriet Hall

Harriet Hall, MD also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so),  and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. She retired with the rank of Colonel.  In 2008 she published her memoirs, Women Aren't Supposed to Fly.