Device-Free Auricular Acupressure Improves Rosacea Outcomes, Eases Flushing: JAMA
China: A randomized clinical trial published in JAMA Dermatology found that device-free auricular acupressure, added to standard treatment, significantly improved clinical outcomes in patients with rosacea, potentially relieving acute flushing and burning symptoms. The intervention also reduced serum levels of key inflammatory and neurovascular biomarkers associated with the skin condition.
The study, led by Bingyang Xu from the Department of Dermatology at the Second Affiliated Hospital of Xi’an Jiaotong University, China, and colleagues, investigated whether applying pressure to specific points on the ear could improve rosacea symptoms by modulating neuroimmune responses without requiring specialized stimulation devices.
Rosacea is a chronic inflammatory skin disorder characterized by facial redness, flushing, and burning sensations. Although transcutaneous auricular vagus nerve stimulation has shown potential in managing the condition, reliance on specialized equipment has limited its wider application. The researchers explored device-free acupressure as a simpler, low-cost alternative.
The single-center, randomized, sham-controlled trial included 204 patients receiving standard first-line treatment at the hospital's dermatology outpatient department between October 2025 and May 2026. Participants were randomly allocated to active or sham acupressure groups, with 102 patients in each group.
In the active group, a Vaccaria segetalis seed was placed on both sides of the cavum conchae, an ear region supplied by the auricular branch of the vagus nerve. The sham group received seed placement along the upper margin of the auricular tubercle, an area with somatosensory innervation. Participants applied pressure three times daily for 30 seconds over eight weeks, with additional pressing permitted during acute flare-ups.
The primary outcome was treatment success at week eight, defined as an Investigator Global Assessment (IGA) score of 0 or 1.
The study findings revealed the following:
- Higher treatment success: At week eight, 56.9% of patients receiving active acupressure achieved treatment success, compared with 35.3% in the sham group (relative risk, 1.61). The number needed to treat was five.
- Rapid vascular improvement: Multispectral imaging showed immediate vascular improvement in 59.3% of the active acupressure group, compared with 7.4% of the sham group.
- Reduced inflammatory biomarkers: The active intervention produced greater reductions in serum cathelicidin antimicrobial peptide (LL-37), calcitonin gene-related peptide (CGRP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6).
- Sustained benefits: At week 20, patients in the active group continued to show significantly lower IGA and Clinical Erythema Assessment scores.
- Safety: No serious adverse events were reported.
The findings provide preliminary biochemical evidence that auricular acupressure may modulate neuroimmune responses, offering rapid symptom relief and sustained benefits alongside standard treatment.
However, the single-center design, lack of direct measures of vagal activation, and limited biomarker assessments warrant further validation in larger, multicenter trials.
Device-free auricular acupressure may be a promising complementary approach to rosacea management, but its long-term safety and effectiveness during unsupervised use remain to be established.
Reference:
Xu B, Chu J, Wang Y, et al. Device-Free Auricular Acupressure for Rosacea: A Randomized Clinical Trial. JAMA Dermatol. Published online October 14, 2026. doi:10.1001/jamadermatol.2026.3999
Next Story