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Direct Answer
Acupuncture may provide modest, short-term symptom relief for allergic rhinitis in some patients, but it does not treat the underlying immune dysfunction that causes allergies. Multiple randomized controlled trials show small improvements in nasal symptoms and quality of life compared to sham acupuncture, though effect sizes are small and benefits fade after sessions stop. Acupuncture is best understood as a possible complementary therapy—not a replacement for evidence-based treatments like antihistamines, nasal corticosteroids, or sublingual immunotherapy (SLIT) that address the root cause.
What the Research Actually Shows
The ACUSAR Trial (2013)
The most cited study on acupuncture for allergies is the ACUSAR trial, published in the Annals of Internal Medicine. This German randomized controlled trial enrolled 422 patients with allergic rhinitis and compared real acupuncture (12 sessions over 8 weeks) to sham acupuncture and to rescue antihistamine medication alone.
Results: Patients receiving real acupuncture reported better symptom scores and used fewer antihistamines compared to the sham group. However, the differences were small—the improvement in quality of life scores was statistically significant but below the threshold most clinicians consider clinically meaningful. By the 16-week follow-up, differences between real and sham acupuncture had narrowed further.
Cochrane Review (2015)
The Cochrane Collaboration reviewed 13 randomized controlled trials involving 2,365 participants. Their conclusion: there is “limited evidence” that acupuncture may have a small benefit for allergic rhinitis symptoms and quality of life. They noted that the evidence quality was low to moderate and that blinding issues (patients can sometimes tell whether they received real or sham acupuncture) may have inflated results.
AAAAI Position
The American Academy of Allergy, Asthma & Immunology (AAAAI) acknowledges that some patients report symptom improvement with acupuncture but does not include it in recommended treatment guidelines for allergic rhinitis. The AAAAI’s practice parameters recommend allergen avoidance, pharmacotherapy (antihistamines, nasal corticosteroids), and allergen immunotherapy as the evidence-based treatment pathway.
Why Acupuncture Falls Short as an Allergy Treatment
It Does Not Change the Immune Response
Allergies are caused by an immune system error: your body produces IgE antibodies against harmless substances like pollen, dust mites, mold, or pet dander. When you encounter these allergens, IgE triggers mast cells to release histamine and other inflammatory chemicals, causing symptoms.
Effective allergy treatment must either block these chemicals (what medications do) or retrain the immune system to stop producing the inappropriate IgE response (what immunotherapy does). There is no published evidence that acupuncture changes IgE levels, shifts the Th1/Th2 immune balance, or produces any measurable change in immune function related to allergy.
The Placebo Effect Is Significant
Acupuncture trials consistently show that sham acupuncture (placing needles in non-specific points or using retractable needles that do not penetrate the skin) produces substantial symptom improvement—sometimes 60–70% as much as real acupuncture. This is a well-documented pattern across acupuncture research for many conditions, not just allergies.
This does not mean the relief patients experience is not real. Placebo responses involve genuine neurological changes—release of endorphins, modulation of pain perception, and activation of reward pathways. But it does mean that the specific needle placement taught in acupuncture traditions may not be driving the benefit.
Benefits Do Not Last
The key limitation for allergy patients: acupuncture benefits do not persist after treatment stops. Allergic rhinitis is a chronic condition that recurs every season or every day (for perennial allergens). A treatment that requires ongoing sessions to maintain benefits—without changing the underlying disease—is managing symptoms, not treating the allergy.
By contrast, sublingual immunotherapy (SLIT) produces immune changes that persist for years after the 3–5 year treatment course ends. Studies show sustained benefit for 7–12 years or longer following completion of immunotherapy.
Where Acupuncture May Fit
For some patients, acupuncture may have a role as a complementary—not alternative—therapy. Here are the scenarios where it might make sense:
- Patients who want to reduce medication use but are not ready for immunotherapy. Some patients report using fewer antihistamines during acupuncture treatment courses. If this reduces medication side effects (drowsiness, dry mouth), it may improve quality of life for that individual.
- Patients who respond poorly to medications. A small subset of patients gets inadequate relief from antihistamines and nasal sprays but is not yet ready for immunotherapy. Acupuncture may provide modest additional symptom control while they consider long-term options.
- Patients already receiving evidence-based treatment who want to add acupuncture. There is no evidence that acupuncture interferes with antihistamines, nasal steroids, or SLIT. Adding it alongside standard treatment is safe, though the incremental benefit is uncertain.
Acupuncture vs. Evidence-Based Allergy Treatments
When to See an Allergist
If you are considering acupuncture because your allergies are not well controlled, that is actually a signal that you should see a board-certified allergist. Specifically:
- You have tried over-the-counter antihistamines and nasal sprays without adequate relief
- You are considering acupuncture because you are frustrated with medications that only partially work
- You have never been allergy-tested and do not know your specific triggers
- You want to discuss a treatment that addresses the root cause of your allergies, not just the symptoms
- You are spending significant money on acupuncture sessions and want to know if that investment would be better directed toward immunotherapy
Frequently Asked Questions
Does acupuncture work for allergies?
Clinical trials show acupuncture may provide modest, short-term symptom relief for allergic rhinitis. The largest study (ACUSAR, 422 patients) found small improvements in nasal symptoms compared to sham acupuncture. However, effect sizes are small, sham acupuncture also produces improvement, and benefits fade after sessions stop. No major allergy guideline recommends acupuncture as a primary treatment.
Is acupuncture better than allergy medication?
No. Antihistamines and nasal corticosteroid sprays are more effective, more convenient, and far less expensive than acupuncture for allergic rhinitis. Medications provide rapid symptom relief within hours to days. Acupuncture provides modest relief after multiple sessions and requires ongoing visits. Medications are also backed by decades of high-quality evidence.
Can acupuncture cure allergies permanently?
No. There is no evidence that acupuncture produces permanent changes in the immune response to allergens. Benefits observed in clinical trials fade within weeks to months after treatment stops. The only allergy treatment shown to produce lasting immune system changes is allergen immunotherapy—either allergy shots (SCIT) or allergy drops (SLIT)—which retrains the immune system over 3–5 years.
Is acupuncture safe for allergy patients?
Acupuncture is generally safe when performed by a licensed practitioner using sterile needles. Common side effects include minor bruising, soreness at needle sites, and occasional lightheadedness. Serious complications are rare. Importantly, acupuncture does not interfere with allergy medications or immunotherapy, so it can be used alongside standard treatments if desired.
How much does acupuncture for allergies cost?
Individual acupuncture sessions typically cost $75–$150. Most protocols for allergic rhinitis involve 12–16 sessions over 8–12 weeks, totaling $900–$2,400 per treatment course. This is often not covered by insurance. By comparison, HeyPak® allergy drops start at $47/month and treat the root cause of allergies with lasting results.
What is a better alternative to acupuncture for allergies?
Sublingual immunotherapy (SLIT) is the most effective alternative for patients seeking long-term allergy relief beyond medications. Unlike acupuncture, SLIT is backed by high-quality evidence, recommended by major allergy guidelines, changes the underlying immune response, and produces benefits that last years after treatment ends. It is taken as daily drops at home—no needles, no clinic visits.
Author, Review and Disclaimer
Author: Krikor Manoukian, MD, FAAAAI, FACAAI — Board-Certified Allergist/Immunologist
Bio: Dr. Manoukian is a board-certified allergist/immunologist with over 20 years of experience. He leads HeyAllergy’s clinical team and specializes in telemedicine-enabled allergy care and personalized sublingual immunotherapy programs.
Medical Review: HeyAllergy Clinical Team (Board-Certified Allergists/Immunologists)
Disclaimer: This article is educational and not a substitute for personalized medical advice. Discuss all treatment options, including complementary therapies, with your healthcare provider.
References
- Brinkhaus B, et al. Acupuncture in patients with allergic rhinitis: a pragmatic randomized trial. Annals of Internal Medicine. 2013;158(4):225-234.
- Feng S, et al. Acupuncture for the treatment of allergic rhinitis: a systematic review and meta-analysis. American Journal of Rhinology & Allergy. 2015;29(1):57-62.
- AAAAI, Allergic Rhinitis Treatment Guidelines. AAAAI
- Xue CC, et al. Acupuncture for persistent allergic rhinitis: a randomised, sham-controlled trial. Medical Journal of Australia. 2007;187(6):337-341.
