Expert Insight: A Traditional Chinese Doctor’s Take On Acupuncture Bruises


Reviewed & Fact-Checked By

Dr. Mengfei (Devin) Yuan

Mengfei (Devin) Yuan is a Professor at Fundación Europea de Medicina Tradicional China in the Tarragona Area of Spain. He has served as a Doctor of Medicine in the foundation for over 5 years.

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Are you curious about the mystery behind acupuncture bruises? Welcome to our interview with a traditional Chinese doctor! We dive into the world of acupuncture and talk about the mysterious bruises that sometimes appear after treatment.

From causes to prevention methods and recovery time, our expert shares their knowledge on the topic, giving you a better understanding of what to expect when getting acupuncture. So sit back, relax, and get ready to become an acupuncture pro!

An Interview with Dr. Yuan

We had the absolute pleasure of sitting down with acupuncturist Dr. Yuan, a veritable storehouse of knowledge on traditional Chinese medicine (TCM) and acupuncture. We picked his brains about acupuncture bruises (yes, they can happen!), and here’s what we found out.

 An Explanation of Acupuncture Bruises

  •  Why do acupuncture bruises occur and how are they different from other forms of bruising?

 Answer: The whole science of acupuncture is founded on the stimulation of certain acupressure points on the body using extremely tiny needles. These needles stimulate the points by piercing the skin, causing the body’s self-healing reflexes to kick in and take over. Sometimes, depending on the expertise of the acupuncturist, these extremely fine needles can penetrate tiny blood vessels, which burst and form minor bruises in the area.

Compared to other bruises, an acupuncture bruise is smaller, recovers faster, and doesn’t come with any of the secondary symptoms that other bruises come with, such as inflammation, swelling, and limitation of movement. These bruises are also typically painless; apart from when you spot them in the mirror, you probably won’t even realize you have these!

  • Is bruising from acupuncture a good thing?

 Answer: Though soreness after a session with your acupuncturist is perfectly normal and doesn’t warrant concern, bruising is uncommon unless you’re taking medication, like blood thinners, that leads to easy bruising, or you’ve got generally sensitive skin. Bruising from acupuncture is not a good thing but if your bruise isn’t troubling you, you don’t need to worry. Any bruise that’s extremely painful or lasts longer than it should, should be looked at by your acupuncturist.

 What Causes Bruising and How Can It Be Avoided?

  • What are some of the most common reasons that cause bruising after acupuncture and how can these be prevented?

 Answer: In my opinion, an acupuncture bruise occurs because of the depth to which the needle is inserted and the stimulation or manipulation that it results in. Acupuncture needles are generally inserted about a quarter to a half inch below the uppermost layer of your skin, but this can go deeper depending on the location and the condition you’re treating. An acupuncture bruise can be prevented only by your acupuncturist! He or she needs to be gentle around the area they’re working on. In case of any bleeding after the needles are removed, gentle pressure should be applied with a pledget to the bleeding points for about three or five minutes. This should stop the bleeding; if it doesn’t, an ice bag may be placed over the bleeding points. After an acupuncture session, the customer should avoid hot showers and exercise, and rest adequately to prevent any further bleeding.

  • How can the risk of bruising be reduced and how long does recovery take?

Answer: Your acupuncturist may be able to adjust the pressure and be gentler in future sessions to prevent bruising. They may also switch to finer needles. These two measures are typically enough to reduce the risk of bruising. In severe cases, non-intrusive methods may be employed instead to achieve the required healing. This is also why we recommend that patients don’t drink alcohol before a treatment session. Alcohol can thin the blood, which, in turn, can cause bruising more easily. How long recovery takes depends purely on a person’s body.

Bruise Location and Treatment

Photo by Katherine Hanlon on Unsplash
  • Is bruising under the toenail after an acupuncture session normal? Can this be treated?

Answer: A bruise under the toenail isn’t normal, as this part has lesser blood vessels than other parts of the body. Additionally, acupuncture on acupoints near the toenail can result in intense pain for patients, so we typically avoid using them.

  • Do bone bruises occur during acupuncture, and if yes, how are they treated?

Answer: Acupuncture can’t cause bruising on the bone.

  • How are bruises caused by acupuncture needles treated?

Answer: As I had mentioned, acupuncture needles can sometimes inevitably puncture small capillaries and cause bleeding and bruising. These are best left to recover on their own and should disappear within a few days without any intervention.

  •  Is bruising on the face after facial acupuncture normal, and why does it happen?

 Answer: The human face is full of blood vessels, and this should be enough of an answer! The tissue on the face is more delicate than the tissue on other parts of the body and has more blood vessels, too. This means that the chances of mistakenly causing bruising with needles are higher.

  • What happens if the needles hit a vein?

Answer: Hitting a vein isn’t an easy task and acupuncturists also know to avoid veins. It’s quite rare when an acupuncturist hits a vein. Hitting a vein will cause the blood to gush out, just as when syringes are used to withdraw blood. You’ll probably feel a pinching sensation, and any bleeding will be stopped by your acupuncturist removing the needle immediately and applying pressure to the area to staunch the blood flow.

  • What happens if the needles hit a nerve?

 Answer: Though it may sometimes feel like your nerve’s being pierced (you know, that jittery, shooting feeling that runs down the length of your leg or arm!), it’s nearly impossible to pierce a nerve with an acupuncture needle. The needles used for acupuncture are extremely tiny and lack the strength required to penetrate our nerves, as these are covered by thick coats, much like TV cables. Pushing these delicate needles into a nerve will actually take quite a bit of effort! As I said, acupuncturists are also trained to avoid nerves and veins, so the chances of hitting either are extremely low—unless your acupuncturist isn’t trained well enough.

  • How are bruises caused after fertility acupuncture treatments?

 Answer: To treat patients for infertility with acupuncture, pressure points on the abdomen are worked on to improve blood flow to the reproductive organs and balance hormones. The skin here is tender just like the face, which means that there’s an increased risk of damaged capillaries, bleeding, and bruising.

  •  How do you treat a bruise from acupuncture needles inserted into the stomach?

Answer: With bruises on the stomach, I assess the bruise’s size and color and check how much discomfort it’s causing the patient. If the bruise is light-colored, doesn’t cause any discomfort, or causes only little discomfort, and is smaller than the size of a coin, I leave it alone—such bruises don’t need to be treated specially and will disappear on their own.

  •  Can acupuncture cause a hematoma?

 Answer: To form a hematoma, a broken blood vessel needs to form a pool of clotted blood in some body part, tissue, or organ. I wouldn’t say it’s an impossibility because there are currently six documented cases of post-acupuncture spinal epidural hematoma (paSEH), caused by acupuncture treatment on the back.

However, compared to the many acupuncture treatment cases out there, six is as close to impossible as it gets. Avoiding the use of very thin needles on the back and epidural space will reduce the risk of spinal hematoma, as extremely thin needles can cause bleeding (even venous) in the area.

 Bruise Recovery

  • How long do acupuncture bruises last?

 Answer: Depending on the person’s blood circulation, the acupuncture bruise may disappear in a few days or last several. The lesser the blood circulation, the lower the chances of bruising, but once bruising occurs, good circulation is what will help clear trapped blood from underneath the skin and reduce the visibility of the bruise. Applying heat to the area is a good way to get your circulation going.

Some bruises may last up to two weeks, as observed in our clinic.

  • Is it normal to see bruises even after a week?

 Answer: Absolutely. What isn’t normal, though, is the bruise not fading or lightening with each passing day. I recommend that patients with bruises wait it out for two weeks and if the acupuncture bruise hasn’t considerably lightened by then, I suggest that they get the bruise examined and treated, if necessary, by a doctor.

  • What does a painful bruise mean?

 Answer: A painful bruise can mean two things. The first is that it needs medical attention and special treatment, which is very rare. The second is that your acupuncture session worked and your point is getting activated. In addition to this, you may feel electric or heavy sensations. It may also seem like your bruise (and other acupuncture points) are emitting heat.

 However, you shouldn’t feel any sort of sharp or severe pain. Such pain, during and after your session, warrants the attention of your acupuncturist.

 The Bottom Line

If post-acupuncture bruises were worrying you, we hope this conversation enlightened you as much as it did us and cleared the mystery behind these marks. Being vocal with your acupuncturist will help you find the treatment that works best for you and avoid bruises.

Author: P. Sze

P. Sze P. Sze is the founder of TCM Tips and Dragon Acupuncture®. She graduated from the National University of Singapore with a first-class honor in Civil Engineering. S he also holds a master’s degree in Engineering and is the brain behind the innovative TCM products of Dragon Acupuncture®. She is the author of The Beginner's Guide to Auricular Therapy: Application of Ear Seeds (ISBN 978-1520451398) and Facial Gua Sha - Fight the Signs of Aging Naturally and Inexpensively (ISBN 978-1980678922). She has dedicated her life to ensuring that the complex theories behind oriental medicine and the seemingly dangerous techniques that involve needles and fire do not scare you from trying oriental medicine. This is why she writes endlessly about acupressure and its countless health and wellness benefits.

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