Hijama (cupping): a review of the evidence

The impact of wet cupping on haematological and inflammatory parameters in a sample of Jordanian team players

Background/objective

The practice of complementary and alternative medicine has significantly gained acceptance worldwide, such as Al-Hijama, also known as cupping therapy. Despite the growing popularity of therapeutic cupping among athletes, little is known about the impact of cupping therapy on sports fields. The current study was designed to explore the effect of wet cupping therapy on the haematological and inflammatory parameters in Jordanian national team players.

Methods

The procedure was carried out at a specialized centre for cupping in Amman on the morning of the 19th Rajab. The data were obtained from 14 healthy male participants aged between 21 and 22 years. The haematological and inflammatory parameters were assessed by comparing venous blood components before and after four weeks of wet cupping.

Results

Complete blood count (CBC) analysis of venous blood samples four weeks after wet cupping showed a significant increase in the values of total white blood cells (WBCs), neutrophils, lymphocytes, red blood cells (RBCs), haematocrit, and haemoglobin as compared with venous blood samples before cupping. Blood film examination of venous blood samples post-cupping revealed normocytic normochromic RBCs; WBCs and platelets were unremarkable. Analysis of inflammatory markers post cupping showed a significant decrease in the monocyte/lymphocyte ratio (MLR) and platelet/lymphocyte ratio (PLR) but no differences in neutrophil/lymphocyte ratio (NLR).

Conclusion

The findings of this study suggest that wet cupping has an indispensable influence on haematological and immunological parameters in athletes, where it reinforces cellular immunity, generates younger blood cells, and reduces inflammation markers. It is probable, therefore, that cupping improves sports performance and achievement. The evidence from this research adds to a growing body of literature on cupping therapy in sports.

Exploring Integrative Approaches: Insights Into Complementary Medicine Practices Among Breast Cancer Survivors in Saudi Arabia

OBJECTIVES

Complementary and integrative medicine (CAM) is a prevalent approach often used with conventional medical practices The study aims to understand the factors influencing breast cancer (BC) survivors' decisions regarding CAM therapy and the drivers behind their use.

SETTING

This research was conducted at an academic hospital in Saudi Arabia. The study used cross-sectional research with a questionnaire. Participants were enrolled in the study through BC survivors' groups on WhatsApp. Individuals who were actively following up at the clinic were also interviewed. Informed consent was obtained.

RESULTS

The study surveyed 211 BC survivors, aged 34-49 (50.2%), who had undergone surgery (93.4%), hormonal therapy (66.4%), and chemotherapy (87.7%). Less than half (44.5%) had chronic conditions such as diabetes and hypertension. CAM users were 43.6%. The most used CAM modalities were Zamzam water, honey, and water read-upon Quran. A significant motivator for CAM use was to boost the immune system. More than half of patients used less than 100 SAR per month on CAM modalities. Exactly 80.4% of CAM users perceived benefits from CAM use. Predictors of CAM use included higher family monthly income, radiation therapy, and being diagnosed from 1 to 5 years. BC survivors without medical conditions after diagnosis were less likely to use CAM.

CONCLUSION

The study highlights the prevalence, predictive factors, motivations, and perceived benefits of CAM use among BC survivors in Saudi Arabia, emphasizing the need for understanding and integration into cancer care plans and the need for further research on CAM safety and efficacy.

Prevalence, types and disclosure of complementary and alternative medicine (CAM) use among chronic kidney disease (CKD) patients in Saudi Arabia

INTRODUCTION

Despite the paucity of scientific evidence, CAM is widely used for the prevention and treatment of illness among patients with chronic kidney disease, including end-stage renal disease and kidney transplant recipients. It is evident that the irrational use of CAM among CKD patients and its non-disclosure to healthcare providers could lead to adverse drug events. Hence, the current study was conducted to evaluate the prevalence, types, and non-disclosure of CAM use among CKD patients and kidney transplant recipients in Saudi Arabia.

METHODS

A cross-sectional study was conducted on 170 CKD patients (121 with stages 3 and 4, two with stage 5 and on hemodialysis, and 47 kidney transplant recipients). Face-to-face questionnaire-based interviews were conducted employing a convenience sampling technique. The study outcomes were the prevalence of CAM, types of CAM use, monthly expenditure on CAM, the source of information about CAM, and CAM disclosure to healthcare providers. A p-value of < 0.05 was considered significant.

RESULTS

The study found that out of 170, 60 (35.3%) CKD patients use CAM. The most used CAM was Acacia gum (49, 81.6%) followed by spiritual therapies (34, 56.6%). Female CKD patients had higher use of CAM compared to the male gender (p = 0.015). The monthly expenditures that most users (47, 78.3%) spent on CAM were less than 50 Saudi Riyals (SR). The study results also showed that 55% of CKD patients did not report their CAM use to their physicians. Furthermore, 46.6% of CAM users discontinue their use of CAM after observing no benefit.

CONCLUSION

This study reported relatively high use of CAM among CKD patients in Saudi Arabia. The study found that most CKD patients use Acacia gum and spiritual therapies and do not disclose the use of CAM to healthcare professionals, which could lead to adverse drug events. Therefore, the study recommends that healthcare providers should inquire and provide evidence-based counselling about the use of CAM to CKD patients to prevent any adverse drug event or unwanted effect on the renal function of the patients.

Wet Cupping-Traditional Hijamah Technique versus Asian Cupping Technique in Chronic Low Back Pain Patients: A Pilot Randomized Clinical Trial

To evaluate the feasibility of comparing the effect of the traditional Hijamah and the Asian wet cupping techniques in the management of patients with chronic low back pain (CLBP), a randomized clinical trial comparing traditional and Asian wet cupping techniques for CLBP was conducted in two secondary care hospitals in Saudi Arabia. Seventy eligible participants with CLBP were randomized to receive one session of wet cupping using either Asian technique (34 patients) or traditional Hijamah technique (36 patients). Cupping was performed at four sites of the bilateral bladder meridian (BL23, BL24, and BL25). The numeric rating scale, Present Pain Intensity, and Oswestry Disability Questionnaire scores were measured immediately after intervention, at seven days, and 14 days after intervention. In both groups, there was a significant decrease in the numeric rating scale, Present Pain Intensity, and Oswestry Disability Questionnaire scores, immediately after intervention, at seven days, and 14 days after intervention. However, there was no significant difference between the two groups across all the outcome measures up to 14 days after intervention. The study did not show a superiority of one technique compared with the other. Longer follow-up periods and more than one cupping session may be needed to evaluate the difference, if any, between both the techniques. TRIAL REGISTRATION: NCT02012205.

Posttraining Knowledge Retention among Licensed Cupping Providers in Saudi Arabia

BACKGROUND

One of the licensing requirements for cupping providers in Saudi Arabia is to attend a compulsory training course that lasts 5 days for non-physicians and 4 days for physicians, irrespective of any previous experience in cupping therapy. The course is conducted by the National Center of Complementary and Alternative Medicine (NCCAM/MOH). As a part of course auditing, the current study aimed to evaluate knowledge retention among licensed cupping providers 1-3 years after passing the official cupping course.

METHODS

Licensed cupping providers were invited to attend a continuing medical education activity. Sixty-two attended the continuing medical education activity. Before the event, participants were asked to answer 35 multiple-choice questions taken from the same data bank as the pretest and posttest of the course. The test scores were linked and compared with the pre- and posttest of the training course.

RESULTS

A paired t test showed significant differences between the pre- and posttest knowledge scores (mean difference: 224.6 ± 86, p = 0.0001) and between the posttest and follow-up knowledge scores (mean difference: -115.26 ± 103.9, p = 0.0001). The follow-up score was still significantly higher than the pretest score, with a mean difference of 112 (95% CI: 83.66-140.34, p = 0.0001). There was no significant effect of category (physician vs. non-physician) on knowledge retention after controlling for the postcourse score. Gender, the total duration of experience, and total years of experience in cupping did not affect knowledge score retention between the physicians and the non-physicians.

CONCLUSION

The official cupping training course of the NCCAM/MOH achieved reasonable knowledge retention. To achieve long-term knowledge retention, refresher training/courses and continuous professional development will be required.

Wet cupping for hypertension: a systematic review and meta-analysis

To assess the efficacy and safety of wet cupping in adults with hypertension, we conducted a systematic review and meta-analysis using 13 databases. Wet cupping alone or in combination with antihypertensive medication or acupuncture was used. Seven randomized trials were included, most not of high methodological quality. A few small studies suggested that wet cupping alone versus antihypertensive medication significantly reduced blood pressure and Traditional Chinese Medicine syndrome (hypertension-related symptoms). However based on current evidence, no firm conclusions can be drawn and no clinical recommendations made. Research projects included need validation. Studies indicate that wet cupping is a safe therapy.

Cupping therapy in Saudi Arabia: from control to integration

Cupping therapy or Hijamah is a leading traditional practice after spiritual healings and herbal medicine in Saudi Arabia. Wet cupping is by far the most common type of cupping therapy. Hijamah in Saudi Arabia and other Muslim countries is a model of religious influences, interconnectivity, and cross-cultural influences between different civilizations. Accordingly, differentiating the cupping practiced in Saudi Arabia, and other Muslims societies from that practiced in other countries like China, by Korea only by the technique or cupping sites is an underestimation of the differences. In Saudi Arabia, the profile or characteristics of cupping therapy user is distinct from the profile of other traditional medicine users by being more educated, with higher job rank and not affected by nationality or gender. After an era of unregulated practice, cupping therapy is currently regulated and monitored by the National Center for Complementary and Alternative Medicine in the Ministry of Health (NCCAM/MOH) of Saudi Arabia. Regulations and licensing include practitioners, practice place, and cupping equipment. After regulation, cupping is mainly offered by the private sector and paid directly by the client as insurance does not cover it. In the private sector, licensed cupping service is usually provided as a parallel and not an integrated service. However, there are few models of integrated cupping clinic in universities, academic institutions, and governmental hospitals. Further health system research is needed to develop more models of integrated cupping service pending for the healthcare transformation which is going on in Saudi Arabia.

Cupping therapy for treating ankylosing spondylitis: The evidence from systematic review and meta-analysis

OBJECTIVE

Cupping therapy has been widely used in Eastern Asia, the Middle East, or Central and North Europe to manage the symptom of ankylosing spondylitis (AS). The aim of this systematic review was to review data from randomized controlled trials (RCTs) of cupping therapy for treating patients with AS.

METHODS

Databases that were searched from their inception until December 2017 included: MEDLINE, CINAHL, EMBASE, AMED, Cochrane Central Register of Controlled Trials, four Chinese databases [Chinese BioMedical Database, China National Knowledge Infrastructure, Wan-Fang Data, and the Chinese WeiPu Database], KoreaMed, The Korean National Assembly Library, Japana Centra Revuo Medicina (http://www.jamas.gr.jp/) and CiNii. In this systematic review, only RCTs that were related to the effects of cupping therapy on managing AS were included. A quantitative synthesis of RCTs will be conducted using RevMan 5.3 software. Study selection, data extraction, and validation were performed independently by two reviewers. Quantitative analysis of RCTs were performed using RevMan 5.3 software, and cochrane criteria for risk-of-bias were used to assess the methodological quality of the trials.

RESULTS

A total of 5 RCTs met the inclusion criteria, and most were of low methodological quality. Participants in cupping therapy plus Western medicine group showed significantly greater improvements in the response rate [RR = 1.13, 95%CI (1.06, 1.22), p < 0.01] with low heterogeneity (Chi² = 2.88, p = 0.41, I² = 0%). Moreover, when compared with western medicine alone, meta-analysis indicated favorable statistically significant effects of cupping therapy plus western medicine on the Bath Ankylosing Spondylitis Functional Index (BASFI) [MD = -16.63, 95%CI (-17.75, -15.51), p < 0.01] and Bath Ankylosing Disease Activity Index (BASDAI) [MD = -9.93, 95%CI (-10.34, -9.52), p < 0.01], with low heterogeneity (Chi² = 0.32, p = 0.85, I² = 0% in BASFI; (Chi² = 2.46, p = 0.29, I² = 19% in BASDAI). Furthermore, when compared with western medicine alone, meta-analysis demonstrated statistically significant effects of cupping therapy plus western medicine on the serum level of ESR [MD = -1.28, 95% CI (-1.44, -1.13), p < 0.01] and the serum level of CRP [MD = -3.97, 95%CI (-4.71, -3.22), p < 0.01], with low heterogeneity (Chi² = 0.50, p = 0.78, I² = 0% in the serum level of ESR; Chi² = 0.19, p = 0.91, I² = 0% in the serum level of CRP).

CONCLUSION

Taken together, only weak evidence supported the hypothesis that cupping therapy had potential benefits for patients with AS.

The medical perspective of cupping therapy: Effects and mechanisms of action

Cupping Therapy (CT) is an ancient method and currently used in the treatment of a broad range of medical conditions. Nonetheless the mechanism of action of (CT) is not fully understood. This review aimed to identify possible mechanisms of action of (CT) from modern medicine perspective and offer possible explanations of its effects. English literature in PubMed, Cochrane Library and Google Scholar was searched using key words. Only 223 articles identified, 149 records screened, and 74 articles excluded for irrelevancy. Only 75 full-text articles were assessed for eligibility, included studies in this review were 64. Six theories have been suggested to explain the effects produced by cupping therapy. Pain reduction and changes in biomechanical properties of the skin could be explained by "Pain-Gate Theory", "Diffuse Noxious Inhibitory Controls" and "Reflex zone theory". Muscle relaxation, changes in local tissue structures and increase in blood circulation might be explained by "Nitric Oxide theory". Immunological effects and hormonal adjustments might be attributed to "Activation of immune system theory". Releasing of toxins and removal of wastes and heavy metals might be explained by "Blood Detoxification Theory". These theories may overlap or work interchangeably to produce various therapeutic effects in specific ailments and diseases. Apparently, no single theory exists to explain the whole effects of cupping. Further researches are needed to support or refute the aforesaid theories, and also develop innovative conceptualizations of (CT) in future.

Cupping therapy for treating knee osteoarthritis: The evidence from systematic review and meta-analysis

OBJECTIVE

Cupping therapy is widely used in East Asia, the Middle East, or Central and North Europe to manage the symptom of knee osteoarthritis (KOA). The purpose of this systematic review was to evaluate the available evidence from randomized controlled trials (RCTs) of cupping therapy for treating patients with KOA.

METHODS

The following databases were searched from their inception until January 2017: PubMed, Embase, the Cochrane Central Register of Controlled Trials and four Chinese databases [WanFang Med Database, Chinese BioMedical Database, Chinese WeiPu Database, and China National Knowledge Infrastructure (CNKI)]. Only the RCTs related to the effects of cupping therapy on KOA were included in this systematic review. A quantitative synthesis of RCTs will be conducted using RevMan 5.3 software. Study selection, data extraction, and validation was performed independently by two reviewers. Cochrane criteria for risk-of-bias were used to assess the methodological quality of the trials.

RESULTS

Seven RCTs met the inclusion criteria, and most were of low methodological quality. Study participants in the dry cupping therapy plus the Western medicine therapy group showed significantly greater improvements in the pain [MD = -1.01, 95%CI (-1.61, -0.41), p < 0.01], stiffness [MD = -0.81, 95%CI (-1.14, -0.48), p < 0.01] and physical function [MD = -5.53, 95%CI (-8.58, -2.47), p < 0.01] domains of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) compared to participants in the Western medicine therapy group, with low heterogeneity (Chi² = 0.00 p = 1.00, I² = 0% in pain; Chi² = 0.45 p = 0.50, I² = 0% in stiffness; Chi² = 1.09 p = 0.30, I² = 9% in physical function). However, it failed to do so on a Visual Analog Scale (VAS) [MD = -0.32, 95%CI (-0.70, 0.05), p = 0.09]. In addition, when compared with Western medicine therapy alone, meta-analysis of four RCTs suggested favorable statistically significant effects of wet cupping therapy plus western medicine on response rate [MD = 1.06, 95%CI (1.01, 1.12), p = 0.03; heterogeneity: Chi² = 1.13, p = 0.77, I² = 0%] and Lequesne Algofunctional Index (LAI) [MD = -2.74, 95%CI (-3.41, -2.07), p < 0.01; heterogeneity: Chi² = 2.03, p = 0.57, I² = 0% ].

CONCLUSION

Only weak evidence can support the hypothesis that cupping therapy can effectively improve the treatment efficacy and physical function in patients with KOA.

The prevalence extent of Complementary and Alternative Medicine (CAM) use among Saudis

Introduction: There is worldwide interest in the use of CAM. Studying CAM in Saudi population is important as it will reflect the influence of psychosocial, cultural and religious factors on health beliefs and behaviors. The objective of this study was to present an updated review on the use of CAM practices in Saudi Arabia including commonly used types, common conditions for which it has been used and who uses CAM. Methods: This review used data from national surveys conducted in Saudi Arabia and published between 2000 and 2015. The literature search was performed considering standards adopted such as Moose guidelines for observational studies. Two authors independently reviewed each article. The search yielded 73 articles, and a total of 36 articles were included. Further careful data extraction was carried out by two independents reviewers. Results: Most of the reviewed studies were cross-sectional in design and were published between 2014 and 2015, and mostly in Riyadh region. Substantial difference in the findings for the patterns of CAM use was revealed. The most commonly employed practice was of spiritual type such as prayer and reciting Quran alone or on water. Other types include herbs (8-76%), honey (14-73%) and dietary products (6-82%). Cupping (Alhijamah) was least used (4-45%). Acupuncture was more practiced among professionals. Conclusion: The utilization of CAM is widely practiced in Saudi Arabia. There is need for efforts to promote research in the field of CAM to address each practice individually. Population surveys should be encouraged supported by mass media to raise knowledge and awareness about the practice of different CAM modalities. The national center of CAM should play a major role in these efforts.

Risk factor analysis of hepatitis C virus seropositivity in Iranian blood donors: a case-control study

BACKGROUND

Due to blood screening and blood donor selection, the prevalence of hepatitis C virus (HCV) is expected to be lower among blood donors compared to the general population. The effective control of blood-transmitted infectious diseases should be one of the goals of public health. Thus, this case-control study was conducted to evaluate the risk factors of HCV in a representative sample of blood donors in Iran.

STUDY DESIGN AND METHODS

A case-control study was conducted on HCV-negative and on serologically confirmed HCV-positive donors across the country from 2009 to 2013. Univariate logistic regression, multiple logistic regression, and subgroup analyses were performed to assess the risk factors in first-time blood donors (FTs) and repeat blood donors (RDs) independently.

RESULTS

A total of 970 cases and 1542 controls were selected from the cohort of Iranian blood donors registered in the Iran Blood Transfusion Organization. Intravenous (IV) drug abuse (ORFT , 6.42; 95% CI, 3.34-12.34; and ORRD , 27.62; 95% CI, 12.58-60.62), living with an IV drug abuser (ORFT , 3.47; 95% CI, 1.26-9.55; and ORRD , 6.95; 95% CI, 1.54-31.34), prison history (ORFT , 2.4; 95% CI, 1.48-3.88; and ORRD , 2.42; 95% CI, 1.38-4.27), sharing personal razors (ORFT , 2.00; 95% CI, 1.01-3.96; and ORRD , 5.62; 95% CI, 2.65-11.89), and medical exposure (ORFT , 1.97; 95% CI, 1.15-3.37; and ORRD , 2.19; 95% CI, 1.27-3.76) were significant independent risk factors in both types of blood donation.

CONCLUSION

The findings of this analytic study on HCV exposure in Iranian blood donors conforms to those of international studies. Behavioral and medical factors should be examined in the donor health screening process.

Translation, cross-cultural adaptation and psychometric properties of the Back Beliefs Questionnaire in Modern Standard Arabic

Purpose To translate and cross-culturally adapt the Back Beliefs Questionnaire (BBQ) into modern standard Arabic and examine its validity, acceptability and reliability in Arabic-speaking patients with low back pain (LBP). Method The BBQ was forward, back-translated and reviewed by an expert committee. Seventeen bilingual patients completed Arabic and English BBQs. LBP patients (n = 199) completed the Arabic BBQ. Sixty-four repeated it a week later, and 151 completed the Arabic Fear-avoidance Beliefs Questionnaire (FABQ). Results The expert committee followed advice from the developers to maintain Arabic equivalence of "back trouble(s)". Patients found the questionnaire comprehensible and acceptable. Agreement between the English and Arabic versions of the BBQ was acceptable, ICC =  0.65 (0.25-0.86). Most item-by-item agreement ranged from fair to moderate (K = 0.12-0.54). Mean (SD) of BBQ, FABQ total, work and physical activity subscales were 25.31(6.13), 44.76(19.49), 21.17(10.10) and 13.95(6.65). The BBQ correlated with the FABQ at r = -0.33, work subscale r = -0.29 and physical activity r = -0.30 (all p < 0.01). Cronbach's α = 0.73 indicated high internal consistency. Test-retest reliability was high, ICC = 0.80 (0.68-0.87). Item-by-item agreement ranged from fair to acceptable (K = 0.31-0.66). Conclusions The Arabic BBQ has good comprehensibility and acceptability, acceptable agreement with the English BBQ, high internal consistency and test-retest reliability. We recommend its use with Arabic-speaking LBP patient to determine their beliefs and attitudes about their back pain, as they have been shown to be important predictors of persistent LBP disability. Implications for Rehabilitation There are limited valid and reliable outcome measures for back pain in Arabic. The Back Beliefs Questionnaire (BBQ) is a tool that measures attitudes and beliefs about back pain. We recommend the use of our valid and reliable, translated and cross-culturally adapted tool with Arabic-speaking patients. The tool can measure attitudes and beliefs concerning the future consequences of LBP, with regards to recovery and return to work in this sample. Findings will improve back pain management options aimed at reducing back pain disability though challenging and modifying beliefs in the Middle East or with migrant populations in the West.

Cupping therapy: A prudent remedy for a plethora of medical ailments

Since ancient times, complementary and alternative medicine (CAM; bǔ chōng yǔ tì dài yī xué) have played an important role in human health and welfare. Many therapeutic approaches in healthcare outside the realm of conventional medicine persist in various parts of the world. There is considerable scientific and commercial potential in CAM, which needs to be explored precisely. Cupping therapy ( bá guàn liáo fǎ), one of the CAM, is practiced across the world. This therapy is believed to act by correcting imbalances in the internal bio field, such as by restoring the flow of "Qi (qì)". Cupping involves applying a heated cup to generate a partial vacuum that mobilizes the blood flow and promotes effective healing. This review outlines various tools and techniques of cupping therapy.

The Use of Wet Cupping for Persistent Nonspecific Low Back Pain: Randomized Controlled Clinical Trial

Objectives: To evaluate the effectiveness and safety of wet cupping therapy as a single treatment for persistent nonspecific low back pain (PNSLBP).

Design: Randomized controlled trial comparing wet cupping versus no treatment in PNSLBP.

Setting: Outpatient clinic in three secondary care hospitals in Saudi Arabia.

Patients: Eighty eligible participants with PNSLBP for at least 3 months were randomly allocated to an intervention group (n=40) or to a control group (n=40).

Interventions: Six wet cupping sessions within 2 weeks, each of which were done at two bladder meridian (BL) acupuncture points among BL23, BL24, and BL25. Only acetaminophen was allowed as a rescue treatment in both groups.

Outcome measures: The Numeric Rating Scale (NRS), McGill Present Pain Intensity (PPI), and Oswestry Disability Questionnaire (ODQ) were used as outcome measures. Numbers of acetaminophen tablets taken were compared at 4 weeks from baseline. Adverse events were recorded.

Results: At the end of the intervention, statistically significant differences in the three outcome measures favoring the wet cupping group compared with the control group were seen: NRS score, 29.2 (95% confidence interval [CI], 24.6–33.8) versus 57.9 (95% CI, 53.3–62.6), respectively; PPI score, 1.17 (95% CI, 0.96–1.4) versus 2.3 (95% CI, 2.1– 2.7); and ODQ score, 19.6 (95% CI, 16.5–22.7) versus 35.4 (95% CI, 32.3–38.5) (p=0.0001). This improvement continued for another 2 weeks after the end of the intervention. Acetaminophen was used less in the wet cupping group, but this difference was not statistically significant. No adverse events were reported.

Conclusions: Wet cupping is potentially effective in reducing pain and improving disability associated with PNSLBP at least for 2 weeks after the end of the wet cupping period. Placebo-controlled trials are needed.

Treatment of psoriasis by using Hijamah: A case report

Hijamah (a well-known Prophetic complimentary treatment) has been used for centuries to treat various human diseases. It is considered that this traditional treatment (also known as wet cupping) has the potential to treat many kinds of diseases. It is performed by creating a vacuum on the skin by using a cup to collect the stagnant blood in that particular area. The vacuum at the end is released by removing the cup. Superficial skin scarification is then made to draw the blood stagnation out of the body. This technique needs to be performed in aseptic conditions by a well trained Hijamah-physician. Prophet Muhammad (PBUH) had described Hijamah as the best treatment humans can have. This novel treatment methodology has been successfully used as cure for numerous diseases including skin diseases. In this case report, we discuss about the application of this method in the treatment of psoriasis (an autoimmune skin disease). Results illustrated that with Hijamah, disease can not only be controlled but can be brought to a nearly complete remission.