Clinical Efficacy of Leech Therapy (Ta'līq al-'Alaq) in Eczema (Nār Fārsī): An Open-Label Single-Arm Clinical Study

BACKGROUND: Eczema, known as Nār Fārsī in Unani medicine, is a chronic skin disorder characterized by intense pruritus, dryness, and scaling of skin, along with periodic flares and remissions. Unani literature recognizes it as a disorder caused by safrāwī (bilious) humor. Conventional treatment relies on emollients, humectants, and anti-inflammatory drugs. Unani medicine recommends the expulsion of morbid matter by local blood-letting or oral therapies. Leech therapy, used in many traditional medicine systems for centuries, is a method of expulsion of morbid humors from a disease site. It is prescribed for diseases of joints, skin, the nervous system, etc. Contemporary research has identified many bioactive enzymes and proteins in leech saliva that have anti-inflammatory, analgesic, vasodilatory, antimicrobial, and many other effects. PRIMARY STUDY OBJECTIVE: This study aimed to assess the efficacy and safety of leech therapy in eczema patients based on standard parameters. METHODS: An open-label, single-arm clinical study was conducted on 20 patients diagnosed with eczema. INTERVENTION: Four sessions of leech therapy were carried out with a one-week gap in between. PRIMARY OUTCOME MEASURES: The effectiveness of leech therapy was assessed using the Eczema Area and Severity Index (EASI) Score. RESULTS: Statistically significant improvement was observed in the severity of eczema, as reflected in the EASI Score parameters, i.e., redness (P = .0001), edema (P = .0001), excoriation (P = .0022), and lichenification (P = .0001). However, the decrease in total area involved was not statistically significant (P = .24). CONCLUSION: Leech therapy was found to be safe and effective in relieving the severity of eczema. All patients expressed satisfaction with the treatment, without any drop-outs, indicating excellent adherence to the therapy. With further research, leech therapy may provide positive outcomes in eczema in clinical settings, providing relief to the suffering patients.

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In an open-label, single-arm study, 20 eczema patients received four leech therapy sessions, and Eczema Area and Severity Index measures of redness, edema, excoriation, and lichenification improved significantly, though affected area did not.

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