American Society of Hirudotherapy

Alternative Non-Drug Treatment Options of the Most Neglected Parasitic Disease Cutaneous Leishmaniasis: A Narrative Review

Review published in Trop Med Infect Dis (2023)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical TrialsSafety & Infection ControlDrug DevelopmentOrabi MAA et al. · Tropical medicine and infectious disease, 2023

Abstract

With more than 12 million cases worldwide, leishmaniasis is one of the top 10 neglected tropical diseases. According to the WHO, there are approximately 2 million new cases each year in foci in around 90 countries, of which 1.5 million are cutaneous leishmaniasis (CL). Cutaneous leishmaniasis (CL) is a complex cutaneous condition that is caused by a variety of Leishmania species, including L. (Leishmania) major, L. (L) tropica, L. (L) aethiopica, L. (L) mexicana, L. (Viannia) braziliensis, and L. (L) amazonensis. The disease imposes a significant burden on those who are affected since it typically results in disfiguring scars and extreme social stigma. There are no vaccines or preventive treatments available, and chemotherapeutic medications, including antimonials, amphotericin B, miltefosine, paromomycin, pentamidine, and antifungal medications, have a high price tag, a significant risk of developing drug resistance, and a variety of systemic toxicities. To work around these limitations, researchers are continuously looking for brand-new medications and other forms of therapy. To avoid toxicity with systemic medication use, high cure rates have been observed using local therapy techniques such as cryotherapy, photodynamic therapy, and thermotherapy, in addition to some forms of traditional therapies, including leech and cauterization therapies. These CL therapeutic strategies are emphasized and assessed in this review to help with the process of locating the appropriate species-specific medicines with fewer side effects, lower costs, and elevated cure rates.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview

Summary

Narrative review of non-drug treatments for cutaneous leishmaniasis including leech therapy alongside cryotherapy, photodynamic therapy, and thermotherapy. Discusses traditional therapies in the context of drug-resistant cutaneous leishmaniasis.

Why This Matters for Hirudotherapy

This review assessed treatment options for cutaneous leishmaniasis, covering both systemic chemotherapeutic medications (antimonials, amphotericin B, miltefosine, paromomycin, pentamidine, antifungals) and local and traditional therapies including cryotherapy, photodynamic therapy, thermotherapy, leech therapy, and cauterization. The abstract states that high cure rates have been observed using local therapy techniques alongside traditional therapies including leech and cauterization therapies, presented as alternatives to avoid systemic toxicity. For ASH, the relevance is limited: leech therapy is listed as one traditional modality reportedly associated with high cure rates for CL, but no species-specific protocol, mechanism, safety, or outcome data are provided.

Citation

Alternative Non-Drug Treatment Options of the Most Neglected Parasitic Disease Cutaneous Leishmaniasis: A Narrative Review.

Orabi MAA et al. · Tropical medicine and infectious disease, 2023

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.