American Society of Hirudotherapy

Leech therapy in cutaneous surgery and disease

Review and case series published in J Drugs Dermatol (2010)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical TrialsSafety & Infection ControlMamelak AJ et al. · Journal of drugs in dermatology, 2010

Abstract

BACKGROUND: Over the ages, the use of leeches in medicine has evolved from haphazard bloodletting to a well-understood physiologic process with defined, rational applications. OBJECTIVE: The authors describe the current role of leech therapy in cutaneous surgery and medicine. METHODS: Case series and review of the literature. RESULTS: Leech saliva contains anticoagulative, anti-aggregative and vasodilatory components. Combined with the annelid's mechanical ability to extract blood, leeches can contribute to patients' health with minimal risks. CONCLUSION: Leeches should be considered as novel therapies for disorders of coagulation and venous congestion. Implementation of leech treatment should be tempered with the potential adverse effects, including Aeromonas infection and a drop in hematocrit that might require a blood transfusion.

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

Publication typeCase ReportsJournal Article
Indexed MeSH termsAnimalsChild, PreschoolFemaleHumansLeechingMaleMiddle AgedMohs SurgeryPurpura FulminansSkin DiseasesSurgical Flaps

Summary

Case series and literature review of leech therapy in cutaneous surgery and dermatologic disease. Documents anticoagulative, anti-aggregative, and vasodilatory components of leech saliva alongside Aeromonas/transfusion risks.

Why This Matters for Hirudotherapy

This case series and review of the literature describes the current role of leech therapy in cutaneous surgery and medicine, highlighting that leech saliva contains anticoagulative, anti-aggregative, and vasodilatory components that, combined with the leech's mechanical blood-extraction ability, can contribute to patient health with minimal risks. The findings are directly relevant to ASH and hirudotherapy practice, as the authors conclude leeches should be considered as therapies for disorders of coagulation and venous congestion — core applications of medicinal leech use. However, as a case series and narrative review rather than a controlled trial, the study does not provide high-level efficacy evidence, and the authors themselves caution that implementation must account for potential adverse effects including Aeromonas infection and hematocrit decreases that may require blood transfusion.

Citation

Leech therapy in cutaneous surgery and disease.

Mamelak AJ et al. · Journal of drugs in dermatology, 2010

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.