Skin deep

One of the key features of my treatment style nowadays is the adoption of contact needling which forms a key part of the Toyohari style of acupuncture training. This a technique where the point is needled at the surface of the skin and the skin itself is not broken. It is carried out through slowly approaching the surface with a [usually] silver needle then after waiting for a short while the needle is removed. This seems counterintuitive to the commonly held image of acupuncture where one assumes [or at least I did at first] that a needle needs to penetrate the skin to have effect. Most of my treatments begin with this technique and in a few cases it is all I do; though I was sceptical my self in the beginning, after having used it for a number of years my confidence in the technique has grown through the results I’ve seen and also through feeling the body’s response as I use it.

It’s only relatively recently that I’ve come across the work of Dr. Denda a Japanese skin scientist through the journal of North American Oriental medicine [Nov 2013, Vol 20, #59, March 2013 Vol. 20 # 57]. Dr. Denda has discovered that the epidermis or outermost layer [0.06mm-0.2mm] of the skin doesn’t just act as a barrier to protect the interior, rather it is able to monitor the external environment, acting like a giant sense organ and processing this information much like an independent brain. He dubs it the “third brain” [I believe elsewhere people have dubbed the gastro intestinal system as a second brain]. According to Dr. Denda the skin cells can act like sensors picking up more detailed information that could be possible using just nerve receptors, rather the keratinocytes in every cells are able to pick up environmental information, process it and transmit it to the nervous system.

According to Dr Denda stimulating the skin can have a positive effect on the mind in times of stress. This is not really news to most of us, massage and touch have a calming effect in a general way but the emphasis on skin over muscle [as in a deep massage or deep needling] perhaps goes some way to explain the growth of skin level acupuncture techniques in japan such as contact needling. Both epidermis and the brain have a common developmental origin in the ectoderm, and it is known that the hormone oxytocin which promotes positive physical and mental states, is released from stimulation of the skin. But it doesn’t end with oxytocin, the epidermis has receptor also for dopamine, acetylcholine, adrenaline, melatonin, glucocorticoids and more. It is believed that the epidermis has a close relationship to the autonomic nervous system, research has shown stress levels of the pituitary gland showing as changes in the skin barrier function, and the adjustment of circadian rhythms can be achieved by shining light on the skin to affect the sleep centre in the hypothalamus. This relationship between the skin surface and the inner centres of the brain can explain the importance of palpation in diagnosing patterns in traditional acupuncture. It’s as if we can locate internal patterns of stress by feeling disturbances on the surface of the skin.

When it comes to needling, inserting a needle to a depth of around 4 mm will be detected by the brain as the local stimulation is transmitted to the somatosensory areas via unmyelinated and myelinated fibers. This way brain can identify the location of the stimulus, this is an effective means of relieving local pain, improving peripheral and therefore whole body circulation. With contact needling however there is no direct transmission through these nerve fibers, its as if the autonomic system is affected directly via the sensory organ aspect of the hypothalamus, namely the skin surface. This is not registered as a local stimulus but a skin initiated whole body effect. The autonomic system is the body’s autopilot, it governs the moment to moment functioning of the the organs either stimulating or dampening their function. It should ideally maintain optimum functioning of the body in differing situations of physical and emotional stress, when this becomes suboptimal it can begin to the the origin of illness and poor health. If this is not corrected then any symptomatic treatment whether western or Chinese will have limited effect so treating this level of imbalance is seen as a key to maintaining good health in traditional East Asian healthcare. This is what acupuncturists call a root treatment, something to create an overall global balance independent of any particular symptom. It manifests during treatment as a deeper sense of relaxation, changes in breathing and in the pulse. The nature of contact needling as a means of stimulation that does not register as coming from any one particular location makes it especially suitable for this aspect of treatment.

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