A Guide to Managing Moxibustion Burns Effectively

Your friend’s questions are common: Is it normal to get big blisters from moxibustion? Are they burns? Can I continue moxibustion? Moxibustion burns are, in fact, thermal injuries to the skin and subcutaneous tissues. They are caused by factors such as improper handling, excessively high temperatures, or an excessive duration of the moxibustion treatment.

Why does moxibustion cause burns?

There are two main types of moxibustion burns:

• Contact burns (or flash burns) are caused by the direct contact of the burning moxa stick with the skin.
• The other type is low-temperature burns caused by the moxa radiating heat above the skin for an extended period of time. In practice, the most common type and the one that needs special attention is the low-temperature burn.

Moxibustion services are widely available, ranging from professional clinics to unregulated providers, as well as people performing it themselves at home. The following factors frequently cause injuries:

1. Excessive duration of moxibustion or positioning the moxa too close to the skin.
2. The delayed onset of symptoms, where initial discomfort is absent, but a burn is realized only hours later.
3. Improper self-treatment of blisters that appear at home, often due to the initial pain not being obvious.

What to do after moxibustion burns?

• Stop moxibustion immediately and remove the moxa source.
• Initiate cooling by applying cold compresses (or cool running water) to the affected area to relieve pain.
• If blisters appear, do not rupture or pop them, as the intact skin is the best barrier against infection.
• Protect the wound to keep it clean and prevent contamination, which can lead to infection.
• Promptly seek medical attention. Do not apply household remedies such as soy sauce or unauthorized topical antiseptics (like red potion), as these can obscure the wound and interfere with a doctor’s diagnosis.

How to prevent moxibustion burns?

1. Concentration: The operator must remain fully concentrated and avoid distraction to prevent the moxa stick from getting too close to the skin and causing a burn. Extra caution is necessary for individuals with impaired sensation, such as the elderly or those with diabetes.
2. Clothing Selection: Do not wear easily flammable materials like chemical fibers or down when performing moxibustion, as the moxa fire could ignite clothing and cause severe burns.
3. Distance Control: Pay attention to regulating the moxibustion distance. If the treated area is not very sensitive, use your non-treating hand to place two fingers on either side of the moxibustion site to monitor the temperature. This ensures both safety and efficacy.
4. Gradual Approach: For first-time moxibustion, always begin gradually—for instance, by using smaller moxa cones or shortening the treatment time—to minimize the risk of burns or discomfort.
5. Moxa Quality: Only use good-quality moxa sticks. Poor-quality moxa may burn unevenly, and the ash or burning material can fall off and injure the skin. Also, do not use expired or damp moxa sticks.
6. Timely Medical Treatment: If signs of infection (such as pus) or non-healing lesions/ulcers appear after moxibustion, promptly seek professional medical care (ideally at a burn specialist clinic) to prevent the wound from deepening or becoming severely infected.

Distinguishing Moxibustion Flowers or Moxibustion Burns

Moxibustion Flowers (A Normal TCM Reaction)

If you experience blisters when the moxibustion temperature is not excessively high and you feel no burning sensation, these are likely what are commonly called “Moxibustion Flowers.” These are considered a normal reaction in Traditional Chinese Medicine (TCM), representing the body’s natural process of discharging excess cold, dampness, or toxins (pathogenic factors).

• Small Blisters: There’s no need to worry. Allow small blisters to absorb naturally and do not puncture them.
• Large Blisters: Large blisters can be lanced at the edge with a sterilized needle to release the fluid. Follow this with local disinfection and cover with a clean, sterile dressing.

Genuine Thermal Burns (An Adverse Reaction)

Conversely, some people mistakenly believe that the higher the temperature or the stronger the burning sensation, the better the therapeutic effect and the faster the recovery.

Blisters that appear in this case are genuine burns caused by excessively high temperatures or placing the moxa too close to the skin. They are not Moxibustion Flowers and are not a sign of healing. Blisters caused by this type of severe thermal injury are detrimental to the body, as they can deplete the body’s vital energy (qi) and blood, weakening the immune system and protective functions.

Summary of Blister Care

1. Normal Reaction: If the moxibustion temperature was safe and controlled, yet blisters appeared, they are likely Moxibustion Flowers, signifying the discharge of cold/dampness. Do not worry, but ensure proper local care and disinfection until the blisters resolve.
2. Adverse Reaction/Risk: Blisters caused by improper operation or the excessive pursuit of heat indicate that the practice is counterproductive. This not only negates the benefits of moxibustion but also depletes the body’s resources, potentially leading to a decline in physical fitness and health issues.

(Note: Moxibustion therapy, when performed correctly, is highly beneficial for warming the meridians, dispelling cold, promoting blood circulation, and supporting the body’s protective qi (energy). The materials are easy to obtain, making it accessible for home use when safe guidelines are followed.)