top of page



Hirudotherapy is a therapeutic method using leeches that has been known for thousands of years. Leeches are used in treatment because, during the process of feeding on the host, they inject medicinal hirudo compounds through the wound. Leech therapy is a minimally invasive and one of the oldest treatment methods, known in natural medicine in many parts of the world.

Modern hirudotherapy uses over 20 therapeutic technologies of medical leech. There are many ways to locate hirudotherapeutic points for various diseases and body dysfunctions. These points largely depend on the physiological way in which leeches have the most effect on the patient's body.


During the work of the leech, numerous medicinal substances are released from its salivary glands into the human bloodstream. The salivary glands of leeches perform functions related to the collection and storage of blood. They produce a complex of SGS compounds - Salivary Glands Secretion - known as hirudo compounds.


It is thanks to hirudochemicals that the list of diseases that can be cured with leeches is huge. Vascular and circulatory system diseases, cardiological, rheumatological and musculoskeletal diseases come to mind intuitively for people unfamiliar with hirudotherapy. Less obvious, but perfectly treated by leeches, are also skin, eye, hormonal and dental diseases.


Vascular and circulatory system diseases:

  • varicose veins and broken blood vessels

  • internal and external hemorrhoids

  • high blood pressure

  • low blood pressure

  • chronic cerebral circulation failure

  • post-infarction cardiosclerosis

  • circulatory system failure

  • ischemic heart disease

  • postoperative blood clots

  • post-operative and post-traumatic hematomas

  • thrombosis and phlebitis

  • polycythemia vera

Dermatological and cosmetological diseases:

  • psoriasis of the skin and joints

  • atopic dermatitis

  • fresh and hypertrophic scars (including deep scars)

  • acne and pimples

  • purulent inflammation of the skin

  • eczema, seborrheic dermatitis

  • cutaneous manifestations of vascular diseases

  • trophic ulcers

  • cellulite

  • skin aging, wrinkles, unhealthy skin appearance

  • sagging after liposuction

  • acceleration of healing, reduction of hematomas and scars after plastic surgery procedures (liposuction, abdominoplasty, breast augmentation and reduction, eyelid correction, etc.)

Respiratory diseases:

  • respiratory system disorders after COVID

  • pneumonia and bronchitis with symptoms of respiratory failure

  • bronchial asthma

  • pulmonary fibrosis

  • pulmonary tuberculosis

  • tuberculosis of the lymph nodes

  • viral and bacterial infections (stopping the ongoing disease development)

Neurological diseases:

  • migraines and pressure headaches

  • inflammation of the sciatic nerve

  • nerve paralysis and neuralgia

  • cerebral atherosclerosis

  • multiple sclerosis

  • ischemic strokes

  • concussion; brain injuries

  • Heine-Medina disease

  • depression and reduced serotonin levels

  • preventively for Alzheimer's disease and dementia

Urological diseases:

  • inflammation and enlargement of the prostate

  • erectile dysfunction and impotence

  • prostate adenoma

  • secondary infertility in men

  • inflammation and infections of the urinary bladder

  • urethritis

  • inflammation of the urogenital tract

  • urinary frequency

Rheumatological diseases:

  • rheumatism

  • rheumatoid arthritis RA

Cardiac diseases:

  • ischemic heart disease

  • hypertension

  • condition after myocardial infarction

  • circulatory failure

  • myocarditis

  • cardiomyopathy

Disorders of the musculoskeletal


  • back pain, including chronic pain

  • arthritis

  • inflammation of tendons, muscles and fascia

  • conditions after muscle rupture

  • bone fractures, including damage that remains non-union for a long time

  • chronic inflammation of the bone marrow

  • condition after injuries, including hematomas and swelling

  • hematomas and swelling after surgery

Gastrointestinal and gastroenterological diseases:

  • constipation and problems with bowel movements

  • flatulence

  • congestive processes in the liver and gallbladder

  • inflammation of the gallbladder

  • cholelithiasis

  • colitis

  • inflammation of the pancreas

  • gastritis, inflammation and ulcers

  • ulcerative colitis

  • gout

  • metabolism disorders

  • Dyskinesia of the digestive and excretory system

  • Obesity

Gynecological diseases:

  • infertility therapy (including adhesions on the uterus, too thick blood, endometrial hyperplasia, etc.)

  • menstrual cycle disorders

  • cervical erosion

  • ovarian cysts

  • some sexual infections, genital infections and vaginitis

  • adhesion processes in the small pelvis

  • inflammatory processes of the fallopian tubes

  • parauterine inflammation

  • postpartum endometrium

  • mastitis

  • endometriosis

  • uterine fibroids and adhesions

  • inflammation of the Bartholin gland

  • cervical erosion

Otolaryngological diseases:

  • inflammation of the auditory nerve

  • tinnitus and hearing loss

  • sinusitis

  • otitis externa

  • chronic otitis media with effusion

  • external ear boil

  • laryngitis

  • inflammation of tonsils

  • frequent purulent angina

Dental diseases:

  • gingivitis and periodontal disease

  • hypersensitivity of the glossopharyngeal nerve

  • trigeminal neuralgia

  • periostitis and periodontitis

Allergological diseases:

  • atopic dermatitis

  • hives

  • sinusitis and rhinitis

Kidney diseases:

  • glomerulonephritis

  • chronic renal failure


Absolute contraindications:

  • Pregnancy (leech therapy in the third trimester may speed up labor)

  • Haemophilia

  • Malignant tumors (there is a risk of dissemination

Be careful:

In the following cases, the hirudotherapist must select the frequency of treatments and the number of leeches as well as the place where they should be applied depending on the medications currently taken and the current health condition.

  • Taking anticoagulants

  • Hypotension with blood pressure below 60/80

  • Anemia

  • Allergies to insect bites

  • Ongoing menstruation (usually avoid applying leeches on the first day of menstruation due to the patient's weakness as a result of menstruation)

  • Lactation

  • Erosive gastritis and gastrointestinal bleeding

  • Advanced deep vein thrombosis

  • Mental disorders (patient must be able to make independent decisions or the consent of the legal guardian must be given)


Prepare your medical records

Before your first visit, ideally do a blood test. Blood tests should be no older than 5 days in chronic diseases and no older than 48 hours in acute conditions or recent injuries.

Required general examinations:

  • Morphology

  • INR (if you take blood thinners, also measure APTT)

  • D-dimers

  • CRP

  • Liver tests (ALT, AST, ALP, GGTP, and if there were problems with the bile ducts, additionally BIL).

  • Total cholesterol, HDL, LDL

  • Fasting glucose

Do not change the dosage of your medications

It is very important not to increase the dosage of medications, especially heart medications and blood pressure medications, 24 hours before and 48 hours after the procedure, if possible. This may affect bleeding and the course of therapy. Remember to inform your hirudotherapist about all medications and supplements you take before the procedure.

Shave the treatment area

Before the treatment, you should shave or trim the hair to a length of 3-4 mm in the treatment area and around it. This is necessary for two reasons - firstly, the more hair there is, the weaker the patches will hold the dressing, and secondly, tearing the dressing off from the hairy skin is painful and may irritate the hair follicles. It is therefore worth shaving the treatment area about 24 hours before the procedure, because applying the patches to a freshly shaved body may cause an allergic reaction.

NOTE: the first applications are localized on the abdomen, even if the pain affects the knee, prepare the knee as well as the abdomen.

Wash your body with unscented soap

Before the treatment, wash your entire body thoroughly with water, removing any cosmetic residues. When bathing before the procedure, use unscented natural soap. Essential oils and residues from fragrance gels and soaps can discourage leeches from working. Leeches are sensitive to unnatural odors. Also remember that after the hirudotherapy treatment, you will not be able to take a shower for about 24 hours to avoid soaking the dressings.

Do not use cosmetics after washing

After washing before the hirudotherapy treatment, do not use cosmetics, especially perfumed sprays, deodorants, oils or body lotion. This applies not only to the site of the disease, but primarily to the abdomen and chest.

Dress warmly and in loose clothing

It is important that the clothes you wear are loose, e.g. a loose tracksuit. The dressings take up a lot of space, so you may have trouble putting on pants that are too tight. If the treatment is to be performed on the foot, take flip-flops or shoes from which you can remove the laces if necessary. Also make sure that your body is warm and you are warm. This will make it easier for the leeches.

Don't drink alcohol or energy drinks

It is forbidden to drink alcohol for at least 24 hours before the planned procedure, and on the day of the procedure it is strongly discouraged to drink coffee and energy drinks that increase blood pressure.

Do not eat garlic, onion and spicy foods

On the day of the procedure, you should not eat onions, garlic and spicy spices. They change the smell of the skin and deter leeches. Capsaicin, a substance that gives a sharp taste, affects blood pressure and vasodilation and may increase bleeding after the procedure.

Drink plenty of water and eat a nutritious meal

Your body must be properly hydrated. Remember to drink water every day, but it is especially important in the days before therapy. It is also worth taking care of your diet, as blood loss after the procedure may weaken you. Hirudotherapy should not be performed during fasts or restrictive diets.

Ask your questions!

Before making an appointment for therapy, before starting the procedure – ask! The therapist should dispel all your doubts and answer even difficult questions.


Modern assumptions of hirudotherapy, in line with scientific publications and the assumptions of evidence-based medicine, say that we apply from 1 leech upwards at a time, depending on the body weight, age and condition of the patient. The choice of where to attach leeches is not obvious. The fact that a patient suffers from a foot disease does not mean that leeches will be attached to the leg - the place of application depends on the source of the disease and the effect expected by the therapist. Most often, during the first session, 1 to 4 leeches are placed on the navel to improve the patient's visceral condition and, by influencing the internal organs, to significantly accelerate the regeneration processes. It happens that after placing leeches on central applications, we can see a real improvement in the distal parts of the body (e.g. absorption of swelling at the foot) while they are feeding.

The procedure itself usually takes 30 to 40 minutes, after which the leeches are removed and a dressing is applied. It sometimes happens that after hirudotherapy, a so-called fire bubble is placed in order to move the stagnation. bloody bubble. The leech's work is then limited to 20-25 minutes and a glass bulb is placed for another 20-25 minutes. There are also places on the body where treatments are performed for 18-20 minutes or the leech is left for as long as it needs to feed, which is sometimes even more than 2 hours.

The number of leeches needed is determined based on many factors other than just body weight. The patient's body shape is of course important, but the most important thing is the disease, its severity, the patient's general condition, the chronicity of the disease and accompanying diseases. The patient's age and gender, as well as his attitude towards the procedure, are also taken into account.

The number of sessions varies depending on the advancement of the disease - the more recent the condition, the fewer visits. In chronic conditions, several sessions are often necessary.


Do not remove the dressing 24 hours after the procedure

The dressing applied after the procedure should not be removed during the first 24 hours. If the dressing becomes saturated, the patient should not remove the dressing directly adjacent to the wound so as not to disturb the clot that is forming.

It is possible to remove the outer layer of the soaked dressing (medical base) and replace it with a new one, or another layer can be added without removing any of the layers.

Removing the dressing and itching in the morning

After 24 hours, you can carefully remove the dressing. If the adhesive on the patches has hardened, soak the patches in cooking oil and wait a while, then they will come off painlessly.

If the clot breaks and oozes out in the morning, the area should be protected with a smaller dressing and a plaster for the next 24 hours.

If you experience an allergy and a feeling of itching and stinging after the treatment (most often an allergy to the glue or a skin rash from the patches), take calcium (Calcium) every day and lubricate the treatment area with hydrocortisone ointment 3 times a day.

Take a photo of the morning and dressings

After removing the dressing, take a photo of the blood or clot to show it to your hirudotherapist for diagnosis. Don't be surprised if the clot is very large, gelatinous or even hard. Removing stasis from the vascular network is an important element of therapy. Wash the skin and take a photo of the bruises around the leech's feeding areas. This is important for further diagnostics.

Do not scratch the wounds and try not to touch them, as it may cause infection! In case of bleeding longer than 24 hours, cover it tightly. Even if you accidentally scratch the wound and remove the scab dry or wet, before it falls off on its own, a small scar, about 1.5 mm, may remain on the skin.

Don't scratch the wound to avoid scars

Don't worry about even stronger post-application symptoms

After the procedure, skin redness, swelling, bruising (even quite large), burning or itching around the wound may occur, which disappear after a few days. This condition is a normal natural process after therapy and should not worry you. It can be alleviated by using ointments, e.g. ichthyol ointment.

If the redness is large, over 15 cm in diameter and the temperature is clearly raised, you can use Tribiotic ointment topically. If the lymph nodes are enlarged (they will shrink spontaneously after a few days), local pinotherapy, a needle roller or a gentle drainage massage can be used.

Make sure there are no scars and the skin becomes elastic

Every patient who decides to undergo leech therapy should remember that a small mark on the skin (about 1.5 mm) remains on the skin where the leech feeds. If you have mature skin you can avoid scars! Apply collagen and tamanu oil to wet skin after bathing.

Make sure to rest on the day of the procedure

After the procedure, you should not do heavy work for 24 hours, limit your mobility or sit for long periods of time, as this may disturb the healing process and prolong bleeding beyond 24 hours. The greatest fluid leakage in the morning takes place in the first 6-8 hours after the procedure. During this time, if you can, lie down and rest. After the procedure, the patient may feel very drowsy and weak or agitated - depending on individual predispositions.

Do not increase the dosage of your medications 48 hours after the procedure

It is very important not to increase the dosage of medications, especially heart medications and blood pressure medications, 24 hours before and 48 hours after the procedure, if possible. This may affect bleeding and the course of therapy. Remember to inform your hirudotherapist about all medications and supplements you take before the procedure.

Do not shower until the bleeding stops

Remember that after the hirudotherapy treatment, you will not be able to take a shower for about 24 hours to avoid soaking and loosening the dressings. You can wash the areas of the body that are not adherent to the dressing with warm water using a sponge. You can only take a shower after the bleeding stops, but be careful not to tear off the scabs.

Give up sports within 48 hours of the procedure

Avoid intense physical activity for 2 days after the procedure. Swimming is strictly prohibited due to the risk of infection in the morning. Other sports and sauna increase blood pressure, may prolong bleeding, weaken you and worsen post-application symptoms. Moreover, remember that sweat on a fresh wound will certainly irritate it and cause unbearable itching.

Do not drink alcohol for 3 days after the procedure

Alcohol consumption is prohibited for at least 3 days after the procedure. Consumption of alcohol during the entire therapeutic cycle is strictly prohibited prohibited because it significantly reduces the effects of therapy (including affecting the condition of the liver and blood quality).

Drink plenty of water and eat a nutritious meal

Remember to drink lukewarm water after therapy, it is especially important. It is also worth taking care of your diet, as blood loss after the procedure may weaken you. Hirudotherapy should not be performed during fasts or restrictive diets. Do not consume coffee or spicy spices until the bleeding stops. Capsaicin, a substance that gives a sharp taste, and caffeine affect blood pressure and vasodilation and may increase bleeding after the procedure.

Your hirudotherapist will also help you after the procedure

Remember that you can count on your hirudotherapist in every situation. If you have any doubts or questions, first contact the therapist who performed the procedure.

bottom of page