The average patient today, confronted with the prospect of using a medicinal leech, or Hirudo medicinalis, a faceless aquatic invertebrate with a lust for blood, might feel some queasiness, if not outright repulsion. But the parasitic worm has been touted as a cure-all by various ancient medicine traditions: It can be seen in Ancient Egyptian tomb paintings and traditional portraits of Dhanvantari, the Hindu deity associated with Ayurveda. And in medieval and early modern Europe, when impure blood was believed to unbalance the humors of the body and cause disease, the creatures were seen as solicitous helpers, ever ready to relieve a patient of their unwelcome plasma. As the British medical historians Robert G.W. Kirk and Neil Pemberton wrote in their 2013 book, “Leech,” the worms were long celebrated as a gentle alternative to the lancet and became known, during the so-called leech mania of the early 19th century, as “the tools of the physician who cared.” In 1828, the French hospital system alone prescribed tens of millions of leeches, for conditions ranging from insomnia to smallpox.
The worms fell out of favor soon after, as germ theory replaced the humoral concept of disease, but two centuries later they’re recapturing the public imagination. In the past few decades, the slippery creatures have returned, in far smaller numbers, to hospitals: Carl Peters-Bond of the Biopharm leech farm in Hendy, Wales, which has bred medicinal leeches since 1812, estimates the creatures are now used globally in hundreds of thousands of hospitals, mostly those with specialized burn and plastic surgery units. Whatever their other abilities, leeches have proved to be gifted bloodsuckers and offer a noninvasive and precise way to reestablish blood flow in patients recovering from reconstructive and aesthetic operations. People are now also seeking out leech therapy as an alternative treatment for various illnesses; the 77-year-old Serbian performance artist Marina Abramović recently claimed that the practice, along with garlic drops and other old-world treatments, helped cure her Lyme disease. (A new line of skin-care and wellness products developed by Abramović and the holistic practitioner who first treated her with leeches launched in January.) And as aging less rapidly, or at least less visibly, becomes an increasingly obsessive collective pursuit, openness to cosmetic technologies both new and very old is growing: Just as tongue-scraping (shown to reduce oral bacteria), colonics (purported by some to detoxify the intestinal tract), bee-sting therapy (thought to relieve inflammation) and cupping (the Eastern practice believed to promote healing and reduce muscle soreness by creating suction with heated cups) have recently experienced a resurgence in the beauty and wellness worlds, so too has leeching.
While Renaissance-era women would sometimes attach a leech to the skin behind their ear to attain a pale complexion, today the two-inch-long predators are applied directly to a person’s face in an effort to refresh the skin and reduce wrinkles. The experimental procedure can be thought of as a natural alternative to microneedling, the cosmetic treatment in which tiny wounds are inflicted on the skin to improve its texture. Clinics like LA Leeches in Pacific Palisades, Calif., and Beyond Wellness in Tampa, Fla., are also offering an archaic take on the vampire facial — the high-tech procedure in which a patient’s plasma is removed, spun in a centrifuge and reinjected into the epidermis — using, in this case, a blend of human blood and leech saliva, the latter extracted from the insides of the creatures. The mixture is slathered onto the skin for a supposedly rejuvenating effect.
Though they aren’t exactly the panacea that our ancestors believed them to be, leeches are noteworthy for the mix of anticoagulant, analgesic, anti-inflammatory and antimicrobial substances that they naturally secrete while feeding. Beyond their limited scientifically backed (and U.S. Food and Drug Administration-approved, as of 2004) role as blood circulation aids in post-surgical wards, they are still employed as a remedy in many parts of the world, particularly in Eastern Europe and the Middle East, and, increasingly, as a wellness cure by naturopaths and other holistic healers all over. “The interest in this therapy is growing because the rate of chronic illness is going up,” says the German internal medicine specialist Dr. Korbinian Gauss, who practices hirudotherapy at Lanserhof Tegernsee, a health resort in the Bavarian Alps, offering it as a localized painkilling and anti-inflammatory treatment for patients suffering from conditions such as osteoarthritis. (Like acupuncture, leeching is rarely a first resort in Western medicine, but neither is it particularly controversial when used for conditions like joint pain.) On top of the possible therapeutic effects, Gauss sees the treatment as offering a rare occasion to reconnect with the natural world, a brief symbiosis between human and annelid.
The procedure itself requires a higher tolerance for weirdness than for pain. A leech’s bite is apparently no sharper than the prick of an acupuncture needle. Starved for months, the creature fastens its three interlocking tooth-lined jaws into the host and draws a fine stream of blood into its wiggly, minnow-like body, which pulsates and swells until the leech detaches itself, between thirty minutes and an hour later. And how does one pass the time while the leeches are at work? “A lot of patients start taking out their smartphones” and recording videos of the procedure, says Gauss. Indeed, while the therapy’s curative effects aren’t certain, the theatrics are undeniable. It’s no coincidence that among the leech’s most high-profile contemporary devotees are a world-famous performance artist and the rapper and singer-songwriter Machine Gun Kelly, known for his gothic provocations as much as for his music. One could imagine the telltale Y-shaped incisions the worm makes in the skin becoming a wellness-world status symbol much like the circular marks left by cupping. A leeching enthusiast might even consider adoption, as the model Miranda Kerr did: In 2017 she told Goop that she’d rescued a handful of leeches that had fed on her face as part of a cosmetic treatment and later released them into a koi pond at her home in Malibu.