OBJECTIVE: To evaluate the effect on acne vulgaris of pricking-bloodletting cupping at Dazhui(GV 14) under acupuncture anesthesia, and establish whether providing anesthesia to the treatment area by manipulating Hegu(LI 4) and Quchi(LI 11) might have an additional therapeutic benefit. METHODS: Thirty-eight patients were recruited and randomized into a control group and an intervention group with a single-blind(observer-blind) method. The control group was treated by pricking-bloodletting cupping at Dazhui(GV 14) and the studied group by pricking-bloodletting cupping at Dazhui(GV 14) under acupuncture anesthesia at Hegu(LI 4) and Quchi(LI 11). Both groups were treated twice weekly for 6 weeks. The analgesic and therapeutic effects of acupuncture were evaluated on a visual analog scale(VAS) and global acne grading system(GAGS), respectively.RESULTS: There were differences in the VAS scores of pain on pricking and in the pricked area, and the duration of pain between the groups. After 12 treatments, there was a significant reduction in GAGS scores from baseline in both groups, but there was no significant difference between the groups. CONCLUSION: Acupuncture anesthesia at Hegu(LI 4) and Quchi(LI 11) is an effective means of alleviating the pain of pricking-bloodletting cupping and reducing the duration of pain in the treatment area. Pricking-bloodletting cupping at Dazhui(GV 14) improves the skin lesions of patients with moderate acne vulgaris, but acupuncture anesthesia does not appear to have an additional therapeutic effect.