How is moxibustion thought to work

Short answer: researchers describe three possible routes by which moxibustion acts: heat, infrared radiation and chemicals from mugwort and its smoke ^[1]^[2]. Most mechanism work is laboratory or animal research, and authors acknowledge “a great distance from fully understanding the mechanism” ^[1].

Mechanism research explains how something might work. It does not show that it does work for any condition. See Does moxibustion really work?.

1. Heat

A review of the “warming and dredging” mechanism describes moxibustion starting with a local temperature rise at the point. This activates local heat-specific receptors, heat-sensitive immune cells and heat shock proteins, and signals then travel through nerve and body-fluid pathways ^[3].
Heat can trigger inflammatory and vascular responses ^[4].
Japanese research has examined effects on skin, muscle and nerve blood flow and reflex mechanisms ^[5].
Measured effects are not always as expected. In healthy volunteers, neither mugwort nor charcoal moxa cones raised body temperature, though temperature differences between points changed ^[6]. Another trial found that acupuncture at a point raised lumbar skin temperature more than moxibustion did ^[7].

2. Infrared radiation

Study	Finding
Shen et al., 2006 ^[8]^[9]	Traditional moxa stick: high intensity, peak ~3.5 µm. Smokeless moxa stick: much lower intensity, peak ~7 µm. A cigarette also peaked ~3.5 µm but at low intensity
Combustion analysis, 2019 ^[10]	Burning moxa stick emits 2.5–13 µm with peaks near 3.75 and 8.75 µm; heat is released steadily from about 200 to 500 °C
Device materials, 2024 ^[11]	Cardboard-tube moxibustion devices gave the fastest-rising, longest-lasting infrared output among materials tested

Researchers argue that this spectrum makes moxa floss a good thermal material, and that it could guide the design of electric alternatives ^[10].

3. Light versus heat

A multicentre knee osteoarthritis trial tried to separate moxa’s light and heat. It reported effects from both, with heat superior ^[12]. Period-pain researchers have called for study of which parts of the light spectrum matter ^[13].

4. Chemistry of mugwort and smoke

Artemisia argyi leaf contains at least 136 identified compounds ^[14]. Its essential oil has shown anti-inflammatory and other activities in laboratory studies ^[15]^[16].
Compounds identified in mugwort and moxa smoke “have a variety of biological activities” and are thought to contribute to moxibustion’s overall effects ^[1].
Animal studies examine smoke on its own, for example through the sense of smell ^[17].
The same smoke contains combustion products that raise safety questions ^[18]; see Moxa smoke chemistry.

What this means for smokeless moxa

Smokeless moxa heats, but in one study its infrared output was far weaker and peaked at a different wavelength ^[8]. Its smoke chemistry is closer to incense than to traditional moxa ^[18]. If traditional moxa’s effects depend on infrared or smoke chemistry, smokeless moxa may differ; if they depend on heat, it may not. No trial has settled this; see Smokeless vs traditional.

The sham problem

Mechanism uncertainty makes good trials harder. A review of sham moxa devices notes that few double-blind trials exist because of the lack of suitable blinding methods ^[19].

FAQ: related questions

How does moxibustion work?

Researchers describe three possible routes: local heating that activates heat-sensitive receptors and other responses, infrared radiation from burning moxa, and chemicals from mugwort and its smoke. These are hypotheses studied mostly in laboratories; they do not prove clinical benefit.

Is it just the heat?

Not entirely, according to researchers: trials have tried to separate moxa's heat from its light, and burning moxa has a distinctive infrared spectrum. But no study shows that moxa beats other heat sources for a specific condition.

Does smokeless moxa work by the same mechanism?

It heats the skin, but one study found a smokeless stick's infrared intensity far lower and its peak at a different wavelength, and its smoke chemistry differs. Whether that matters clinically is unknown.

Sources for this page

The Mechanism of Moxibustion: Ancient Theory and Modern Research (PMC3789413). pmc.ncbi.nlm.nih.gov/articles/PMC3789413/
Deng et al. The mechanism of moxibustion: ancient theory and modern research. Evid Based Complement Alternat Med 2013. pubmed.ncbi.nlm.nih.gov/24159344/
Huang et al. [Startup mechanism of moxibustion warming and dredging function]. Zhongguo Zhen Jiu 2017. pubmed.ncbi.nlm.nih.gov/29354927/
Does moxibustion work? An overview of systematic reviews (Lee et al.; PMC2987875). pmc.ncbi.nlm.nih.gov/articles/PMC2987875/
Kawakita et al. How do acupuncture and moxibustion act? – Focusing on the progress in Japanese acupuncture research -. J Pharmacol Sci 2006. pubmed.ncbi.nlm.nih.gov/16799260/
Go et al. Comparative effects of artemisia vulgaris and charcoal moxa stimulating Zhongwan (CV 12) on body temperature in healthy participants: a cross-over single-blind randomized study. J Tradit Chin Med 2015. pubmed.ncbi.nlm.nih.gov/26591685/
Zheng et al. Lumbar temperature change after acupuncture or moxibustion at Weizhong (BL40) or Chize (LU5) in healthy adults: A randomized controlled trial. J Integr Med 2025. pubmed.ncbi.nlm.nih.gov/39863500/
Table 1 infrared intensities (PMC3789413). ncbi.nlm.nih.gov/pmc/articles/PMC3789413/table/tab1/
Shen et al. An infrared radiation study of the biophysical characteristics of traditional moxibustion. Complement Ther Med 2006. pubmed.ncbi.nlm.nih.gov/16911902/
Zhang et al. Characterization of moxa floss combustion by TG/DSC, TG-FTIR and IR. Bioresour Technol 2019. pubmed.ncbi.nlm.nih.gov/31176939/
Zhang et al. Analysis of infrared radiation emitted by moxibustion devices made of different materials using Fourier transform infrared spectroscopy. Heliyon 2024. pubmed.ncbi.nlm.nih.gov/39005893/
Liao et al. [Light and heat of moxibustion for knee osteoarthritis：a multi-center randomized controlled trial]. Zhongguo Zhen Jiu 2020. pubmed.ncbi.nlm.nih.gov/32538014/
Pan et al. Moxibustion for Primary Dysmenorrhea: An Adjuvant Therapy for Pain Relief. Evid Based Complement Alternat Med 2022. pubmed.ncbi.nlm.nih.gov/35126603/
Wang et al. A review of the research progress on Artemisia argyi Folium: botany, phytochemistry, pharmacological activities, and clinical application. Naunyn Schmiedebergs Arch Pharmacol 2024. pubmed.ncbi.nlm.nih.gov/38775853/
Liu et al. From longevity grass to contemporary soft gold: Explore the chemical constituents, pharmacology, and toxicology of Artemisia argyi H.Lév. & vaniot essential oil. J Ethnopharmacol 2021. pubmed.ncbi.nlm.nih.gov/34246739/
Gao et al. Pharmacological and bioactive properties of Artemisia argyi H. Lév. & Vaniot essential oil: a review. Front Pharmacol 2025. pubmed.ncbi.nlm.nih.gov/41573729/
Zuo et al. [Effects of moxa smoke through olfactory pathway on learning and memory ability in rapid aging mice]. Zhongguo Zhen Jiu 2023. pubmed.ncbi.nlm.nih.gov/37429660/
Safety recommendations for moxa use based on noxious substances from commercial indirect moxibustion (PMC5466910). pmc.ncbi.nlm.nih.gov/articles/PMC5466910/
Zhao et al. Can moxibustion, an ancient treatment modality, be evaluated in a double-blind randomized controlled trial? – a narrative review. J Integr Med 2014. pubmed.ncbi.nlm.nih.gov/24861833/

Last reviewed: 2026-11-08. Editorial note: this guide re-edits published sources; it does not provide medical advice or new research.

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