Before you invest the money, time, and effort to seek Soliman Auricular Allergy Treatment (SAAT), we want to make sure you are thoroughly informed about how the treatment works, how to time your treatment for best results, and what you can expect as far as outcomes are concerned. Please read this page thoroughly in advance of your first appointment.

Important Notes Before Scheduling Your Appointment:

• During your appointment, tiny needles will be placed in your right ear, covered with adhesive tape, and left in place for three weeks.
• During the three-week needle retention time, you will need to do your best to keep your ear dry. Please take this into consideration when scheduling around vacations or activities that involve swimming and/or very heavy sweating.
• Treatment for seasonal allergens is generally most effective if needles are placed at least 4-6 weeks prior to the onset of your usual allergy season.
• Food allergens should be avoided completely during the three-week needle retention time and environmental allergies should be avoided as much as is practically possible.
• Needles will need to be removed before you undergo magnetic resonance imaging (MRI). If you know that you need an MRI in the near future, please factor this in when scheduling your appointment.
• Needles will need to be removed before any surgical procedure that involves cautery. If you know that you will be having a surgical procedure in the near future, please factor this in when scheduling your appointment.
• If you have a history of anaphylactic reaction(s) to allergen exposure, you should think of SAAT as a means of reducing the risk of life-threatening reaction to accidental exposure to the allergen, not a “cure” that will render intentional or indiscriminate exposure to the allergen safe. Continued vigilance, including diligently avoiding the allergen and carrying appropriate emergency medications (such as an epinephrine auto-injector, antihistamines, etc.) will remain essential, even after successful SAAT treatment.

What Is SAAT?

SAAT stands for Soliman Auricular Allergy Treatment, a specialized form of ear (auricular) acupuncture developed by Nader Soliman, M.D., a board-certified anesthesiologist, pain management specialist, and medical acupuncturist. Dr. Warren trained directly under Dr. Soliman in 2019 and is a certified SAAT provider.

The goal of SAAT is not to permanently cure an allergy in the sense of eliminating it from your immune system’s memory forever, but rather to calm your immune system’s overactive, exaggerated response to a specific allergen — whether that allergen is a food, an environmental trigger, or a chemical sensitivity.

How SAAT Works

SAAT builds on the auricular acupuncture mapping developed by Dr. Paul Nogier, refined further by Dr. Soliman over decades of clinical practice. Unlike body acupuncture points, which sit in the same anatomical location on every person and are consistently active, ear acupuncture points are individualized — their exact location varies from person to person, and they only become electrically detectable when there is a problem with the associated body system. In effect, they function like a warning light on a car’s dashboard.

Dr. Soliman observed that exposure to a specific allergen causes a particular region of the outer ear — the area associated with the liver, in the concha of the right ear — to expand and become more electrically active. Using a specialized device, your acupuncturist locates the most electrically active point(s) associated with your specific allergen. Tiny needles are placed at those precise points, which helps prompt the body to stop overreacting to that substance.

Because this location is unique to each person and each allergen, your treatment plan is individualized — based on your own allergy history, symptom patterns, and testing, not a generic protocol.

To learn more about the unique characteristics of the external ear and why it is so useful for diagnosing and treating a range of health problems, you can read more here.

How to Prepare for Your Appointment & What to Expect

• Please wash your right ear with soap and warm water approximately 24 hours prior to your first appointment. After washing, dry your ear with a towel and then leave it undisturbed in the hours leading up to your appointment. This is important for the accurate identification of the active points on your ear during your appointment.
• Your acupuncturist will take a detailed health history and then will use bio-energetic testing to determine which allergen(s) need to be treated. You can learn more about the bio-energetic testing procedure here. If you have results of allergy testing (whether blood or skin testing), please bring them to your appointment.
• Extremely small, sterile, single-use needles — each about the diameter of an eyelash — are placed at precise points on the outer ear for each allergen being treated. Some patients will only need one needle, others may need as many as six.
• Needles are inserted parallel to the surface of the skin. Most patients do not feel the needles once they are in place.
• Needles are then firmly secured with medical adhesive and tape.
• Needles remain in place for 3 weeks.
• You will be provided with video instructions for removing needles at home. You will need a friend or family member to assist you with removing needles. If you do not have anyone to assist you, you can return to the clinic to have your needles removed (please call ahead to schedule an appointment).
• After needles are removed, use soap and warm water to clean your ear. Any residual adhesive can be removed using rubbing alcohol or a drop of dish soap.
• Leave your ear undisturbed (no washing or rubbing) for 24 hours prior to your follow up appointment. This way your ear will be in a clean, neutral state in case follow-up testing and treatment is needed.

Avoid the Allergen Being Treated During Needle Retention for the Best Chance of Success

• For the three weeks that your needles are in place, it is important to avoid exposure to the specific allergen being treated as completely as you can.
• Food allergens should be avoided completely during this period. If you are being treated for alpha gal allergy, please avoid ALL mammal-derived foods, medications, and body care products (even ones that you have never reacted to.) Please see the Less Obvious Food Sources of Alpha Gal and Medication, Supplement, and Body-Care Ingredients to Watch For sections in the Understanding Alpha-Gal Syndrome handout that you will be given at your first appointment for details.
• For environmental allergens, minimize exposure as much as is practically possible.
• Treatment for seasonal allergens is generally most effective if needles are placed at least 4-6 weeks prior to the usual onset of your allergy season.
• Continued exposure to the allergen while the needles are working can interfere with the treatment’s effectiveness and make it harder to tell whether the treatment succeeded.
• If you have a history of anaphylaxis to the allergen being treated, you must continue to carry and use your prescribed emergency medications (epinephrine auto-injector, antihistamines, etc.) exactly as you did before treatment. SAAT does not change your emergency protocol during or after the treatment period.

Caring for the Needle Site

• The medical adhesive and tape that covers your needles is designed to stay in place for the entire 3-week treatment period.
• Avoid pressing on, scratching, rubbing, or dislodging the needle and tape.
• Do not attempt to remove the tape before the end of the 3-week needle retention period, as doing so will disrupt the precise placement of the needles.
• Keep the site dry. Avoid swimming, hot tubs, steam rooms, or especially dirty, grimy, or dusty environments.
• You will be provided with several plastic “shower caps” that are designed to cover the ear during bathing. Some patients find these covers to be helpful in keeping the ear dry during showering. If the plastic covers do not work with your hairstyle or the size/shape of your ear, holding a plastic drinking cup that is about the same diameter as your ear over your ear when you place your head under the shower is another method for keeping your ear dry.  
• If you must be in a dirty or dusty environment during the 3-week needle retention time, many patients find that waring a stretchy headband such as a Buff arranged so that it completely covers the ear is helpful. We recommend the “neckwear” style Buff because the broad band can more easily be arranged to cover the entire ear, whereas the “headband” style Buff is designed to only cover the tops of the ears. Put the Buff on gently and carefully in order to avoid disrupting the precise placement of your needles.
• Do not attempt to wash or clean your ear during the 3-week needle retention time, as doing so will soak the tape and disrupt the precise placement of the needles.  
• If your ear becomes damp from bathing or sweating, use a clean paper towel to gently blot the tape dry.
• Depending on your individualized needle placement, it may or may not be possible to wear ear buds or AirPods during the needle retention phase. If you are able to wear ear buds comfortably with your needle placement, it is important to make sure that your ear buds are clean – wiping them down with rubbing alcohol or sanitizing wipes before each use is a good practice. If you are not able to wear ear buds comfortably, most patients find that clean over-the-ear earphones are a workable alternative.
• Contact the office if needles become dislodged, if the site becomes red, swollen, or painful, or if you have any concerns between your initial and your follow-up visits.

Your Follow-Up Visit

• You will be provided with video instructions for removing needles at home. You will need a friend or family member to assist you with removing needles. If you do not have anyone to assist you, you can return to the clinic to have your needles removed (please call ahead to schedule an appointment).
• After removing your needles, wash your ear with soap and warm water. Any residual adhesive can be removed with rubbing alcohol or a drop of dish soap.
• Leave your ear undisturbed (no washing or rubbing) for 24 hours prior to your follow up appointment. This way your ear will be in a clean, neutral state in case follow-up testing and treatment is needed.

How Many Treatments Will I Need?

You may have gotten the impression from online discussion groups that SAAT is a “one and done” treatment for allergies. In our clinical experience, this is often not the case.

The total load theory (or “bucket theory”) of allergy posits that allergic symptoms appear when a person’s cumulative exposure to triggers — such as pollen, foods, and chemicals — exceeds their unique physiological threshold. When the figurative “bucket” overflows, the immune system reacts. The number of treatments required to bring about lasting improvement in allergy symptoms depends on your unique physiological threshold (how big your bucket is) and how much water is getting dumped in the bucket (how many allergies you have, the magnitude of your allergies, whether or not you avoid your allergens, etc). This concept is illustrated in detail in the image below.

It is difficult to predict upfront how many treatments you will require. If your case is severe or complex, if you have other health problems, or you are allergic to many things, a number of treatments may be required. For patients with chronic health issues and/or significant underlying imbalances, results from SAAT will often be much better if you also take Chinese herbal medicine and get weekly acupuncture between monthly SAAT sessions.

The Bottom Line

• SAAT uses individualized placement of tiny needle(s) in the right ear to help calm your immune system’s overreaction to specific allergens.
• Success depends in real part on your consistent avoidance of that allergen while the needles are in place — think of this period as protected time for the treatment to do its work.
• If you have a history of severe or anaphylactic reactions to allergen exposure, carry on with every part of the emergency plan prescribed by your physician during and after SAAT treatment.
• Best long-term results are achieved by working to increase bucket capacity (acupuncture, herbal medicine, therapeutic dietary changes, adequate sleep, stress management, etc.) and reducing immune reaction to allergen exposure (SAAT) simultaneously. SAAT should not be viewed as a stand-alone treatment for complex, severe, or long-standing allergic conditions.