Author(s): Ken Feldman, MD, Children's Hospital and Medical Center, Seattle, WA

Date Authored: August 1, 1996

Three school children in a classroom in Southeast Asia
Photo by Asian Development Bank (cc license).

Have you noticed patterned circular scars on the skin of Asian and African patients? Dr. Ken Feldman from Odessa Brown Children’s Clinic, Seattle, WA offers the following information:

Folk medical therapeutic burning, moxabustion, has been observed in both Southeast Asian children (1) and children from East Africa (2). A 15 year old male from Somalia stated that burns along his superior rectus abdominis and dorsum of his wrists had been administered to treat malaria. A translator elaborated that the treatment is used to treat any cause of jaundice; the teen was also hepatitis A immune and a hepatitis B carrier. The translator reported that when used to treat jaundice, the elbows and ankles are also often burned. Sometimes temples and the right subcostal region are also burned.

The translator also indicated that burning is used to treat abdominal problems resulting from the “evil eye”. Small dot burns or incisions to yield drops of blood are made. In this case, only women perform the treatment; while for jaundice, either men or women may treat. The translator reported that such treatment are common throughout that region of Africa.

Like the patterned burns in the Southeast Asian children, these burn injuries are clearly inscribed, appearing like cigarette burns. They could be confused with abusive injuries if the family’s cultural beliefs and native country’s medical practices are not considered.


  • Feldman, KW (1984). Pseudoabusive burns in Asian refugees. American Journal of the Diseases of Children, 138, 768-769.
  • Feldman, KW. Pseudoabusive burns in a Somali child. Child Abuse and Neglect 1995;19:657-658.