TCM practitioners these days generally use indirect moxibustion. It involves burning a moxa or herb stick an inch or more above the skin over the acupuncture point. In this way the heat is targeted; the heat also opens the pores so the herbal smoke penetrates the skin and enters the bloodstream.

Indirect moxibustion also can be combined with acupuncture. In this method acupuncture needles are inserted and the moxa is burned above the needles. Thus the heat is also transferred precisely through the needles to the acupuncture points.

Other moxibustion tools have been developed such as Dr Wang's bamboo tube.

(Shanghai Daily September 1 2009)