Used in the mid 20th century, copper needles have been the most popular type of handle throughout many generations. As copper is flexible, easy to manipulate while being a good electricity and heat conductor, it easily became a favorite among acupuncturists. For acupuncturists, its flexibility allowed the practitioner to feel the insertion feedback.

Downsides: As copper remains flexible, it can be prone to bucking, and long term storage must be strictly observed as copper tarnishes.

Aluminum handles gained more popularity later in the 20th century when mass-produced disposable needles were on the rise. As concerns regarding sterilization and costs were becoming an obstacle, aluminum was an economical choice at the time. To this day, aluminum handles are a budget friendly choice and since it is still a conductive material it is usually used in line with moxibustion. Compared to copper however, aluminum handles are lighter.

Downsides : it has a lower electrical conductivity, and may feel less solid to copper handles. 

Gold plated needles are considered a more premium option compared to other materials. Like other metals, it is an excellent conductor. It was traditionally believed that gold increases Qi stimulation. Moreover, as gold is biocompatible to the body alongside its hypoallergenic properties, it’s a great alternative to patients who have other metal allergies or who have sensitive skin. With all these properties, it has slowly gained popularity in cosmetic and auricular acupuncture.

Downsides: it remains a more expensive option. Needles are only plated, thus, with electro clips, there is a risk of scratching the plating off.

As the name suggests, this needle handle originates from Korean Acupuncture Practice and is made with stainless steel. Its spring coil handle design  favours the space between the index finger and the thumb for easy manipulation and ensures a smooth insertion. However, compared to the loop handles, the needle is not wrapped around by the coil design but instead mechanically fixed, similar to being crimped to ensure a tight hold on the actual needle. As a result, the spring handles feel more elastic upon insertion but it may give less feedback as the needle is not completely wrapped.

Downsides: while it is a great conductor, it is less ideal with electroacupuncture and especially moxa. They are also usually silicone coated.

In the late 20th century, plastic and advanced molding technology boomed worldwide which sparked the creation of plastic handles or acupuncture needles. This time the needles were fused directly around the needle. As a result, the needle is light yet rigid, this allows resistance to buckling while making it easier for experienced acupuncturists. Moreover with its bright colors, they are easier to spot and collect.

Downsides:  they are not at all compatible for electroacupuncture and moxibustion.

Press tack needles are one of the smallest acupuncture needle types. These needles are typically designed with a small coil handle, and at the end, the needle is bent 90 degrees perpendicular to the coil. Generally the coil is attached to the plaster or patch while the needle tip remains exposed for shallow insertion. Press tack needles are usually left in the treatment area for an extended period of time

Downsides: as these needles are left in treatment zones for a longer period of time, skin irritation or adhesive-related allergies may trigger reactions.

Intradermal needles are made of medical-grade stainless steel similar to acupuncture needles without the conventional handle. They are considerably small in size though slightly longer than press-tack needles. They are also shaped similarly to presstack needles, with a coil for the handle. However, instead of the needle bending perpendicularly in the end, it is bent parallel to the coil. Moreover, they are usually inserted shallowly to the skin with tweezers.

Seven Star or Plum blossom Needles is a group of 7 small needles arranged in a star or flora pattern on the head of a handle, with one needle at the center and the other six surrounding it. The head is usually detachable to the handle and it can be replaced. These needles are used in treatments that require mild stimulation by tapping. Most treatments are related to cosmetic treatments as it is popularly used in cosmetic dermatology.

Downsides: Repeated tapping may cause temporary pain, bruising, bleeding, or skin irritation. Improper sterilization may also increase the risk of infection.