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Though its foray into mainstream beauty is recent, gua sha has been a staple in Chinese households for centuries.
If you're wondering whether this buzzy treatment is actually worth the hype and how you can reap its touted benefits, you're in the right place. Let’s dig in.
Gua Sha, also known as "scraping therapy," is an ancient healing practice in traditional Chinese medicine. It offers various health benefits, including reducing stress, pain, and swelling, as well as improving metabolism, mood, and mindfulness. Incorporating gua sha into your self-care routine can be a simple way to enhance your overall well-being. If you have a skin or health condition that may interfere with this practice, check with your healthcare provider to see if gua sha is right for you.
Gua Sha, or "scraping therapy," is a technique in traditional Chinese medicine (TCM) that involves gently scraping the skin with a flat, smooth-edged tool to stimulate the flow of blood, Qi (vital energy), and lymph.
‘Gua’ means “to scrape,” while ‘sha’ refers to the distinctive red or purple spots that appear on the skin surface due to scraping.
These minor bruises (petechiae and ecchymoses) are formed when small blood vessels break open and blood leaks into the innermost layer of the skin, aka the subcutis.
The blemishes clear out in 2–5 days, with the symptoms alleviating immediately or after a few hours from treatment.
The practice can be traced back to the Paleolithic Age when it was used for treating various illnesses.
Thousands of years later, “in the 17th century, the upper-class elite in China adapted these tools using precious stones such as jade and began using them for cosmetic benefits. A different technique was developed during the Qing dynasty once these tools went from the body for illness to the face for aesthetics,” Dr. Yang explains.
As the cosmetic benefits of Chinese facial tools became more widely known, their popularity spread across East Asia. People who did not have access to precious stones would improvise by using readily available objects like soup spoons and lids, even their hands, for massaging their faces and bodies.
Gua sha techniques were handed down within families and among TCM practitioners. Decades later, the practice made its way to the West, notes Dr. Yang.
“The benefits of gua sha can be viewed through two lenses, that of East Asian medicine and that of Western medicine,” says Dr. Jason Chong, a traditional East Asian Medicine physician and director of Australian Shiatsu College.
In TCM, gua sha is known to promote the circulation of qi and blood, the stagnation of which causes pain. This correlates with the Western perspective, which views gua sha as a method to stretch the fascia (connective tissue), to break up adhesions and muscle knots, and relieve constrictions, thus reducing pain, Dr. Chong explains.
Studies suggest that gua sha may not only alleviate various aches and pains, such as neck pain, plantar fasciitis, and chronic lower back pain, but it might also have longer-lasting effects compared to other pain-relief methods, such as heat packs.
It’s also effective in treating chest congestion caused by colds, asthma, bronchitis, and other lung diseases, adds Dr. Tom Ingegno, DACM, MSOM, LAc.
Moreover, animal studies show that the mechanism of gua sha could strengthen metabolism and improve the immune function of the skin and body.
In addition, a randomized research study published in the journal Menopause found that gua sha may relieve perimenopause symptoms such as hot flashes, insomnia, fatigue, and headache.
The benefits of gua sha extend to aspects of mental well-being as well. For example:
Gua sha may help balance the sympathetic and parasympathetic nervous systems (the "fight-or-flight" vs. "rest-and-digest" responses), says Caitria Thiele, LAc. This balance allows us to adapt to different situations effectively, keeping us from getting stuck in chronic stress or overstimulation.
An overactive or disordered nervous system, on the other hand, is linked to anxiety, depression, and mood swings.
Related: Overview of the Autonomic Nervous System
According to Thiele, gua sha can be an excellent tool for self-care and relaxation once you learn the proper technique from a licensed TCM practitioner.
Thiele recommends performing facial gua sha daily to mitigate the effects of stress on the facial muscles.
Similarly, body gua sha can also be a nice stress reliever as it tackles the systemic effects of stress by improving circulation, she adds.
Gua sha is an intentional practice that encourages mindfulness, providing time and space to sit with ourselves and our emotions, notes Dr. Yang.
It’s an opportunity to acknowledge, validate, and empathize with our emotions and experiences, ultimately softening those areas of our stories that have impacted areas of our faces that could use softening, she says.
This might involve, for instance, holding less tension or letting go of negative beliefs about our appearances.
Related: How the Media Impacts Girls' Mental Health
A case study published in the Global Advances in Health and Medicine journal highlights that gua sha, as a complementary treatment intervention, may ease symptoms of anxiety and depression associated with fear-avoidance beliefs in chronic pain patients.
Techniques like gua sha may help boost our mood by increasing blood flow to the brain and body.
Poor blood flow has been linked to impaired tissue function in specific regions of the brain that may contribute to mental health conditions such as depression.
Related: 5 Types of Self-Care for Every Area of Your Life
One of the most touted claims for gua sha is that it can permanently alter the face shape, making it slimmer or more sculpted.
Gua sha can improve microcirculation and lymphatic drainage to reduce puffiness and enhance skin appearance. “However, I find it difficult to fathom how this can influence the contour of the face,” says Dr. Dev Patel, a certified advanced esthetics practitioner.
It cannot permanently sculpt the face as gua sha “can't address structural changes like loss of skin elasticity, collagen decline, and bone restoration,” says Dr. Wafaa El Mouhebb, a cosmetic dermatology physician and esthetician.
“The only exception would be if someone had a lot of fluid retention in the face, then by improving the lymphatic drainage, one could temporarily see a change to the contour of the face,” adds Dr. Patel.
“In many cases, the slimming effect or lifted appearance disappears after 24 hours,” notes cosmetic formulator Dr. Vanita Rattan.
Surprisingly, these viral claims about contouring are not rooted in traditional gua sha philosophy either.
Chinese facial tools such as gua sha have been “vastly (mis)appropriated” by the West and “incorrectly marketed with little understanding or acknowledgment of their origin,” says Dr. Yang.
“Gua sha is not about erasing anything, but actually about embracing everything,” she says.
According to Dr. Yang, the practice encourages us to form a deeper relationship with ourselves by accepting the features that make us uniquely beautiful.
“When you shift your intentions from erasing your face to embracing your face, the aesthetic benefits become even greater because you are no longer in opposition with the self,” she explains.
Dr. Yang adds, “when applied in the context of Chinese history, culture, and medicine, these tools are so much more than a stone that makes you look good.”
“Gua sha can stimulate blood circulation and improve lymphatic drainage, which can increase the delivery of antioxidants to skin cells and reduce puffiness and swelling,” says Brendan Camp, MD, double board-certified in dermatology and dermatopathology.
“Most can benefit from gua sha, especially those concerned about facial tension and swelling related to vascular congestion on the face,” adds Dr. Camp.
However, there is little clinical evidence backing other purported skincare benefits of gua sha, like boosting collagen, altering facial contour, and permanently smoothing out wrinkles and fine lines, says Dr. Rattan.
“If individuals experience improvements in the appearance of their skin after using gua sha, it could be due to increased blood flow, reduced muscle tension, or enhanced lymphatic drainage, rather than a direct effect on collagen production,” she explains.
“Typically, gua sha is considered safe. However, individuals with damaged skin barrier due to conditions such as eczema or psoriasis should avoid gua sha as it could cause further irritation,” says Dr. El Mouhebb.
Similarly, if you have sunburn, active infection, open wound, or have undergone recent surgery, it’s recommended to avoid gua sha until it’s completely healed.
It’s highly recommended to learn the technique from a licensed TCM practitioner first before trying gua sha at home. “It can be at worst harmful or at best ineffective if done incorrectly,” says Thiele.
Next, choose a gua sha tool of your choice.
Contrary to popular belief, you don’t need a vanity-worthy tool made from polished crystal to reap the benefits of this ancient healing practice.
“Any gua sha board that resonates with you is a good place to start,” says Dr. Yang. “There is more emphasis on technique than the tool itself,” she adds.
Even everyday objects like coins, soup spoons, and mason jar lids can double as gua sha tools. “Anything with a rounded edge will work,” says Thiele.
Here are other quick tips to keep in mind to get the most out of your gua sha practice:
Always perform gua sha on clean skin with a clean tool to avoid pushing impurities into the skin.
After cleansing, Dr. Ingegno recommends moisturizing the skin with a face or body oil, lotion, or cream to help the tool glide easily over the skin.
For best results, keep the tool at a 45-degree angle from the skin, suggests Thiele.
Apply mild to moderate pressure if using gua sha for facial rejuvenation. For pain or stress relief, keep the pressure medium to firm, recommends the American Institute of Alternative Medicine (AIAM).
Stop massaging when the skin begins to redden."Overdoing it can damage the skin and possibly cause an abrasion," cautions Dr. Ingegno. It should not be a “no pain, no gain” situation.
Use even strokes following the lymphatic pathways to prevent fluids from pooling in your skin, causing swelling and discomfort.
Allow any scraping marks or 'sha' left by the treatment to fully clear out before treating the same area again, says Thiele.
Place the long edge of the tool on the skin and massage in an upward motion, moving from your collarbone to your earlobe.
Apply medium pressure.
Repeat the movement 3-5 times before moving to the opposite side.
For the throat, place the tool's edge between your collarbones and move it up to your chin.
Keep the pressure light.
Next, move the tool in long, even strokes from the center of your chin and along the jawline until the base of your ear.
Repeat 3-5 times before switching to the other side.
Place the long edge of the tool on the skin and slowly drag it upward past your cheekbone to your ear.
Use mild to moderate pressure.
Repeat the movement 3-5 times, then do the same on your other cheek.
Place the edge of the gua sha tool on the middle of your eyebrow.
Move along the brow until you reach your hairline.
Repeat the movement 3-5 times, then do the same on the other eyebrow.
Next, place the curved edge of the tool flat against the inner corner of the eye.
Use light sweeping motions to massage outwards to the hairline.
Do this 3-5 times, then repeat on the other side.
Place the edge of the tool on top of your eyebrow.
Slowly drag the tool towards the top of the forehead.
Repeat 3-5 times, then switch to the other side.
It's also important to consider the time of day for addressing different concerns. Consider adding gua sha to your morning routine if your goal is to depuff and energize the skin. For releasing muscle tension and stress, add it to your bedtime routine, recommends AIAM.
It’s relatively safe to perform gua sha every day, provided you follow the correct technique learned from a trusted source and don’t overdo it, says Dr. Yang.
To further minimize any potential side effects, it’s important to avoid performing gua sha on certain areas of the body. For example, skin with lesions, cuts, large visible veins, or infections, says Dr. Ingegno.
Individuals with certain health conditions like deep vein thrombosis or those with clotting disorders should avoid gua sha altogether.
While it's unclear if it is unsafe for pregnancy, Dr. Ingegno also advises against this massage technique if you’re pregnant.
Some people can feel relief immediately after the treatment, provided the condition is mild to moderate, says Dr. Ingegno.
However, more than one session may be needed to see any significant improvement if the condition is more serious, depending on its severity, he adds.
If you’re new to gua sha, working with a licensed TCM practitioner to determine which technique and tool is best for your specific goal is a good place to start.
Gua sha is typically safe and effective for most people. However, as with any new treatment or procedure, it’s advisable to check in with your healthcare provider first to see whether it’s right for you.
Medicine
