What Is Gua Sha—And How Do You Use It?

In This Article
View All
In This Article
A black woman using a gua sha tool on her face

andreswd / Getty Images

Gua sha is an alternative therapy massage technique that uses a smooth stone to scrape across the skin. This stone is typically heart-shaped (although, not always) and is usually made of a stone, such as jade.

Gua sha research is limited, but researchers have found gua sha can improve circulation, which may help reduce inflammation and alleviate pain. Here's how the massage technique works and how to add gua sha to your self-care routine. 

Origins of Gua Sha

Gua sha—also called scraping, spooning, or coining—originated from traditional Chinese medicine (TCM). Thousands of years ago, gua sha practitioners would use a spoon, coin, or buffalo horn to scrape the skin upward to release blocked energy (or qi). TCM practitioners believe blocked qi causes inflammation, pain, and disease. During gua sha, specific pressure points are scraped to help reduce pain and inflammation. 

Today, gua sha is typically performed with a flat tool typically made of jade, amethyst, or stainless steel. During a gua sha session, the same upward motion helps stimulate soft tissue to boost circulation. Gua sha sessions are available for your face, neck, back, arms, legs, or buttocks. A licensed acupuncturist or TCM practitioner typically performs gua sha, but you can also do it at home. 

Benefits of Using a Gua Sha Tool

Gua sha is an alternative therapy used to help treat inflammatory conditions, reduce puffiness, and relieve muscle pain. But even after thousands of years, gua sha research is limited. As a result, we don't know if gua sha effectively treats chronic pain and inflammation, but it seems to work.

Here's what the science says about the potential benefits of gua sha. 

Reduces Inflammation and Swelling

There's no evidence that gua sha can help prevent wrinkles, but it may reduce puffiness and inflammation on the face and body. Research shows the scraping motion of gua sha can reduce inflammation by promoting microcirculation, which is blood flow through small blood vessels.

The scraping motion of gua sha can also create petechiae, small red areas where small blood vessels have burst. Research shows petechiae can trigger an anti-inflammatory immune response. These effects of gua sha may help reduce inflammation and puffiness of the face and body. 

Reduces Headache Pain

There needs to be more research to prove gua sha is an effective headache treatment. However, some anecdotal claims and limited research show gua sha may help alleviate chronic headache symptoms.

The only anecdotal evidence of using gua sha for headache relief comes from a 2007 German case study of a 72-year-old woman with chronic headaches. The study reported that two weeks of gua sha helped ease chronic headache symptoms. Still, we need more extensive studies to prove gua sha is effective.

Relieves Shoulder, Neck, and Back Pain

Gua sha may also help reduce upper body pain related to sitting at a computer. A small 2014 study found gua sha reduced neck and shoulder pain in participants who regularly used a computer. Participants also reported more range of motion after gua sha.

A small 2011 study found that folks with neck pain reported less pain than the heating pad group after a week of gua sha sessions. People who had gua sha also experienced less pain when they moved. Similarly, a 2017 study of older adults found that gua sha was better at relieving lower back pain and improving mobility than using a hot pack. Still, we need more research to know the long-term effects of gua sha for body pain.

Aids Muscle Recovery and Pain Relief

Massage techniques, in general, can help relieve muscle injury pain and aid in recovery. Gua sha may help muscle recovery and prevent injury after fatigue. In a 2019 study of 44 male weightlifters, people who had 16 gua sha sessions over eight weeks improved their weightlifting abilities.

Gua sha may also help reduce plantar fasciitis pain caused by swelling and irritation of the thick tissue under your heel. A 2023 clinical trial of 36 people found gua sha was better at reducing pain than traditional cryostretch methods. Gua sha also reduced skin tenderness.

Offers Chronic Pain Relief

People often seek gua sha to treat chronic pain conditions like fibromyalgia. Some studies have shown gua sha helps reduce musculoskeletal pain, but we need more quality research to prove gua sha achieves pain relief. Pain relief associated with gua sha is likely temporary, but it may be possible based on counterstimulation and the placebo effect.

Counterstimulation involves irritating a part of the body that distracts pain receptors and reduces your pain perception. For example, gua sha's scraping motion and pressure may temporarily tell your body to refocus pain receptors and alleviate some pain. The placebo effect means your positive expectations of gua sha make you feel and believe you experience pain relief. In reality, gua sha may not do anything physically that helps relieve pain, but you still perceive pain differently. 

Relieves Breast Engorgement

If you're breastfeeding, scraping the breast with a gua sha tool may help express milk to relieve discomfort from breast engorgement. There's not much research on gua sha for breast engorgement, but gua sha is similar to other milk expression massage techniques. 

In a 2010 study of 54 breastfeeding people, two cycles of gua sha helped ease breast engorgement. Researchers also found gua sha was just as effective as applying a warm compress and massaging the area for 20 minutes. 

Reduces Perimenopause Symptoms 

Gua sha is often used in East Asia to help relieve symptoms of perimenopause, a transitional period where the body prepares for menopause. Studies have shown gua sha may help relieve perimenopause symptoms like insomnia, fatigue, headaches, and hot flashes. 

In a 2017 study of 80 perimenopausal women, participants had 15-minute gua sha sessions a week for eight weeks. The gua sha group reported more reduction in perimenopause symptoms compared to those who had conventional treatments. A 2018 research review of gua sha and perimenopause also concluded that gua sha effectively treats perimenopausal symptoms. Research seems promising, but we need more studies to understand how gua sha helps perimenopause symptoms.

How To Use a Gua Sha

You can use gua sha tools on the face or body. Before you start, clean the skin and apply a serum or oil to your skin to help reduce friction. 

To do gua sha on the body, you'll gently apply pressure and glide the contoured edge of your tool on the desired body part in an upward motion (think toward the heart). Keep the edge of the gua sha stone at about a 45-degree angle. The movement should follow the curve of the body part you're targeting. For example, if you're scraping your calf, you'd start above the ankle and glide the gua sha tool to the outer base of your knee. Even with light pressure, you will notice temporary redness after completing gua sha. 

The gua sha stone should move in an upward and outward motion on the face. To do facial gua sha at home, follow these steps:

  1. Apply a face oil or serum to a clean face and neck. 
  2. Glide the curved edge of your gua sha tool from the base of your neck to your chin. Repeat at least twice on both sides. 
  3. From your chin, use the curved edge to glide up your jawline to your ear. Repeat at least twice on both sides. 
  4. Starting at the base of your cheekbone near your lip, apply the curved edge of the stone in an upward motion up to your ear. Repeat at least twice on both sides. 
  5. Below your eye, near the inner corner, apply light pressure and move outwards. Repeat at least twice on both sides. 
  6. Move to your inner brow bone and use the top of the heart shape to glide to the outer edge. Repeat at least twice on both sides. 
  7. Finally, place the flat edge of the tool at the top of the bridge of the nose and glide up to the hairline. Repeat at least twice. 
Gua sha should involve gentle pressure and feel relaxing. You should not dig deeply into the skin. If gua sha is painful, you're probably pressing too hard.

How to Choose a Gua Sha Tool

If you're new to gua sha, opt for a flat, thin heart-shaped tool with a curved edge. The curved edge of your gua sha tool should also contour the area you want to massage. For example, if you do gua sha on your face, the curve in the heart-shaped stone should contour your cheekbones and jawline. Choose a tool you can also comfortably grip to avoid slipping and fumbling.

Jade, amethyst, stainless steel, or other stone materials can make good gua sha tools. However, different materials can create a different experience. Jade and amethyst can feel cooling on the skin, and natural stones can be easier to hold onto since they are often heavier than synthetic crystals.

How Often Should You Use a Gua Sha?

How often you do gua sha at home or visit a gua sha practitioner will depend on your skin type and how your body responds to gua sha.

Gua sha practitioners typically recommend doing gua sha once a week. However, you may be able to do it more often—about two to three times a week—if your skin can tolerate it. Some people also like to do gua sha for about five minutes daily. 

When in doubt, ask a gua sha practitioner how often you should do gua sha at home if you have specific health goals.

The Risks of Gua Sha

Gua sha is typically considered a safe practice. However, it's not without risks and isn't safe for everyone. 

If you have open skin wounds or are healing from a sunburn, you should avoid gua sha. Gua sha may be unsafe for you if you have blood circulation issues. Healthcare providers often recommend you also avoid gua sha if you:

  • Recently had surgery
  • Take blood thinners
  • Have a clotting disorder
  • Have diabetes

The pressure and scraping motion of gua sha can also burst blood vessels near the skin's surface, causing bruising or light bleeding. Bruises typically go away after a few days. Bleeding can increase your risk of getting or transferring bloodborne illness if your technician doesn't properly disinfect gua sha tools.

A Quick Review

Gua sha is a type of traditional Chinese medicine where a flat, heart-shaped stone tool scrapes across the skin. No research proves a gua sha face massage will reduce wrinkles. But, studies show gua sha may help reduce inflammation, improve circulation, and help relieve pain. 

Gua sha research is still limited, and we don't know how effective gua sha is at treating chronic pain and aiding muscle recovery. However, at-home gua sha is typically safe if you don't have blood circulation issues. You can also visit a licensed acupuncturist or TCM practitioner for a gua sha session.

Was this page helpful?
16 Sources
Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Nielsen A, Knoblauch NT, Dobos GJ, Michalsen A, Kaptchuk TJ. The effect of Gua Sha treatment on the microcirculation of surface tissue: a pilot study in healthy subjectsExplore (NY). 2007;3(5):456-466. doi:10.1016/j.explore.2007.06.001

  2. Nielsen A. Gua sha and the history of traditional medicine, West and East. In: Gua sha: a traditional technique for modern practice. Churchill Livingstone Elsevier; 2013.

  3. Chu ECP, Wong AYL, Sim P, Krüger F. Exploring scraping therapy: contemporary views on an ancient healing - a review. J Family Med Prim Care. 2021;10(8):2757-2762. doi:10.4103/jfmpc.jfmpc_360_21

  4. Schwickert ME, Saha FJ, Braun M, Dobos GJ. Gua Sha bei Migräne in der stationären Entzugsbehandlung von medikamenteninduziertem Kopfschmerz [Gua Sha for migraine in inpatient withdrawal therapy of headache due to medication overuse]Forsch Komplementmed. 2007;14(5):297-300. doi:10.1159/000107731

  5. Saenlee K, Eungpinichpong W, Chatchawan U. Immediate effects of gua Sha therapy for reducing neck and shoulder pain associated with myofascial trigger point in computer users. Arch AHS. 2014;26(2):169-7. 

  6. Braun M, Schwickert M, Nielsen A, et al. Effectiveness of traditional Chinese "gua sha" therapy in patients with chronic neck pain: a randomized controlled trialPain Med. 2011;12(3):362-369. doi:10.1111/j.1526-4637.2011.01053.x

  7. Yuen JWM, Tsang WWN, Tse SHM, et al. The effects of gua sha on symptoms and inflammatory biomarkers associated with chronic low back pain: A randomized active-controlled crossover pilot study in elderlyComplement Ther Med. 2017;32:25-32. doi:10.1016/j.ctim.2017.03.010

  8. Waters-Banker C, Dupont-Versteegden EE, Kitzman PH, Butterfield TA. Investigating the mechanisms of massage efficacy: the role of mechanical immunomodulationJ Athl Train. 2014;49(2):266-273. doi:10.4085/1062-6050-49.2.25

  9. Wang X, Jia B, Zhong H, Huang X, Chen R, Yang J. Effects of gua sha therapy on weightlifting training: a randomized trialJ Tradit Chin Med. 2019;39(4):575-581.

  10. Jadhav A, Gurudut P. Comparative effectiveness of gua sha, cryostretch, and positional release technique on tenderness and function in subjects with plantar fasciitis: a randomized clinical trialInt J Ther Massage Bodywork. 2023;16(1):13-23. doi:10.3822/ijtmb.v16i1.749

  11. Lee MS, Choi TY, Kim JI, Choi SM. Using Guasha to treat musculoskeletal pain: a systematic review of controlled clinical trialsChin Med. 2010;5:5. doi:10.1186/1749-8546-5-5

  12. Chiu JY, Gau ML, Kuo SY, Chang YH, Kuo SC, Tu HC. Effects of gua-sha therapy on breast engorgement: a randomized controlled trialJ Nurs Res. 2010;18(1):1-10. doi:10.1097/JNR.0b013e3181ce4f8e

  13. Ren Q, Yu X, Liao F, et al. Effects of gua sha therapy on perimenopausal syndrome: a systematic review and meta-analysis of randomized controlled trialsComplement Ther Clin Pract. 2018;31:268-277. doi:10.1016/j.ctcp.2018.03.012

  14. Meng F, Duan PB, Zhu J, et al. Effect of gua sha therapy on perimenopausal syndrome: a randomized controlled trial. Menopause. 2017;24(3):299-307. doi:10.1097/GME.0000000000000752

  15. Ren Q, Yu X, Liao F, et al. Effects of gua sha therapy on perimenopausal syndrome: asystematic review and meta-analysis of randomized controlled trialsComplement Ther Clin Pract. 2018;31:268-277. doi:10.1016/j.ctcp.2018.03.012

  16. Nielsen A, Kligler B, Koll BS. Safety protocols for gua sha (press-stroking) and baguan (cupping)Complement Ther Med. 2012;20(5):340-344. doi:10.1016/j.ctim.2012.05.004

Related Articles