Is Gua Sha Really Effective?

Medically Reviewed by Jabeen Begum, MD on May 10, 2024
Written by Alexandra Benisek, Stephanie Booth
7 min read

Gua sha (pronouced "gwa-shah") is an East Asian healing technique. A trained professional uses a small, smooth-edged tool to firmly stroke your skin in one direction. This can help improve blood flow and reduce inflammation.

How can gently "scraping" your skin help it heal? According to traditional Chinese medicine, good health relies on chi, or energy, to easily flow through your body. If this important force gets blocked in an area, you can start to have health issues. Gua sha is believed to get this vital energy "unstuck" and flowing again.

Gua sha is sometimes also called coining, skin scraping, or spooning. It's called "Kerikan" in Indonesia and "Cao gio" in Vietnam.

While gua sha is a fairly new concept in the U.S., it's been used in China for over 2,000 years. It's often used to help treat chronic pain throughout the body. Today, gua sha is getting noticed for its skin benefits, but more research needs to be done to prove them.

Gua sha vs. the Graston technique

Here in the Western part of the world, licensed acupuncturists often offer gua sha. But similar techniques are also used by physical therapists and chiropractors. Instead of gua sha, you might hear it called instrument-assisted soft tissue mobilization (IASTM). A small tool is used to help loosen up tight muscles or areas of scar tissue. There's no mention of chi.

One well-known IASTM method is called the Graston technique. The founder, David Graston, modeled it after gua sha. But besides skin scraping, the Graston technique also focuses on stretching, strengthening, and using ice to relieve any pain or inflammation.

There are several other types of IASTM that physical therapists and chiropractors use. They have different techniques and skin-scraping tools.

To prepare you for treatment, your provider will put oil on your body. They’ll then use a stonelike gua sha massage tool to scrape your skin in long, downward strokes. This motion breaks tiny capillaries (blood vessels) under your skin. As a result, you'll see temporary small, red, rash -like dots called petechiae.

As the session goes on, your provider may slowly add more pressure to the strokes. They should only apply as much pressure as you’re comfortable with. Gua sha shouldn't be painful.

You can get gua sha all over your body, including your:

  • Back
  • Neck
  • Butt
  • Arms
  • Legs

You might also have gua sha done on your face, but that process is gentler.

Scraping your skin and causing petechiae to appear on your skin is believed to activate both your immune system and nervous system, setting off a complex chain of events in your body. Studies show that when done correctly, gua sha can release chemicals that improve blood flow, lessen toxins, reduce pain, and promote healing in the area.

Gua sha may be able to help with issues such as:

  • Tight muscles
  • Swelling
  • Anxiety
  • Sinus pressure
  • Fatigue

But the research is limited.

Some studies have also looked into how gua sha can help treat health conditions such as:

Hepatitis B . One study showed that gua sha might help lower the amount of liver inflammation caused by the hepatitis B virus. But more studies are needed to know for sure.

Migraines . One study showed that as part of a 14-day hospital treatment, gua sha appeared to help ease migraine pain. But experts need more research and clinical trials to prove this.

Tourette's syndrome . This condition affects your nervous system and causes "tics," or sudden twitches. In one study, a man with Tourette's syndrome used a combination of acupuncture, herbs, lifestyle changes, and gua sha once a week for 35 weeks. He saw his symptoms improve by 70%. But researchers need more evidence to confirm the links.

Neck pain . In a clinical trial, 48 people with chronic pain in their necks were divided into two equal groups. After a week, the people who had gua sha treatment saw their pain ease significantly for a short time. Experts are undecided about the long-term effects of gua sha on neck pain.

Perimenopausal symptoms. Once you near menopause, it's common to have irregular periods, hot flashes, sleep issues, and mood changes. In one study, participants who used gua sha once a week for 8 weeks saw those symptoms improve. Researchers are still trying to understand the link.

Breast fullness. If you breastfeed, your breasts might overfill with milk. This can cause them to swell and become painful. In one study, people who were having trouble breastfeeding because of breast fullness got gua sha treatment while they were in the hospital and for a couple of weeks after they went home. It improved their pain so they were able to breastfeed more easily.

There's a lot that's still not understood about gua sha, and it's possible that some benefits are due to a placebo effect. Studies show that when you expect to feel better and see your symptoms improve, it's more likely to happen.

Typically, gua sha is considered safe. But you may have some bruising or notice that your skin looks discolored for a while. You could also be sore and tender afterward. These effects usually go away in 3-4 days.

A bacterial skin infection is also possible, although unlikely. To reduce this risk, make sure to properly clean your gua sha tool in between uses, or seek treatment from a provider who does.

Generally speaking, you should avoid gua sha if:

  • You have diabetes
  • You have issues with circulation
  • You take blood thinners (medicine for blood clots)
  • You're pregnant or think you may be

Also, skip gua sha on your face if:

  • You've had skin fillers (such as Botox) injected into your face within the past month
  • You have an ongoing skin issue, such as psoriasis or rosacea

If you want to try gua sha, talk with your doctor first to make sure it's safe for you.

The idea of "skin scraping" may make you think of a squeegee, but gua sha tools have rounded edges. They don't break your skin. Traditionally, gua sha might be done with a natural tool, such as a buffalo horn. Sometimes oil is used to help it glide more easily across your skin. Today, you can find several different gua sha tools to buy online. But you could even use a small wooden kitchen spoon.

Gua sha stone

Some gua sha stones are made from polished stones such as rose quartz or jade. They come in all kinds of shapes from hearts to moons. No matter the form, a gua sha stone has a double notch on one side and a long handle on the other.

You can use the double notch to gently scrape your skin in areas such as your:

  • Eyebrows
  • Jaw
  • Throat

 The longer edge can be used on areas such as your:

  • Cheeks
  • Forehead

Choose a stone that's easy to clean. (Check the manufacturer's notes.) And look for a material that won't easily chip. If your tool breaks, get a new one so you don't accidentally damage your skin.

Jade roller

This is a kind of handheld self-massage tool, which looks like a tiny paint roller. It is a good choice for your face. It can help cool your skin and reduce puffy areas. It's also unlikely to worsen any ongoing skin issues, such as eczema.

If you're doing gua sha on yourself, make sure you clean your roller or stone with mild soap after each use.

Face oil for gua sha

You can apply a face oil right before you do gua sha. This will help the stone or roller glide more easily. If you have a skin condition such as acne or sensitive skin, use an oil-free face lotion or serum instead. You may need to apply it more than once during the process.

If you want to try gua sha facial massage, remember to:

  • Wash your hands first. Your gua sha tool should be clean, too.
  • Hold the tool correctly. It should touch your skin at a 35-45 degree angle.
  • Find the right touch. Use light to medium pressure.
  • Use even upward and outward motions.

Gua sha for face

  • Apply lotion or serum on clean skin.
  • Starting at your neck, use your tool to make smooth upward strokes from your collarbone to your earlobe.
  • Repeat three to five times, then repeat on the other side.
  • Next, put the roller or double-edged part of your tool at the center of your chin, then move it along your jawline to your ear.
  • Repeat on the other side.
  • Slowly, drag the roller or long edge of the tool across your cheekbone to your ear.
  • Repeat on the other side.
  • Starting under your right eye, gently slide your gua sha tool outward toward your ear. Move it smoothly and in a straight line.
  • Repeat on the left side.
  • Starting in the middle of your right eyebrow, drag the notched side of your tool or roller outward until you reach your hairline.
  • Repeat on the other side.
  • Firmly press the roller or long edge of your tool from the top of your right eyebrow to the top of your forehead.
  • Repeat on the opposite side.

A few gua sha tips

  • Always scrape from the inside to the outer edges of your face.
  • The skin on your face is thinner than on your body, so be careful not to apply too much pressure. This routine shouldn't hurt.

How often should you gua sha?

Some experts suggest that trying gua sha two to three times a week will help you see positive results. Talk to your doctor if you have any questions or concerns.

Gua sha is a healing method that's been around for thousands of years. Still, few studies have been done in the U.S. to prove its benefits. If you're interested in trying it, check with your doctor first.