Gua sha is the practice of press-stroking or scraping the surface of the skin to produce intentional redness and petechiae, known as “sha”. It’s also known as scraping, spooning, kerokan, or coining. Gua sha is an ancient practice rooted in Chinese medicine and culture, treasured for its versatility and powerful healing impact. In much of south and east Asia, therapies like this are a common form of folk medicine, often performed among family members for ailments of all kinds. From a Chinese medicine perspective, when things become stuck, pain and dysfunction result. Gua sha moves what is stuck, resolves pain, and improves function. Gua sha has beneficial anti-inflammatory and immune system protective effects, helps prevent and treat acute infectious illness, reduces pain, treats acute and chronic musculoskeletal issues, and supports internal medicine concerns like digestive or respiratory disorders. More gentle gua sha techniques can be performed on the skin of the face to encourage a bright, smooth, and lifted complexion. When done properly, gua sha is very comfortable and safe.
In recent years, gua sha has become popular in the mainstream. Gua sha tools and appropriated techniques have become a hot commodity in the beauty industry. Many chiropractors and physical therapists practice Graston Technique for muscle pain and tension, a system derived from from gua sha techniques. Because gua sha is a therapeutic intervention, it is best to receive gua sha treatment and learn gua sha techinques from a trained Chinese medicine provider.
What can gua sha treat?
Gua sha can be used for a variety of concerns, such as....
preventing the onset of colds and reducing fever
asthma, chest congestion, chest tightness
breaking up scar tissue from injuries or surgeries
tight muscles and "knots" anywhere in the body
promoting lymph fluid circulation and detoxification
plantar fasciitis pain and tension
supporting digestion and promoting regular bowel movements
general wellness and preventative care
when performed with light, non-marking pressure on the skin of the face, it encourages movement and drainage of mucous from the sinuses, moves lymphatic fluid, reduces puffiness, sculpts the tissues, and supports a vibrant, smooth complexion
What does gua sha feel like? Does it hurt?
Gua sha feels like firm, steady, stroking pressure against the skin. During a treatment, the skin is lubricated with oil to ensure a smooth, easy glide. Everyone’s tolerance for gua sha varies. Some people love firm pressure, while other people do best with very light pressure. Light pressure usually feels extremely soothing. When medium to firm pressure is applied, it feels like a deep massage, and can occasionally “hurt so good”, but should never be painful. The intensity of pressure is guided based on what is most appropriate for your symptoms, and what feels best for you. Gua sha performed on the skin of the face and the front and sides of the neck is very gentle to protect the delicate skin and structures of these areas.
What are gua sha tools made of?
Essentially, anything with a smooth edge that you can easily hold on to can be a gua sha tool.
In folk healing traditions, gua sha might be done with a porcelain soup spoon or a coin - it’s called “coining” in some regions for a reason! There are also an abundance of manufactured gua sha tools in a variety of shapes in sizes, made from materials like stone, bone, horn, plastic, or metal. In the clinic, we often use disposable jar lids, porcelain soup spoons, or stone tools.
Is gua sha safe?
Although the red color of “sha” can be surprising the first time you see it, when done appropriately the practice of gua sha is safe and non-invasive, and can be used on patients of all ages. Gua sha may not be appropriate for everyone, however - read on!
What are the contraindications (reasons not to get gua sha)?
If you are very weak, are dealing with a prolonged disease, or have low blood pressure, you may be able to receive gua sha, but it would be gentle treatment and you should give yourself plenty of time to rest afterward
If you have a bleeding disorder or taking blood thinners, gua sha treatments may or may not be appropriate, depending on your unique situation
Pregnant people should not receive gua sha on the trapezius, low back, sacrum, or abdomen
Gua sha should not be done on areas of severely dry/flaky, infected, broken, sunburned, burned, inflamed skin, acne, or cysts
Gha sha should not be performed on areas of edema, ascites, or swelling
Gua sha should not be performed over broken bones, herniated discs, dislocations
People should not receive gua sha if experiencing severe health conditions such as cardiac failure, renal failure, liver failure
How often do I need gua sha?
That depends entirely on your body and your situation. Acute or short-term symptoms tend to resolve more quickly than long-term symptoms. We have some patients who come every week for treatments involving gua sha, while some patients only get it once a month or once a seasons. Because it has a cumulative effect, for chronic issues we recommend coming weekly for 4-6 treatments including gua sha, acupuncture, and other modalities to get the best results, then re-evaluating.
If you had a recent treatment with marking gua sha, please wait for the sha to completely fade before performing gua sha again on that same area.
Gentle facial gua sha can be performed daily if done properly.
How do I take care of myself after receiving gua sha?
Avoid exposure to the wind, drafts, direct sun, and cold for at least 24 hours, preferably until the sha is gone! Keep the area well covered and warm.
If activity has been reduced due to pain or stiffness, and feels better after gua sha, build up the activity level slowly to prevent re-injury and to rebuilt strength and mobility.
Avoid large quantities of cold, sour, or salty foods and drinks after gua sha treatment. From a Chinese dietary therapy perspective, cold stagnates and congeals the qi, worsening pain! Sour foods contribute to nervousness and increase pain conditions. Salty foods can also worsen pain by increasing swelling and puffiness.
How do I schedule, or learn how to do gua sha myself?
At the clinic, gua sha can be included in acupuncture appointments as appropriate for the patient and their chief concerns. Your provider will help determine if gua sha is right for you during appointment!
To perform gua sha on yourself safely and effectively, it is best to learn from a trained Chinese medicine practitioner. We love educating our patients on how they can do gua sha themselves as part of their own self-care routine! If this is something you’re interested in, ask about it at your next treatment.
We also strongly recommend the gua sha educational tutorials and traditional Chinese facial tools from Dr. Paige Yang, LAc of Yang Face.
