When stress, anxiety or chronic pain strikes, some people are turning to the ancient healing technique of gua sha for relief.
Also known as “skin scraping” or “scraping therapy,” it’s used to soothe discomfort, stiffness and tension, and ease headaches by stroking the body with a smooth edged tool.
It may even ease symptoms of perimenopause. Women who received 15-minute gua sha treatment sessions once a week in addition to conventional treatment reported fewer hot flashes and less fatigue, insomnia and depressed mood, one study found.
Gua sha may work because the skin, nervous system and immune system all interact with one another to generate "a cascade of physiological responses to the scraping," which may result in therapeutic benefits, according to a 2021 review in the Journal of Family Medicine and Primary Care.
The technique also involves the concept of "counterirritation" — artificially irritating the skin to relieve pain elsewhere in the body, the authors wrote.
The appeal is that it's a non-drug way to potentially ease some common health complaints.
“I’ve seen the benefits over and over again, definitely,” Dr. Vincent Minichiello, a family physician and faculty member of the University of Wisconsin-Madison Integrative Health Program, tells TODAY.com.
“From my experience, there really appears to be a true biochemical, mechanical reason why gua sha is effective.”
After living in China and studying traditional Chinese medicine, he now offers it for patients in the U.S.
Janet Shaffer, an acupuncturist at Duke Health Integrative Medicine Center in Durham, North Carolina, calls gua sha one of her favorite techniques for freeing up the fascia — the connective tissue that wraps every structure in the body.
“For some people, it’s like the knife comes out of the back,” Shaffer says of the reactions she has seen from patients after gua sha treatment. “It’s like loosening a stuck jar.”
But both experts cautioned about facial gua sha — a trendy version of the technique made popular on social media. Some videos promise massaging the face with a gua sha tool can lead to a lifting and firming the skin, less puffiness and more sculpted features. Some also claim it can prevent fine lines and wrinkles.
However, there's little scientific evidence for any health or cosmetic benefits for the face, while the bruising potential is real, both experts say.
“I do not do it for other people on their face,” Shaffer says. “If folks are really forcing it, they could bruise themselves. It could be dramatic because the face is so delicate.”
What is gua sha?
A gua sha practitioner will scrape across a person’s lubricated skin in one direction — never back and forth — with a smooth edged tool, as if creating stripes, until tiny pinpoint red spots appear. These spots, known as petechiae, indicate there’s some bleeding just beneath the surface of the skin, Minichiello says. They’re different from bruising, which is deeper in the skin, he notes.
“When we see the petechiae, we’ve reached release, we’ve reached flow, we’ve unstuck,” Shaffer added. “It does look like a rash, but it’s not. And it does look like the skin is broken, but it’s not.”
She likens achieving the correct amount of redness to baking — you watch carefully to get the right browning and then you know you're done.
Arya Nielsen, a U.S. acupuncturist and assistant clinical professor at the Icahn School of Medicine at Mount Sinai in New York, calls gua sha “one of the best kept secrets of traditional East Asian medicine” on her website dedicated to the practice.
What is the gua sha tool?
It’s any smooth edged object. At UW Integrative Health, Minichiello uses a porcelain soup spoon. They’re ordered in bulk and given to each patient to keep for future sessions.
Shaffer uses a jar lid, or tools shaped from jade or an animal’s horn.
Gua sha benefits
From a traditional Chinese medicine standpoint, it improves stagnation within the body or expels influences that can cause the body to feel still, sore, achy or painful, Minichiello says.
From a Western biomedicine standpoint, studies suggest a few different mechanisms, including decreasing the body’s sensation of pain and having some anti-inflammatory properties, he noted.
The practice can help with chronic neck pain, researchers reported in the journal Pain Medicine.
Since the source of chronic tension headaches is often musculoskeletal tension in the upper neck, gua sha can offer headache relief, too, Minichiello said.
It also appears to be an effective treatment for patients with chronic low back pain, according to a 2019 study published in Complementary Therapies in Clinical Practice.
There’s less evidence for “lymphatic drainage” touted by some gua sha enthusiasts, though it’s theoretically possible, Minichiello says. Anytime you manipulate the tissues in the body — or exercise, for that matter — there’s going to be some movement of lymph, he notes.
Where on the body is gua sha performed?
The neck, back and shoulders are common areas since research specifically points to benefits for musculoskeletal pain, Minichiello says.
Is gua sha painful?
The redness it brings about looks like it might be uncomfortable, but most people enjoy gua sha and liken it to the sensation of a deep tissue massage, Minichiello says.
“It might feel a little sore, but it’s like a good type of sore,” he describes the feeling. “If it’s the appropriate treatment, usually people will feel relief pretty much right away.”
“The scraping, if done well and with the correct number of repetitions, it is not painful for most people,” Shaffer adds.
Trying gua sha: What to keep in mind
Try it on a small portion of the body at a time and rest after treatment — no heavy exercise, Minichiello advises. He recommends going to a practitioner trained in traditional Chinese medicine, or a massage or physical therapist who has had gua sha training.
The redness usually goes away within about 72 hours, both experts say, so don’t schedule a session if you want to wear a backless dress the next day.
Gua sha it is not recommended on any areas of the body where the skin is already injured or compromised by sunburn, an abrasion, a rash or a previous bruise.
It can be safely used in people who are on blood thinners, but they will actually bruise, not just develop the petechiae, Minichiello says.
Can you perform gua sha on yourself?
Definitely, he notes.
“I lived in China for about a year and it was actually quite common practice. It’s not meant to be a fancy thing. It’s supposed to be a very simple technique that can be done by anybody in your family,” Minichiello recalls. "They might just do a little bit of gua sha for themselves."
A good place to learn how to do gua sha at first is the upper back, which is “very meaty” on most people and allows you to see the red spots easily, Shaffer adds.