How Gua Sha Works: Key Benefits and Techniques 

Published September 23, 2022
Woman with gua sha

Gua sha, pronounced 'gwasha,' is an ancient Chinese practice gaining popularity in the Western World. You may have seen one of the three million-ish videos on Tik Tok showing you exactly how to do it, while still not really understanding what 'it' is. Also known as scraping, coining, or spooning (no not that kind), gua sha was traditionally done with a coin. The coin was scraped along the skin to work out muscle knots, get the 'qi' flowing, and rejuvenate skin.

Qi (sounds like 'chi') is roughly translated as 'vital life force,' but actually encompasses a much larger idea in Chinese culture. To fully understand the concept of qi, you may need to read one (or several) articles on the subject, but just know that it's a good thing, you want more of it in your life, and many people from the Chinese culture claim gua sha can help you get it.

The practice of gua sha is well established in traditional Chinese medicine and most acupuncturists use it as a part of their practice. Understandably, almost all research on gua sha has been done in China. Most of these studies are quite small and more studies with a larger scope are needed to show quantifiable results from using the gua sha technique.

Plenty of people online give glowing testimonials about the effects of this practice. But does gua sha work?

How Does Gua Sha Work?

Gua sha is performed using a firm but smooth object to scrape the skin in a certain pattern. For the face, you scrape the stone quite gently over the skin, whereas for deeper muscle tissue, you can push the stone much more firmly to work out those pesky knots.

This scraping motion increases blood circulation and causes microtrauma. Microtrauma may sound a bit frightening, but it simply refers to the fact that gua sha scraping frequently breaks tiny blood vessels in the skin, which forms light bruising or tiny red dots called petechiae.

Gua sha also flushes the lymphatic system, which is a network of vein-like structures in your body that help fight infection and remove unwanted chemicals from your system. A diagram of the lymph system looks remarkably similar to that of blood vessels but differs quite a lot. Blood vessels have the heart to push things through, but the lymph network functions as a drainage system only. As a result, it can get backlogged.

A practice similar to gua sha does exist in western medicine and is called Instrument Assisted Soft Tissue Mobilization (IASTM). Also known as the Graston technique, physical therapists use it frequently. The only real difference between IASTM and gua sha lies in the vocabulary describing it. While an acupuncturist will likely speak to you about your qi, your physical therapist will speak in more medical terms about the lymph system and musculature.

Gua Sha Benefits

Practitioners of gua sha claim many varied benefits including improved circulation, promotion of collagen production, pain management and diminishment of wrinkles, dark circles and scars.

Pain Relief

The pain-relieving effects of gua sha seem to be far-reaching. One study demonstrated gua sha led to meaningful improvements in pain and mobility in a group of elderly participants. Another small study found quantifiable improvement in chronic low back pain.

In a German study, gua sha users' neck pain improved after one week. Gua sha has reduced carpel tunnel syndrome symptoms and promoted faster muscle recovery in weight lifters.

According to several studies, gua sha can be used pretty much anywhere you experience pain. It can decrease pain and muscle tightness in the back, neck, buttocks, arms and legs.

Peri-Menopausal Symptoms

Gua sha can also decrease peri-menopausal symptoms including hot flashes, excess sweating, paresthesia, insomnia, anxiety, fatigue, and headaches. You ladies out there on the menopause ride might love the sound of that!

Peripheral Neuropathy

Diabetic peripheral neuropathy is a common and very unwelcome symptom of diabetes. Because of chronic high sugar levels, the nerves in your extremities begin to break down, causing numbness, tingling and pain in your hands, legs and feet. Gua sha can help reduce these symptoms. However, when performing gua sha, you must be especially careful not to break the skin, as people with diabetes are prone to infection and have a much harder time healing.


Anyone would covet the claimed cosmetic effects of gua sha, from scar healing to the 'sculpted face' everyone keeps talking about. As microtrauma caused by gua sha heals, it can encourage the reduction of scars. This change cannot be achieved quickly. It takes some time to be noticeable.

However, the change in facial tissues can be seen much more quickly. Studies are notably lacking in this area, so all information remains fairly subjective, but many people report a decrease in fine lines, wrinkles, dark bags under the eyes, and an increase in facial tone after using the gua sha technique. How does this work? Let's get into the nitty-gritty.

Gua Sha Technique

Appropriate gua sha technique differs depending on what part of the body you're working on. For example, you should apply much less pressure to the face than, say, your butt.

Facial Technique

Facial Gua Sha Infographic

For the face, gua sha especially targets the lymphatic system. Lymphatic vessels branch out from nodes along your jawline, under your eyes, in front of and behind your ears.

You don't need to apply much pressure at all to see results. In fact, pushing too hard can cause temporary bruising on your face. Even though the discoloration should dissipate in 2-5 days, you would probably like to avoid it.

Muscle Release Technique

Because of the location of many of your muscles, you may need to have a trained professional use gua sha to target specific muscle groups. The stone will first be moved back and forth over the muscle knots until they are broken up. Then, long strokes will dissipate the knots entirely.

If you're wondering which way to scrape the stone, take another look at the lymphatic system diagram. You always want to drain those vessels, so you want to pull the stone from the end of the vessel toward the lymph node. If you're scraping your arm, for example, you'll slide the stone from fingers to elbow, and elbow to armpit.

Gua Sha Tools

You can use many different types of gua sha tools. A quick internet search will show you a myriad of different shapes, sizes, and materials to get the job done. Perhaps some different shapes will fit the contours of your face or body better than others, but the most important aspect of an effective gua sha tool is its smooth edge. You don't want to scrape away at your face with just any old jaggedy stone.


No one seems to agree on an official list of gua sha tool types, but some are more common than others. You will most easily find the heart-shaped stone in makeup aisles and drug stores. However, you can find a huge amount of variations online.

Some sellers promote long curvy stones specifically for the forehead. Others sell more rectangular tools with a square notch on one side for the jaw and spine. You can try as many as you like, and find the tool that works best for you.


You may also wonder what material makes the best gua sha stone. The most popular and budget-friendly gua sha stone is jade. This stone comes in many colors and if undyed, should look somewhat opaque. Another common stone, Bian, is often presented as the original gua sha stone. Heavier than jade, this option works well for deep tissue massage. Some claim these stones have antibacterial properties but no studies have been done to confirm or deny this assertion.

When a physical therapist uses IASTM, the western version of gua sha, they will often use curved metal tools. No difference between tools has been proven, so you can rest easy no matter which you choose.

Who Should Not Use Gua Sha

Practitioners do not universally recommend gua sha and some people should avoid its use.

Rashes and Sunburns

Even the smoothest gua sha stone will worsen already-irritated skin. A rash or sunburn will not thank you for any kind of scraping and will likely leave you cranky and sore. If your skin feels raw or looks red, steer clear of gua sha until it heals fully.

Coagulation Issues

When you massage your lower legs, your veins squeeze and push blood toward the heart. Gua sha accomplishes much the same thing. This isn't a problem unless a rogue blood clot is hanging out in one of those veins. If a clot breaks free, it can travel to your brain and cause a stroke, or to your heart and cause a heart attack. If you have a known coagulation diagnosis or a history of blood clots, speak to your doctor about where on your body you can use gua sha.

Give It a Try

Even though gua sha isn't enormously backed up by studies, it holds its place in a long history of Chinese tradition and is a part of many people's daily care routines. Who knows, maybe it will become one of your favorite self-care practices.

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How Gua Sha Works: Key Benefits and Techniques