What Is Gua Sha?

If you live in the United States and you’ve heard of gua sha, you might associate it with facials that involve pretty little stone tools. Those treatments are popular, with abundant DIY tutorials available online. Yet this skin-scraping technique existed long before Instagram, and it does much more than reduce puffiness around the jawline.

Go With the Flow

Gua sha is the Chinese name for a ­traditional healing modality that’s been practiced for more than 2,000 years across Asia. Called cao gio in Vietnam and kerokan in Indonesia, gua sha also goes by “coining” or “spooning” because coins or soup spoons are sometimes used to ­perform it.

“Gua,” loosely translated, means to press or to scrape; “sha” refers to blood stagnation. Gua sha’s effects include mimicking sweating and moving fluids. Traditional East Asian medicine views stagnant energy and fluids as the root causes of many ailments, so increasing the circulation of blood, lymphatic fluid, and qi can help restore health.

In the United States, gua sha is typically performed by acupuncturists to treat respiratory ailments, like colds, bronchitis, and asthma, as well as conditions involving pain and stiffness. It’s also used to treat inflammatory ailments more broadly, including headaches and migraine.

Minneapolis-based acupuncturist Melinda Van Eeckhout, Dipl. OM ­(NCCAOM), LAc, decides whether to add gua sha to a treatment based on what she sees when she presses the skin on a client’s neck or back. “You can tell gua sha will help because your finger will displace the skin color,” she says. “Extravasated fluids are built up in there.”

A gua sha treatment itself typically results in skin discoloration. The procedure involves firm, repetitive strokes with a tool, which produces minor damage to the blood vessels near the skin’s surface, leaving marks. These are called petechiae or sha, and they usually fade in two to four days. Your practitioner will be interested in how long that process takes because it can reveal how well circulation has (or hasn’t) been restored.

Gua sha facials, on the other hand, do not involve the same level of pressure or marks on the skin. Their goal is to gently stimulate circulation of blood and lymphatic fluid and reduce tension in your facial muscles.

How Does Gua Sha Work?

Despite the surprisingly dark marks it leaves on the skin, a gua sha treatment can feel good — especially if your muscles are stiff and sore. The pressure and rhythmic strokes help loosen muscles and restore range of motion. (The Graston Technique, a physical therapy approach, resembles gua sha but without the accompanying goal of reducing stagnation.)

During a session, a practitioner spreads oil to the back and neck, or wherever they’re planning to apply pressure. Then, using a small tool with a rounded edge — this could be a formal tool, or a soup spoon or jar lid — they apply long, firm, scraping strokes to places of tension and along the energetic meridians, specifically targeting stiffness and pain. (Meridians are the body’s energy channels. Learn more about them here.)

You’ll feel some mild pressure, but it shouldn’t be uncomfortable. After your session, you’ll notice the sha marks. Their presence can be a little troubling until you get used to them.

Because gua sha involves deep pressure, it might not feel great for those with especially sensitive skin. And it’s not recommended for people who are pregnant, taking blood thinners, or have circulatory issues.

But if you’re in generally good health, with nothing more than everyday aches and pains, adding gua sha to your list of complementary therapies can be worthwhile. Van Eeckhout believes applying gua sha on the back of the neck can help “stop a cold in its tracks.” It’s also an effective way to address muscle soreness without NSAIDs. Better circulation beats stagnation every time.

To make sure you’re receiving genuine gua sha, seek it out from a certified professional.