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Gua sha is a traditional Eastern Asian medicine technique that uses a series of tools to scrape or rub the skin in order to relieve blood stagnation, or stasis, which refers to when blood does not adequately reach all areas of the body. This lack of blood flow can cause symptoms, such as stiffness, swelling, tightness or pain. The overall goal of gua sha is to move a person’s qi (chi)—a vital energy that exists in the body, according to Chinese medicine—to release pain or other symptoms.

Used on the body and face, gua sha is thought to have a series of health benefits. Read on to learn more about this practice, what it does, how it’s performed and if it’s worth considering for your own wellness routine.

Gua sha utilizes smooth tools to rub or “scrape” the skin, with the intention of increasing blood flow and releasing stagnation.

“Gua sha can provide a variety of results,” says Lee Wilcher, a certified massage therapist at Five Star Therapeutic Massage in Fort Wayne, Indiana. Improving the immune system is also among its potential benefits, and it may even stave off your next cold by helping the body flush toxins and promote lymphatic drainage.

“I have used gua sha primarily for musculoskeletal conditions, such as pain, muscle tension and spasms, tendonitis and for treatment on scar tissue,” says Daniel Katz, a licensed acupuncturist and physical therapist at Wildwood Medicine in Portland, Maine, and a Forbes Health Advisory Board member. “The treatment is used to promote circulation to the local area in order to reduce pain and promote healing.”

The ancient practice is most commonly performed on the neck, shoulders, back and face. Gua sha can be used as a home remedy or practiced in a clinical setting with a licensed acupuncturist or massage therapist.

There are numerous styles and applications of gua sha for different areas of the body, ranging from intense and vigorous movements to gentle and relaxing.

“The use of gua sha is traditionally done in a vigorous and more intense way which results in transient petechiae (tiny red dots formed by broken blood vessels) on the skin,” says Katz.

Applying pressure with the rounded-edge tools used during gua sha treatment on the body can cause capillaries to burst, resulting in petechiae and bruise-like marks. This release of blood vessels has a therapeutic effect on the body and increases blood flow to the areas being treated and should not cause pain. Any markings typically disappear within a few days of treatment.

“Gua sha primarily promotes circulation in the local tissues and circulation of qi along acupuncture channels or meridians,” says Katz. “This is done through promotion of blood circulation or lymphatic (watery bodily fluid) movement.”

When used on the body, gua sha is often performed to release stagnation and relieve pain in conditions, such as chronic lower back pain, musculoskeletal pain and neck pain. One study reports gua sha treatment on participants resulted in increased circulation in small blood vessels throughout the body, as well as a significant decrease in pain[1]Nielsen A, Knoblauch NT, Dobos GJ, Michalsen A, Kaptchuk TJ. The effect of Gua Sha treatment on the microcirculation of surface tissue: a pilot study in healthy subjects. Explore. 2007;3(5):456-66. .

Facial gua sha is known to stimulate circulation, produce collagen, decrease puffiness and inflammation, tighten skin, brighten complexion, release tension and shape facial muscles, according to Wilcher. This is done through the promotion of blood circulation and lymphatic movement.

“A more modern use is the gentle use of facial gua sha to promote circulation and achieve fewer wrinkles and clearer skin,” says Katz. “This is promoted as a ‘natural face lift.’”

Gua sha for the face uses a facial gua sha stone. These stones are made from materials like jade, bian and rose quartz, and are shaped into a smooth edge. Oil is applied to the face before the practice begins, allowing the stone to glide smoothly and softly over the skin in long, slow strokes.

“Treating the face is a gentle and delicate way of reducing adhesions to the skull and draining excess toxins and fluid from the face,” says Wilcher. Gua sha can also be used to treat  temporomandibular joint (TMJ) dysfunction—pain or problems caused by the joint connecting the jawbone and the skull, including jaw stiffness, clicking or popping—and jaw disorders in the soft tissue, he adds.

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The method of practicing gua sha and which tools work best varies depending on an individual’s needs.

“The technique of using gua sha to treat different areas of the body and considering the complexity of the person’s condition is the primary difference in how it is applied,” says Katz. “For example, a young athlete with a tendon strain requires a more vigorous and aggressive approach, while an older person or someone with delicate skin will require a much gentler technique.”

A myriad of tools have been used throughout the history of gua sha, including a Chinese soup spoon, a smooth metal cap, a honed jade stone or bone, such as a cow rib or water-buffalo horn. Using oil or water for smooth application, one of these tools is typically rubbed over the skin with some pressure to mimic a scraping motion.

If practicing gua sha at home, first consider which area of the body is being treated. Common modern tools for facial gua sha or gua sha on the neck and shoulders are the gua sha stone or a gua sha spoon:

Gua sha stone. This small tool can be made of jade, quartz or other types of smooth stone and has rounded edges. It’s commonly used for facial gua sha to relieve tension, sculpt skin and increase circulation.

Gua sha spoon. Designed to release tension through acupressure points and sculpt facial muscles, the gua sha spoon is used for more precise work. As the name might suggest, this tool is shaped like a spoon and can be made of stone varieties, including jade or rose quartz.

When practicing gua sha on the face, the technique should be gentle and thought of more as a way to massage the face, explains Katz.

First, apply a light facial oil to the face to ensure the stone glides over the skin. To begin the facial massage, Wilcher recommends using the tool of your choice to make smooth movements from the cheekbone towards the chin using a downward motion. This allows the fluid to drain away from the face in sync with your body’s natural flow. Smooth, upward movements can also lift the skin. To do this, move the stone in a long upward stroke from the chin to the outer edge of the eyebrow. Pressure when applying facial gua sha should be light and pain-free.

Next, move the stone in long, smooth strokes following the jawline, starting at the chin and ending near the ear. Then move down the neck, stopping at the collarbone. Repeat each of these movements six to nine times. To relieve puffiness and swelling under the eyes, apply gentle pressure under the eyes and move the gua sha stone in smooth strokes from the inner corner of the under eye to the outer corner of the eye.

To attend to the forehead area, Wilcher suggests moving the stone along the brow line, then across the forehead in upward strokes beginning at the brow and gliding up to the hairline. Repeat all movements six to nine times, three times a week to see noticeable results.

If you’re interested in gua sha, rest assured that the practice is safe and effective. While slight bruising or discoloration may occur after a gua sha massage on the body, it’s considered a normal side effect. Some soreness following treatment may also occur.

Each individual’s body will respond differently, adds Wilcher. A patient’s muscle texture and density play heavily into how a practitioner chooses to incorporate gua sha into a massage or facial treatment. Individuals who are interested in gua sha for their body should seek treatment with a trained professional who specializes in acupuncture, eastern medicine practices or massage therapy, specifically in the form of gua sha.

Gua sha treatment is not recommended for patients taking blood thinners. Let your massage practitioner or acupuncturist know of any medical conditions in advance of your treatment so they can make the proper adjustments. As with any wellness regimen, speak to your health care provider when deciding if gua sha is right for you.

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Erin Gregory has served the health and wellness industry in a variety of roles, including as a certified fitness instructor and team coordinator, varsity athlete and YMCA director. She is passionate about serving the community and educating readers about the importance of health in their everyday lives. She has shared her expertise as a writer for a variety of publications for the last 15 years.