Definition and Overview

Gua sha is an ancient Chinese medical treatment that involves the application of pressure on a part of a body (usually the back) to cause what appears like slight bruising. The technique is based on the belief that the causes of ailments or pain will go out through these injured areas, leading to pain relief as well as stimulated blood flow.

Like many forms of Chinese medicine, gua sha has a very long history and has been passed on to several generations and across countries where the Chinese have settled. However, its popularity significantly differs according to locations. While it’s almost mainstream in countries like Vietnam, it is recognized as folk medicine in other parts of Southeast Asia and a novel Chinese treatment in Western nations like the United States.

Some people who have undergone the procedure attest to its effectiveness, although some health experts are concerned about the possible risks and complications as others call it a form of abuse or torture.

Who Should Undergo and Expected Results

Although gua sha can be taken advantage of by anyone, most of the patients are those who complain of physical pain, like chronic back or neck pain.

According to the beliefs of its practitioners, the procedure is helpful to people who are suffering from cold wind, which leads to illnesses like a cough or fever. Cold wind, they say, can enter the body in many different ways such as the back of the neck, causing the muscles to stiffen, which can reduce mobility or introduce discomfort over time.

There’s not enough study to measure the success rate of the practice, and most of what can be read are anecdotal or observational. Equally, it’s hard to determine whether it’s a practice that can be considered safe.

How Does the Procedure Work?

Gua sha or Chinese skin scraping begins with a consultation to determine the actual illness, complaint, and parts of the body to be treated.

The procedure, which is performed in clinics that offer traditional Chinese medicine services, is done on an outpatient basis and may last for at least an hour. Usually, the patient in a private room lies in a prone position (face down) to expose the back. The practitioner then applies a lubricant such as massage oil to the area. Using an instrument like a rounded cap made of metal, the practitioner starts to apply firm and direct pressure onto the skin by following different meridian points.

In other countries, the method can slightly vary. For example, many Vietnamese prefer using coins than other types of metals or materials for scraping or combine these coins with an egg yolk, which serves as the skin’s lubricant.

This process is repeated multiple times, causing the appearance of what looked like bruises on the skin. It’s expected that these will disappear within 48 hours after treatment. The practitioner may also introduce complementary therapies such as herbal medicine, acupuncture, and massage to further improve the results of skin scraping.

Possible Risks and Complications

There may be some physical pain and discomfort after the procedure. However, more than these, some health experts express concerns on the practice such as possible exposure or transmission of infectious diseases as the practitioner may come into contact with the patient’s fluid or other blood cells (or vice versa). Further, there seems to be no universal safety standards for practicing gua sha, which means the level of care (e.g., sterilization of the equipment used) may be significantly different among clinics.


  • Nielsen, Arya, Ben Kligler, and Brian S. Koll. "Safety Protocols for Gua Sha (press-stroking) and Baguan (cupping)." Complementary Therapies in Medicine 20.5 (2012): 340-44.

  • Tsai, Keng-Kuang, and Chih-Hung Wang. "Acute Epiglottitis following Traditional Chinese Gua Sha Therapy." CMAJ 186.8 (2014)

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