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How to Use Gua Sha for Tension, Puffiness, and Lymphatic Drainage




Gua sha is a body and face scraping technique that’s used for a variety of health benefits. It’s a part of the system of Traditional Chinese Medicine (TCM) with mentions in the Shanghan Lun, a Chinese medical text on illness from BC 220.

Gua sha involves the use of a tool to stroke the skin and increase circulation. This may promote detoxification, relax tight muscles, and encourage healing.



The literal meaning of gua sha is “to scrape sand,” which refers to the light, speckled bruising on the skin after a treatment. In TCM, gua sha is believed to move blood and qi.

The most common conditions and symptoms treated with gua sha include:

  • back pain

  • shoulder and neck tension

  • carpal tunnel syndrome

  • tennis elbow

  • poor circulation

  • scar tissue

“In TCM, if there is blood stagnation or a blockage of qi, pain or illness is the result,” explains Gabriel Sher, the director of acupuncture at ORA in New York City. “Gua sha disperses stagnant blood and energy, facilitating the free flow of qi throughout the body.”

Gua sha is sometimes referred to as “spooning” or “coining.” This is because gua sha was historically done using a ceramic Chinese soup spoon or a blunt, well-worn coin.

“Today, practitioners commonly use polished tools made out of jade, quartz, or bone,” says Shari Auth, DACM, the co-founder of WTHN studio in New York City.

If you give gua sha a try, don’t be alarmed if you see light bruising. “The scraping sometimes produces light petechiae on the skin that can vary from light pink to red and even purple,” says Auth.

Bruising can last anywhere from 1 to 7 days and is not painful or sensitive if done correctly. It’s not guaranteed that gua sha will leave marks at all, especially if done with a light touch.




There have been multiple studies done to prove the effectiveness of gua sha.

In a 2017 studyTrusted Source, older adults with back pain were treated with either gua sha or a hot pack. While both treatments relieved symptoms equally well, the effects of those treated with gua sha lasted longer.

In a 2014 study, researchers found that gua sha improved the range of movement and reduced pain in people who used computers frequently compared with a control group that had no treatment.

Studies have also shown that gua sha may reduce painTrusted Source, speed muscle recoveryTrusted Source, balance hormone levelsTrusted Source, and promote healing of various conditionsTrusted Source, such as peripheral neuropathy, or the malfunctioning of the part of the nervous system that delivers messages to the brain.



Gua sha is simple to perform and can be done at home if you learn the proper techniques and safety precautions. Be sure to speak with your healthcare provider before adding gua sha to your routine.

On the body

Gua sha is performed along the meridians of the body. According to TCM, meridians are channels or streams of energy where qi flows in our bodies.

The gua sha tool is scraped in a fluid motion to disperse stagnant blood. Long strokes over lubricated skin with a fair amount of pressure help to stimulate blood flow in the affected area. Mild bruising often occurs, which is the result of blood flowing to the surface of the skin.

Practitioners often work areas of pain or perform gua sha along meridian lines, depending on the desired result. Gua sha is typically performed on the back, neck, shoulders, and sometimes on the legs.

“Scraping the area between the shoulder blade and the vertebrae helps to reduce inflammation, strengthen the lungs, and disperse pathogens in the chest,” says Sher.

On the face

According to Auth, facial gua sha is different from gua sha on the body, and it does not leave marks.

“Typically, a polished tool made from jade or quartz is used to massage the face,” she says. “Facial gua sha increases circulation and the production of anti-aging molecules, collagen, and elastin.”

Collagen helps to reduce wrinkles, and elastin helps to firm and tone the face. This increased circulation helps with detoxification. This may lead to a clearer complexion and promote lymphatic drainage.

To reduce puffiness around the eyes

  1. Lubricate your eye area with lotion or oil.

  2. Sweep a gua sha tool over the under-eye area and out to the temple, all the way to the hairline.

  3. Repeat three times on each eye, then work the tool from the inside corner of the brow bone out to the temple area.

To promote lymphatic drainage

  1. Start at the chin, then sweep the gua sha tool along your jawline and up to the ear.

  2. Move the tool behind the earlobe, and then down the neck.

  3. Repeat three times.

To relieve tension in the head

  1. Start in the middle of your forehead and work your way out toward the temples, all the way to the hairline.

  2. Repeat as many times as you’d like.

To contour and de-puff your nose

  1. Lightly scrape the tool up the bridge of your nose.

  2. Bring it down along the side of the nose to the cheek.

  3. Repeat three times.

To contour and de-puff the chin

  1. Gently guide the tool from the middle of your chin along your jawline toward the ear.

  2. Repeat three times on both sides of the face.

To firm the décolletage

  1. Start at the outer corner of the jaw near the earlobe.

  2. Sweep down the neck to just above the collarbone.

  3. Repeat three times on each side.

How often should you use gua sha? Facial gua sha should be practiced regularly to get the best result. Once or twice a week is ideal. When it comes to the body, Auth says treatment can be as needed or once per season.

What oil to use and how to use it To use any oil with a gua sha tool, dispense a few drops into your hand and rub the oil onto your face or body, depending on where you’re using your tool. Almond oil Almond oil hydrates, reduces skin irritation, and can even help reduce the appearance of stretch marks. Vitamin E oil Known to help reduce hyperpigmentation and wrinkles, vitamin E oil helps with hydration and has antioxidant and anti-inflammatory properties. Jojoba oil A popular oil used in many facial skin care products, jojoba oil works to hydrate skin, balance natural oil production, reduce acne, and much more. Jojoba oil has both antioxidant and anti-inflammatory properties, as well as antibacterial properties. Argan oil Argan oil has many anti-aging propertiesTrusted Source, including adding moisture back into the skin and helping to reduce the appearance of wrinkles. Plus, it helps to brighten skin and fade dark spots.


Materials used in gua sha tools Rose quartz One of the most common stones used in gua sha, rose quartz is light pink in color. It’s considered by some to be a healing crystal and the stone of unconditional love. Jade Jade is another common material used for gua sha tools. Jade is said to promote calm, balance, and positivity, as well as protect against negative energy. Amethyst Amethyst is believed to help relieve stress and reduce negative energy. The dark purple stone is also said to promote clarity and relaxation. Stainless steel Some stone gua sha tools can potentially trap and harbor bacteria due to their porosity. Stainless steel gua sha tools are non-porous and cooling, so you don’t have to worry about cleaning your tool as often. Bone Traditional gua sha tools were once made from animal bones, but this is less common today. Most gua sha tools are now made with stone materials. Bian stone Bian stone has been used in TCM for thousands of years. It’s a stone containing trace minerals that are believed to benefit overall health. Evidence suggests bian stone may be helpful in regulating blood pressure and reducing lower back painTrusted Source.

Takeaway While the science behind gua sha is limited, studies show that it may be effective at reducing stress, inflammation, and pain. Gua sha may be a beneficial alternative therapy to use alongside other treatments. While you can perform gua sha at home, it’s advised to seek out a licensed acupuncturist or practitioner of Chinese medicine. And, as always, talk with your doctor first.


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