Gua sha, an ancient healing technique rooted in traditional Chinese medicine (TCM), has gained popularity in the West for its potential health and beauty benefits. This article delves into the world of gua sha facials, exploring its origins, benefits, techniques, and precautions.
What is Gua Sha?
Gua sha, loosely translated as "scraping, rubbing, or pushing," is a tool-assisted massage technique used in TCM. According to TCM principles, the body's vital energy, or qi, must flow freely for optimal health. When qi becomes stagnant, health problems can arise. Gua sha aims to improve circulation and promote healing by gently scraping areas of the body with a smooth-edged tool where there is inflammation or stagnant qi.
Tim Sobo, a licensed acupuncturist, explains that gua sha is a standard treatment modality used by most acupuncturists. It essentially involves using a tool to assist with massage.
Gua Sha vs. the Graston Technique
The Graston Technique is a trademarked version of the gua sha massage technique. While qi is associated more with gua sha, both muscle scraping methods are about the same.
Physical therapists sometimes incorporate muscle scraping to stretch and relax muscles or scar tissue. This is similar to gua sha but is known as the Graston Technique® in the industry. In 1990, David Graston, an amateur athlete, introduced his version of gua sha to the United States.
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The Graston Technique is just a trademarked version of the gua sha massage technique. The difference is that you get Graston from a physical therapist. They’re going to talk about the technique entirely in anatomical or physiological terminology. If you go to a very strict acupuncturist, you’ll probably hear more about promoting qi and blood circulation and helping to break up the stagnation of energy in your body. But at the end of the day, both therapies have the same goal outcome.
Is Gua Sha Routinely Offered During Acupuncture Sessions?
Acupuncturists are trained in gua sha, but it is not always offered during acupuncture sessions. This may be because it does not make sense for the areas of the body being treated or because the acupuncturist chooses not to do it. However, if you are interested in experiencing gua sha, you can always request it when making your appointment.
Does Gua Sha Hurt?
Despite involving "scraping," gua sha is generally gentle. The intensity can be adjusted based on the individual's comfort level and the types of knots encountered.
Gua sha tools have smooth, rounded edges and are not designed to cut or pinch the skin. Practitioners typically apply cream or lotion to the treatment area before starting and adjust the pressure according to the individual's comfort level. They will find the tense tissue, work on it gently, and gradually build up the intensity to promote circulation and help break up the areas that are all twisted up.
Benefits of Gua Sha
Gua sha offers a range of potential benefits, including:
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Relieving Musculoskeletal Problems
Gua sha is effective for musculoskeletal issues, particularly tightness in the shoulders, legs, and back.
Alleviating Tension Headaches and Migraines
Gua sha can help alleviate tension headaches and migraines by promoting blood flow and releasing muscle tension.
Reducing Neck Pain
A study on the effectiveness of Gua Sha therapy in patients with chronic neck pain shows that Gua Sha can have short-term positive effects on pain and functional status in patients.
Diminishing Swelling
Gua sha can help reduce swelling in the body by promoting lymphatic drainage.
Helping with Anxiety, Fatigue, and Insomnia
Gua sha, when combined with acupuncture, may help with anxiety, fatigue, insomnia, and perimenopausal symptoms. Gua Sha massages can have a grounding and calming effect, making Gua Sha beneficial for those struggling with anxiety.
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Promoting Faster Muscle Recovery
A study involving 44 men receiving Gua Sha showed that those who received Gua Sha treatments reported less perceived effort in completing the snatch and clean and jerk exercise. As the men weren’t limited by fatigue from part training sessions, Gua Sha might have helped promote faster muscle recovery.
Boosting the Immune System
Gua sha can help boost the immune system by promoting lymphatic drainage, as the lymph contains white cells, which are at the front in fighting infections and illnesses.
Treating Breast Engorgement
A randomized controlled trial on the effects of Gua Sha therapy on breast engorgement shows that Gua Sha can be effective in treating it.
Relieving Perimenopausal Symptoms
Once you near menopause, it's common to have irregular periods, hot flashes, sleep issues, and mood changes. In one study, participants who used gua sha once a week for 8 weeks saw those symptoms improve. Researchers are still trying to understand the link.
Promoting Blood Flow and Nerve Conduction
Gua sha helps promote the flow of qi throughout the body, ensuring better blood supply and proper nerve conduction. This can help alleviate symptoms and restore homeostasis.
He adds: “With gua sha, acupuncture and TCM, we look at a host of illnesses. If you don’t have that smooth flow of blood and energy throughout your body, it can manifest as muscle knots, soreness, weakness or pain. Acupuncture along with gua sha is just going to help promote that blood supply and the conduction of everything through the tissues healthily so we can get your body as homeostatic as possible.”
Improving Blood Circulation
One of the main benefits of Gua Sha treatment is increased blood circulation. A study on the microcirculatory effects of Gua Sha on the skin demonstrated that it could improve blood circulation in the small blood vessels in the treated area.
Helping the Body to Produce Collagen
One of the exciting benefits of Gua Sha is helping the body to produce collagen, which leads to a brighter complexion and softens fine lines and wrinkles.
Diminishing Acne Scars
Gua Sha massage can help diminish acne scars, as enhanced blood circulation helps the skin cells get the nutrition they need and renew underlying skin cells.
Relieving Chronic Neck and Low Back Pain
Gua Sha can also help relieve chronic neck and low back pain.
Gua Sha for the Body
Sobo says gua sha for the body is tissue-dependent, meaning you want to work in a way that supports treatment goals. If you have a muscle knot, you want to start by going across it with your gua sha tool. You’ll want to work perpendicular to the muscle fibers so you can break up all of the adhesions. Then, you want to go in the direction of the muscle fibers to lengthen and get them in the correct direction again. With those painful knots in your upper shoulders, you want to go back and forth across them with your tool to break the knots up. Once things start to loosen up, you’ll start moving your gua sha tool in the direction of the muscle fibers, which is usually inwards to outwards. However, you don’t want to start gua sha in this direction because you’ll only make the tissue tighter.
Gua Sha for the Face
Gua sha has been proven to help relieve tension in the face, reduce puffiness and inflammation, and it can even help reduce sinus pressure. However, since the musculature of the face is much thinner, you’ll want to avoid applying too much pressure as you’re working on this area.
Generally, the musculature of the face is very thin and it doesn’t bulge up the same way as other muscles do. With gua sha on the face, you don’t want to drag your tool from the outside edges of your face. Instead, divide your face in half and use your nose as the middle point. If you’re working under your eyes, you’d start at your nose and work your gua sha tool outward. Keep your tool moving in a smooth, straight line. Don’t rub your gua sha tool back and forth, up and down, and in all different angles vigorously because that’s going to just stretch and aggravate the skin. Keep things going in one smooth direction, and do it enough to get a little redness to form, but not so much that it hurts.
To help things along, you can even apply lotion or a serum before doing gua sha on your face. This way, your tool will glide across the skin much easier. Sobo suggests avoiding overly swollen areas. You don’t want to press too hard into those because you can burst capillary beds and end up with bruises on your face.
Step-by-Step Facial Gua Sha Guide
Here's a step-by-step guide to performing gua sha on your face:
- Apply lotion or serum on clean skin.
- Starting at your neck, use your tool to make smooth upward strokes from your collarbone to your earlobe. Repeat three to five times, then repeat on the other side.
- Next, put the roller or double-edged part of your tool at the center of your chin, then move it along your jawline to your ear. Repeat on the other side.
- Slowly, drag the roller or long edge of the tool across your cheekbone to your ear. Repeat on the other side.
- Starting under your right eye, gently slide your gua sha tool outward toward your ear. Move it smoothly and in a straight line. Repeat on the left side.
- Starting in the middle of your right eyebrow, drag the notched side of your tool or roller outward until you reach your hairline. Repeat on the other side.
- Firmly press the roller or long edge of your tool from the top of your right eyebrow to the top of your forehead. Repeat on the opposite side.
- Always scrape from the inside to the outer edges of your face.
- The skin on your face is thinner than on your body, so be careful not to apply too much pressure. This routine shouldn't hurt.
Frequency of Gua Sha
Some experts suggest that trying gua sha two to three times a week will help you see positive results. Talk to your doctor if you have any questions or concerns.
Choosing a Gua Sha Tool
You can go simple with a small wooden spoon or you can get a gemstone gua sha tool. Whatever you choose, keep it clean and in good condition. There’s no clinical difference between one versus the other. You just want to get a tool that you can easily clean and maintain. And if it chips or breaks, which it shouldn’t do but it can, you’ll want to stop using it. If you get a little gash in a jade gua sha face tool, you don’t want to rub that all over your face.
Sobo says you always want to work with a clean tool. He adds that some tools can be cleaned in boiling water or with a watered-down bleach solution.
When choosing a gua sha tool, consider the following factors:
Material
Gua sha tools are often made from natural materials like polished jade or rose quartz or plastic. Common materials include:
- Jade: Denser, smoother, and cooler, with benefits for working out tight muscles
- Rose quartz: Softer, more porous, which may provide a lighter massage
- Natural horn: Durable and stronger
- Stainless steel or metal: Durable, stronger, and easier to clean
- Bian stone: Durable, stronger, and able to be heated
- Wood: Softest and most porous
- Plastic: Inexpensive and softer
Some stones have antimicrobial qualities that make them especially well-suited for facial techniques. A quality tool made with authentic crystal or other natural material will often be of a slightly heavier weight than a knock-off or man-made synthetic tool.
Shape and Size
Gua sha tools come in various shapes and sizes. Nazarian recommends finding one that is smooth and rounded and fits the curvature of the area you want to treat. Tobia recommends gua sha tools with varying contours on each edge "so that you can find the right curvature to fit the angles of your face.
Some common types of gua sha tools include:
- Gua sha stone: Some gua sha stones are made from polished stones such as rose quartz or jade. They come in all kinds of shapes from hearts to moons. No matter the form, a gua sha stone has a double notch on one side and a long handle on the other.
- You can use the double notch to gently scrape your skin in areas such as your:
- Eyebrows
- Jaw
- Throat
- The longer edge can be used on areas such as your:
- Cheeks
- Forehead
- You can use the double notch to gently scrape your skin in areas such as your:
- Jade roller: This is a kind of handheld self-massage tool, which looks like a tiny paint roller. It is a good choice for your face. It can help cool your skin and reduce puffy areas. It's also unlikely to worsen any ongoing skin issues, such as eczema.
Cleanliness
Choose a stone that's easy to clean. (Check the manufacturer's notes.) And look for a material that won't easily chip. If your tool breaks, get a new one so you don't accidentally damage your skin.
Who Should Avoid Gua Sha?
Most people should be able to tolerate gua sha well, but if you have problems with your circulation or have diabetes, let your practitioner know before your session starts. That way, they’ll know to adjust the pressure to prevent any potential issues.
Generally speaking, you should avoid gua sha if:
- You have diabetes
- You have issues with circulation
- You take blood thinners (medicine for blood clots)
- You're pregnant or think you may be
Also, skip gua sha on your face if:
- You've had botulinum toxin or skin fillers injected into your face within the past month
- You have an ongoing skin issue, such as psoriasis or rosacea
While you might think that gua sha would be too much for someone who has peripheral neuropathy, Sobo says it’s not. He adds that when done in conjunction with acupuncture, gua sha can help promote blood flow for those with peripheral neuropathy. But if you’re on blood thinners, your practitioner should either avoid doing gua sha or do it very gently so they don’t break up too many blood vessels.
If you want to try gua sha, talk with your doctor first to make sure it's safe for you.
Potential Risks and Precautions
Typically, gua sha is considered safe. But you may have some bruising or notice that your skin looks discolored for a while. You could also be sore and tender afterward. These effects usually go away in 3-4 days. A bacterial skin infection is also possible, although unlikely. To reduce this risk, make sure to properly clean your gua sha tool in between uses, or seek treatment from a provider who does.
When done correctly, gua sha is a pretty safe bet for all skin types. (In other words, if gua sha hurts, you are likely doing it incorrectly).
Here are some precautions to keep in mind:
Communicate with Your Practitioner
If you’re new to acupuncture and gua sha, you might not know what to expect when it comes to the intensity of these services. Know right off the bat that these services should not hurt or leave you bruised. If you find yourself digging your nails into the table or tensing up a great deal at any point during your session, you need to let the practitioner know immediately so they can adjust accordingly. You have to be comfortable saying, ‘Ouch that hurts,’ because the acupuncturist won’t know if you don’t tell them. At the same time, the acupuncturist needs to explain to you that if you’re in pain, you’re not getting a beneficial treatment. They’re trying to loosen things up. If it hurts too much, you’re just going to tighten up more and the acupuncturist is just going to be running around in circles as they’re trying to get you to feel better.
Avoid Overly Swollen Areas
Sobo suggests avoiding overly swollen areas when performing gua sha on the face. You don’t want to press too hard into those because you can burst capillary beds and end up with bruises on your face.
Skin Conditions
Gua sha is not recommended for those with rashes, sunburns, or blood coagulation issues.
Contraindications
If you have a chronic health condition, take blood thinners, have a blood clotting disorder, or are taking medication that affects your blood cell production (such as chemotherapy) consult with a healthcare professional before use.