Fact Checked

This Dr. Axe content is medically reviewed or fact checked to ensure factually accurate information.

With strict editorial sourcing guidelines, we only link to academic research institutions, reputable media sites and, when research is available, medically peer-reviewed studies. Note that the numbers in parentheses (1, 2, etc.) are clickable links to these studies.

The information in our articles is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.

This article is based on scientific evidence, written by experts and fact checked by our trained editorial staff. Note that the numbers in parentheses (1, 2, etc.) are clickable links to medically peer-reviewed studies.

Our team includes licensed nutritionists and dietitians, certified health education specialists, as well as certified strength and conditioning specialists, personal trainers and corrective exercise specialists. Our team aims to be not only thorough with its research, but also objective and unbiased.

The information in our articles is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.

Gua Sha Therapy: Is It a Safe Anti-Aging Beauty Practice?


Gua sha - Dr. Axe

Have you heard about the “botox of the Far East“? There are no needles, and you can even do it yourself! Have any idea what it might be? It’s a natural therapy called gua sha. It is an ancient massage technique that is going mainstream, especially facial gua sha.

Considering how easy it is to find the necessary tools and perform facial gua sha in the comfort of your own home, it’s no wonder why it’s so popular. But does gua sha work? Many users speak highly of its positive effects. Here’s one first-hand account of trying gua sha facial massage: “Using a rose crystal gua sha to gently massage lymphatic points on the face and neck has been a game-changer for my skin’s circulation.”

Why is this ancient form of skincare possibly so effective? A New York–based gua sha facial specialist, Britta Plug, explains, “With this type of treatment, we’re moving lymph, which carries away toxins, or in this case, blackheads, and stimulating the chi or prana. It tones the muscles and firms the skin, and, plus, it’s deeply relaxing. This is one of the biggest benefits of gua sha, because when the client is receiving it, they get to really sink into that parasympathetic nervous system.” Sounds intriguing, doesn’t it?

What Is Gua Sha?

If you’re wondering about the correct gua sha pronunciation, it’s “gwa sha.” Rather than using the hands, this ancient (likely overly 2,000 years old) Chinese therapy uses a tool to rub or scrape the skin’s surface in long strokes. The purpose is to help move energy, known as qi or chi, around the body. Traditional medicine practitioners have used this method for centuries to boost circulation, increase blood flow, break up scar tissue, help chronic pain and generally improve the health of the entire body.

This type of therapy can be used on areas of the body such as the back, arms, legs and buttocks, and it can also be used on the face.  Right now, gua sha facials are seeing a huge surge in popularity. It feels similar to a massage but rather than a hand, you’re feeling the gliding strokes of a hard tool with rounded edges against your skin. Oil is used to ensure the tool glides easily and doesn’t tug on your skin.

Gua sha is also sometimes referred to as coin rubbing or coining therapy. Coining can be defined as an ancient treatment method that is used to rid the body of “heat” or “negative energies.” The gua sha technique is also called “spooning.” Most practitioners use tools made out of natural materials such as gem stones, animal bone or animal horn, but some even use soup spoons or coins. The similarity that all of these tools share? A rounded edge.

If you’re comparing gua sha versus the graston technique, both forms of natural therapy are non-invasive, use tools to manipulate the soft tissue and are used for pain-related issues. However, the graston technique is focused more on breaking up fascia restrictions, while gua sha aims to increase circulation and lymphatic flow.

To this day, gua sha is still widely practiced in China and South East Asia. In China, the practice is called “gua sha,” in Vietnam it goes by the name of “cao gio” and if you’re in Indonesia, you’ll hear the term “kerokan.” When used on the body traditionally, practitioners purposely create petechiae, which are non-raised patches of brown-purple or red spots due to bleeding under the skin. (This is why if you Google “gua sha,” you may see some scary images come up.) The idea is that this micro-trauma can help the body to break up scar tissue and increase energy flow. This intense skin scraping and muscle scraping is controversial. The technique that is really popular right now uses light pressure focusing on the face and neck.

Related: What Is Face Rolling? Face Roller Benefits + How to Use

5 Gua Sha Benefits and Uses

1. Improves Pain (Including Back and Neck)

One of the top uses of gua sha on the body is for pain. A randomized study published in 2017 in the journal Complementary Therapies in Medicine evaluated the effects of gua sha on chronic lower back pain symptoms and inflammatory biomarkers in elderly subjects. The elderly study subjects with chronic back pain were treated with gua sha or a hot pack. The researchers found that during the one-week follow-up period, while both treatments improved movement of the lower back, the amount of pain reduction and disability improvement were notably greater in the gua sha-treated group compared to the hot pack group.

Another randomized controlled clinical trial also found that gua sha has “beneficial short-term effects on pain and functional status in patients with chronic neck pain.”

2. Possible Cellulite Reducer

Some people use gua sha for cellulite, a condition in which the skin has a dimpled or lumpy appearance. While there hasn’t been much research conducted to date, many first-hand accounts have been positive. One gua sha practitioner claims the practice helps to get rid of cellulite, which she calls “globules of constricted toxins.”

3. Major Skin Booster

Many people love gua sha facial massages because of their potential skin-boosting and anti-aging benefits. Since research has shown gua sha can boost circulation, it’s not surprising this type of facial is known to have impressive effects on the health and appearance of skin. It is said to decrease puffiness, clear congested pores, firm the skin and make it generally more radiant than it was pre-treatment.

Cecilia Wong, a Manhattan celebrity facialist has used facial gua sha on her clients for years and started practicing the technique on herself at the age of 10. She says, “What I love most about gua sha is that results are immediate, and you can’t say that about everything. After gua sha, my skin is lifted, tightened, and any puffiness is gone.”

If you’re looking to use gua sha for face wrinkles and fine lines, there are no guarantees, but if you are going to see any improvements in signs of aging (or in other skin concerns like acne), then consistency is key. If you do see improvement, it won’t be overnight (unfortunately), but if you make it a regular practice, you just may find yourself looking more youthful.

4. Acne Helper

While it’s important to avoid using gua sha if you have cystic acne or open lesions, some people have found facial gua sha to be helpful in their fight against breakouts. For example, after eight to 10 weeks of weekly professional facial gua sha, acne-sufferers have seen improvements in their chronic acne. Some regular users also report that their pimples go away faster and they experience fewer and less intense breakouts.

5. Breast Engorgement (During Lactation)

When nursing, it’s possible to experience breast engorgement, which is when the breasts overfill with breast milk, becoming swollen and often painful. Engorgement can be a challenge to successful breastfeeding and sticking with breastfeeding if the situation does not resolve.

One scientific paper reveals how a woman experiencing breast engorgement benefited from the gua sha she received from nurses the second day after giving birth up until leaving the hospital. Along with other helpful factors (including education on proper breastfeeding techniques), gua sha appears to have played a role in helping this mother to continue breastfeeding successfully.

Gua sha breast massage using light pressure is also used to increase circulation and lymphatic drainage of the breasts, or even to possibly promote firmer breasts.

Side Effects and Risks

If performed incorrectly or with too much pressure, there are potential risks and side effects. Gua sha side effects can include bruising caused by the bursting of tiny blood vessels (capillaries) near the surface of the skin. Other side effects may include swelling, tenderness or pain.

If really excessive pressure is used on the muscles, this can tear the membrane that covers them. Although not common, this level of tissue trauma can lead to muscle swelling and rhabdomyolysis or “rhabdo,” a rare but life-threatening condition in which muscles release a protein that can overtax the kidneys. If you experience rhabdo symptoms, including post-treatment pain that worsens, fever, dizziness, pressure, warmth or increasing redness in the treated area, after gua sha, you should seek immediate medical attention.

The skin should not be broken as a result of gua sha scraping. While broken skin is not common, there is a chance this can occur and pose the risk for infection. This is one of the reasons why it’s so important that practitioners sterilize their tools between clients. You should also make sure to clean your tools between home uses.

Gua Sha Tools and Technique

You can’t obtain any of the potential gua sha benefits if you don’t have the appropriate tool! Gua sha tools for the face and body come in several shape options and are usually made out of real crystal or stone. These tools are used to stroke the skin’s surface.

A gua sha face tool varies in price depending upon its material. For example, there are amethyst, rose quartz and jade tools. The ones that are not made using true crystal or stone will cost less, possibly as little as $6. If you’re looking for jade stone benefits from true jade massage therapy, you’ll want to make sure your gua sha tool is made from real jade, which will likely cost somewhere around $30. Same thing goes for amethyst or rose quartz (the real versions will cost more than the ones that just look like they’re made of these crystals).

In case you’re wondering, gua sha is not the same as jade rolling, another popular skin practice right now. According to Joshua Zeichner, MD, Director of Dermatology at Mount Sinai Hospital in New York City, “Jade rolling is a process that takes advantage of the actual contact between the stone and the skin. In gua sha, the treatment is not as much about the material used, but rather the scraping technique itself.” So with that said, depending on who you ask, the authenticity of a gua sha stone may or not matter.

What are the best gua sha tools? It really is often a matter of personal preference. If you’re choosing a tool for the face, you want one with curves and rounded knobs that work well with your facial curves. The shaping is also designed to apply pressure to the meridian points on the face to encourage a better flow of Qi, or vital life energy. In terms of what the tool is made out of, you can make your choice based on color or if you’re into the possible healing properties of crystals, you can make your choice based on that.

According to Anna Lam of Ginger Chi, a natural boutique in New York that carries its own line of gua sha tools and jade rollers, Each stone is known to have different healing properties, but all should provide similar results as it’s more about the gua sha technique than the crystal of choice.”

How to Use Gua Sha Tools and Perform Gua Sha

According to the holistic facialist and “gua sha guru,” Julie Civiello Polier, these are the basic steps to giving yourself a great gua sha facial:

  1. Start with a clean face and clean hands.
  2. Apply facial oil (four to 10 drops) over the face and neck, starting with the forehead and moving downward (following the direction of lymph fluid drainage).
  3. Warm your tool between your hands.
  4. Sweep up your neck on both sides, going very lightly over the Adam’s apple.
  5. Sweep under your chin from the middle of your face out to your earlobe, keeping your tool flat.
  6. Sweep from the middle of your chin over your jawline toward your earlobe. You can also gently jiggle at your ear to encourage the fluid to drain down the neck to the lymph nodes at the base, just above your collarbone.
  7. Sweep underneath your cheekbone, aiming to move fluid that tends to be stored here and direct it towards your hairline. You can also lightly and gently jiggle your tool at your hairline.
  8. Sweep over your cheekbones, finishing at the hairline.
  9. Sweep under your eyes extra gently. Julie adds, “I love sweeping from the corner of the eye moving in toward the midline. The muscle contracts in this direction and the lymph has little rivers flowing down from the eyes all the way from the inner corner of the eye to the outer corner. But if it feels better to sweep from the inner corner of the eye to the hairline, then do that — this is a more traditional direction for gua sha.”
  10. Sweep over the eyebrow out toward the hairline and then up from the brow bone over the forehead to the hairline. To cover this area best, do it in three to five smaller sections.
  11. Sweep from between the eyebrows and up to the hairline.
  12. Sweep from the middle of the forehead out to the hairline.
  13. Perform the same steps on the other side side of your face.
  14. Finish the treatment by sweeping down the neck to the collarbone.

You should sweep each area three to five times. It’s important not to sweep over each area too many times, because this may cause counterproductive overstimulation. Try to keep your tool almost flat to your skin at about 15 degrees. Don’t hesitate to try out using tools with various shapes and also using various sides of a tool to best fit the contours of your face.


If you feel unsure about practicing gua sha therapy at home for the first time, you can always get a facial or massage from a professional who has a gua sha certification.

Gua sha is generally not recommended for people who:

  • Bleed easily
  • Take blood thinners
  • Have deep vein thrombosis
  • Have an implant (like an internal defibrillator or pacemaker)
  • Have cystic acne
  • Have a skin infection or open wound
  • Have tumors or cancer
  • Have any medical condition that affects the skin or veins

Check with your healthcare provider before trying gua sha if you are pregnant, nursing, have a medical condition or are currently taking medication.

Final Thoughts

  • Gua sha is an ancient, non-invasive Chinese therapy that uses a tool to rub or scrape the skin’s surface in long strokes.
  • The goal of this massage technique is to help move energy, known as qi or chi, around the body.
  • Traditional medicine practitioners have used gua sha for centuries to boost circulation, increase blood flow, break up scar tissues, help chronic pain and generally improve the health of the body.
  • When this therapy is practiced using intense strokes of pressure, it becomes more controversial. The greater the pressure used with any gua sha treatment, the higher the likelihood of adverse side effects.
  • Benefits (using light pressure) may include: reduced pain, increased circulation, improvements in breast engorgement and lymph flow and a reduction in cellulite, breakouts and signs of aging.

More Health