A Beginner's Guide to Gua Sha

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Gua Sha has quickly become one of the buzziest beauty trends, including popping up on — where else? — TikTok. The social media platform has become one of the go-to spots for the latest wellness, makeup and skin-care trends, especially for Gen Z, and if the multiple “how to” videos is any indication gua sha is now the latest obsession.

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Gua sha, pronounced gwa sha, is a facial treatment based on Traditional Chinese Medicine (TCM). While typically promoted as a tool to aid the face, gua sha can also be used on other parts of the body, including the neck, shoulders, back, and décolletage.

If you’re curious about the practice (or if the TikTok trend brought you here) — here’s what you need to know.

What is Gua Sha?

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“Gua sha is one of the oldest recorded forms of Ancient Chinese medicine treatments,” says Tsao-Lin E. Moy, L.Ac., MSOM Founder/Director at Integrative Healing Arts Acupuncture, P.C. “Gua literally means ‘scraping’ while Sha translates as ‘toxins and pathogens.’  Gua sha literally means to ‘scrape away illness.’”

The treatment involves using tools with a rounded smooth surface such as a coin, spoon, jade, or ox horn made specifically for gua sha; however, the majority of TikTok profiles use a flat jade or rose quartz stone. Gentle stroking called pressure stroking is applied to an area of the skin and has a scraping effect on the skin surface. This is done repeatedly in one direction.

According to Tsao-Lin E. Moy, the strokes cause red marks, which are called “sha,” to come to the surface. “In Chinese medicine this is the “sha”, stuck, qi and blood that readily moves from the tissue (muscles & lymph).” While the marks can look pretty dramatic, Moy says they aren’t painful. What they are experiencing is the effect known as transitory therapeutic petechia, the extravasation of the blood below the skin surface.

Typically, “Patients feel warmth and a freeing of movement and it is similar to cupping.”

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Gua Sha Benefits 

While TikTok users love to use the treatment for its beauty facial benefits, Dr. Jenelle Kim, doctor of Chinese Medicine, points out that gua sha can benefit the entire body. “It can reduce signs of aging such as dull, sagging, or wrinkled skin, while also relieving tension, encouraging lymphatic drainage to de-puff and eliminate bloat and stimulating circulation for increased oxygenation and nutrients being carried to skin cells.”

And gua sha isn’t just for beauty mavens or women either. Dr. Joy Moy, DAc, LAc, says she often uses the treatment, followed by acupuncture, for her athlete patients. “[The athletes] especially my professional hockey patients, will often ask for gua sha to relieve muscle tension in the shoulder and scapula areas, and upper and middle back areas.”

Beware of what you see on TikTok

While there are beauty experts trained in gua sha on TikTok, including Dr. Joy Moy, our panel of experts stress that it’s important to note that beauty experts may be experts in beauty, not necessarily in gua sha and everything people need to know about it.

“Gua Sha is a technique that requires sufficient training,” says Dr. Kim. “It is not just sweeping the tool along your body and face. You must stimulate key meridians and specific acupoints, so I recommend everyone begin by watching a tutorial, such as this one I created, to familiarize themselves with the techniques.”

Additionally, Tsao-Lin E. Moy notes that it’s key to respect and acknowledge the cultural background of gua sha. “The beauty industry has started a beauty frenzy without giving credit to the cultural origins and wellness practice of East Asian and Chinese medicine. Chinese medicine practitioners are trained in the use of gua sha as part of foundational knowledge and clinical practice.”

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How to start your own Gua Sha daily routine  

If you’ve watched Dr. Kim’s tutorial video and ready to try gua sha as part of your beauty regime, here are some tips she has for you to get started.

A simple protocol for facial gua sha is:

  1. Start with a clean, dry face

  2. Apply face oil or moisturizer

  3. Always begin by moving in a downward motion on the sides of the neck along the sternocleidomastoid (SCM) muscle. This opens up the lymph prior to massage.

  4. Starting at the center of your forehead move the gua sha from your brow-line to the edge of your hairline. Repeat working your way outward to your temples.

  5. Continue working the gua sha from the center of your face out as you move to your eyes, nose, mouth, and chin

  6. Use very gentle pressure as you move around your eyes.

  7. Gradually apply slightly more pressure as you approach the outer edges of your face, paying special attention to the cheekbones and jawline.

And, while, yes, everyone wants a clear and bright complexion, as Tsao-Lin E. Moy points out beauty is more than skin deep, and how you treat your skin and body will go a long way to achieving that glow. “Diet, sleep, exercise, mindfulness and stress will influence the outcome with any anti-aging techniques.”

A version of this story was published September 2021.

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