person receiving gua sha
person receiving gua sha

What is Gua Sha?

What is Gua Sha?

Gua Sha traces its origins back to ancient China and is, according to, one of the oldest recorded forms of traditional Chinese medicine treatments. Gua sha roughly translates to “scrape petechiae,” and traditionally uses tools made of bian stone, jade, or ox horn, while modern, cheaper alternatives are often made from resin or plastic. These tools are used to scrape and rub parts of the skin in one direction with the goal of activating blood circulation to dissipate blood stasis.


Gua sha tools come in a variety of shapes, thicknesses, and materials that all offer different benefits or are meant to be used on different parts of the body. “The main requirement is that it have a smooth, fine edge,” says Doryne Pederzani-Dinneen, LMT. Some of the most common types of material currently are jade, rose quartz, bian stone, amethyst, stainless steel, and black obsidian.

“The tools are usually different to fit different parts of the body or the practitioner’s hand,” says Christina Fabia, LMT and owner of New Morning Massage. For example, a heart-shaped tool is a great beginner’s tool because it is small and easy to hold.

A heart-shaped gua sha tool contours nicely to areas of the face such as the jawline, nose bridge, chin, and undereye area. Other available shapes include wave-shaped, dolphin-shaped, and wing-shaped.

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The thickness of the tool also affects the gua sha experience for both the client and the massage therapist. Hand feel is very important, and tools typically range in thickness between 0.3 cm and 1 cm. Typically, thicker tools are heavier and easier to hold and scrape with, but the choice of the tool ultimately comes down to individual preference.

“It’s best for therapists to try different tools (shapes, materials) to judge what feels most comfortable and easy to use for the application they employ,” says Meredith Walsh-Beteta, LMT.


Paying attention to pressure and making sure any tools are used appropriately during the gua sha session are necessary, but generally this technique is considered

safe. If too much pressure is applied or the skin is massaged in the wrong direction, however, side effects can occur. Some of the most common side effects include increased bruising or broken blood vessels, minor bleeding, and increased redness, according to

Additionally, gua sha isn’t recommended for individuals with bleeding disorders or those on blood thinners, with injuries such as sunburns or rashes, or for women who are pregnant or menstruating. “Therapists should also be mindful of the client’s skin type,” Walsh-Beteta says. “Older clients can have fragile skin that may react adversely to scraping techniques.”

“The practitioner should not spend more than 10 minutes in one area,” Fabia adds.


Athletes are one client demographic that may find gua sha particularly helpful, as well as clients who are trying to manage chronic issues. “Athletes and anyone with a chronic problem area may benefit most from gua sha,” says Fabia.

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“The type of client that I work with who benefits the most from gua sha therapy are people who have jobs where they are doing strenuous repetitive work,” says Pederzani-Dinneen. “I have a client who paints houses and if she has a lot of overhead work like painting ceilings, the repercussions of that type of work can be very painful. Gua sha never fails to help.” Pederzani-Dinneen also notes people who find themselves in awkward positions throughout the day, such as dentists or dental hygienists, landscapers, hairdressers, and other massage therapists, also stand to benefit greatly from gua sha.

Overall, gua sha may provide benefits to a wide variety of people. “Gua sha is such a beneficial addition to massage therapy,” says Walsh-Beteta. “I use it during almost every session. My clients report relief and I save my hands from overuse.”

This article is meant to provide a general overview of gua sha and is not intended to cover every situation. Information presented here does not replace the independent judgment of a practitioner. Before practicing any new technique, massage therapists should check with their state regulatory board to ensure they are practicing within their state’s defined scope of practice.