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The Complete Guide to Gua Sha: Healing Benefits and Uses

What is Gua Sha?

Gua Sha, known as kerokan in Indonesia, is a healing technique originally practiced as “folk medicine” in East and Southeast Asia. It is also commonly known as “scraping” “scooping” and “coining” as spoons and coins were often used to perform manipulation of the skin with a scrapping motion. Gua sha was a common practice that was later integrated into Traditional Chinese Medicine and today has been used by physiotherapists in sports medicine protocols, incorporated into massage sessions and practiced as an at-home beauty ritual (I personally love chilled jade rollers and jade gua sha stones!) Harper’s Bazaar has even dubbed gua sha treatments “natural botox.” With holistic beauty and ancestral healing practices moving into the mainstream, women are apparently moving on from their injectors and booking gua sha facial appointments with their local esthetician/ gua sha sculptor instead.

Does gua sha work?

Therapies involving manipulation of the skin like gua sha and cupping are believed to have been in practice for the past 2,000 years. Today, these therapies are referred to collectively in modern medicine as Instrument Assisted Soft Tissue Mobilization (IASTM) and they’ve been shown to be effective for a variety of both clinical and common conditions from chronic pain to the common cold.

Does the type of gua sha stone matter?

Gua sha stones- and tools based on gua sha such as Graston Technique, RockBlades and other soft tissue instruments- come in a variety of specialized shapes and have various edges, angles and contours made from different materials from bull horn to bian stone, rose quartz, jade and other semi-precious stones, to metals like surgical grade stainless steel and titanium. The evidence-based designs of some of the instruments are made to detect myofascial adhesions and build-up of tissue through the resonance capability of the material and friction which produces ultrasonic pulses against the skin. If you’re wondering which gua sha stone is the best to use, bian stone is known to be the most resonant.

Onto the benefits…

Gua Sha improves immunological function of the skin.

The skin is the largest organ of the body and the first-line of defense from the external elements. Gua Sha has been shown to improve immunological features of the skin. Repeated, unidirectional press-strokes using the smooth edge of an instrument against the skin has been shown to stimulate the wound-healing process by up-regulating pro-inflammatory cytokines and decreasing the number of immunosuppressive cytokines. Studies have also shown that gua sha increases surface microcirculation in the tissue of the skin following treatment [1]. This increase in blood flow and surface circulation brings a fresh supply of nutrients and oxygen to the local soft tissue, facilitating healing and reducing muscle pain (myalgia) [3].

Gua Sha stimulates collagen production.

Gua sha massage and IASTM are said to stimulate remodeling of fascia/ connective tissue and healing of fibrosis, along with stimulating fibroblast recruitment and collagen production for dermal reconstruction and wound healing. In instrument assisted soft tissue repair, localized inflammation increases the activity and number of fibroblasts and fibronectin which then facilitates the synthesis and realignment of collagen. These proteins and glycoproteins of the extracellular matrix repair and re-structure the damaged tissue [2][3]. This damaged soft tissue just beneath the skin is fascia. When it is damaged, it can restrict the flow of blood, lymph and surrounding muscle, causing pain and limiting range of motion. Gua sha can be used to increase local circulation of blood, lymph, and life-force energy to facilitate natural healing, tissue repair and regeneration.

Gua sha balances the energy body.

Fascia, the connective tissue beneath the skin is a piezoelectric tissue. This means that sustained pressure or compression on the system stimulates a flow of interstitial bioelectric fluid containing ions of differing charges. Electrical potentials called streaming potentials are created as the interstitial fluid flows through fixed-charged collagen causing a shearing of collagen fibers which generates an electrical field. This stimulates a new line of collagen to be laid down along the areas of stress or damage. This piezoelectric property is what allows the tissue to heal. Gua sha, Graston Technique, and other instrument-assisted fascial release methods all stimulate the flow of interstitial fluid carrying the charged particles through tissue fibers with their fixed electrical charges, creating a stronger electrical field. A piezoelectrically induced current activates the healing processes in the stimulated area [4][5]. This accelerated healing process balances bio-electrochemical nature of the body, increasing overall qi or subtle, radiant energy.

Gua sha relieves pain and releases muscle tension.

Gua sha can be used to break down adhesions, areas of scar tissue or connective tissue that is restricting joint movement, causing pain, or effecting surrounding musculature. On limbs of the body (like the arms and legs) use long, quick strokes moving toward the body. For example, on the arm, direct strokes from the wrist toward the elbow. For maximum piezoelectric stimulation, hold the stone against the area at an angle no greater than 45 degrees to the surface of the skin, directing the stone in unidirectional strokes. Use firm pressure and a rhythmic motion to stimulate the tissue, increase circulation and encourage lymphatic flow, especially at distal regions of the body. Any areas of soreness or tension can indicate nerve current inference caused by accumulation of waste material in the tissue supplied by that nerve center and a lack of drainage of waste material and fluid.

On areas of tension, use heavy, firm pressure. On areas of tenderness, use a gentle touch.

How to use a gua sha stone:

Por favor, do not use gua sha instruments on dry skin. They will not glide. A smooth and rhythmic stroke is key, so you will need to apply a mist, balm, or oil such as jojoba, sesame, coconut, or other natural oil or blend.

This is what I use for my own gua sha self-massage:

DAILY RITUAL Soul Revival CBD Balm — 2 oz / $32
Meraki Nomad Oum Oil — 3.4 oz. / $42
EVERYDAY OIL — 8 oz. / $48

I use a gua sha comb to stimulate my scalp by brushing along my hairline and nape of my neck.

For facial gua sha sessions, I put the jade heart-shape stones in the freezer for a few minutes and then place them over the under-eye area to soothe puffy eyes.

What are the benefits of facial gua sha?

Gua Sha has been incorporated into spa services to relax facial muscles and release areas of facial tension. The contours of the gua sha stone work great for stimulating acupressure points which are often common areas of tension held in the face. So, if you’ve been searching for a tool to bring awareness to how and where you are holding tension in your face, I highly recommend making this a daily self-care ritual and you’ll experience facial tension relief. Gua sha has been reported to relieve tension headaches, jaw tension, and alleviate symptoms of TMJ.

Gua sha increases circulation.

Gua sha is great for bringing a fresh supply of oxygenated blood to the skin cells. This increase in surface circulation instantly boosts complexion. Guiding the stone upward is a technique to firm sagging skin and decrease fine-lines/ wrinkles. Gua sha is best done just before your skincare routine as it enhances product penetration. Consistent gua sha facial massage can significantly improve skin texture and elasticity as well as reduce facial and peri-orbital puffiness. Light pressure for a couple minutes is all that is needed to promote lymphatic drainage and ‘sculpt’ your facial contours. Beyond the beauty benefits of gua sha, applying outward strokes with gentle pressure is a great way to relieve sinus pressure and congestion.


RESOURCES


[1] Chen, Tingting et al. “Gua Sha, a press-stroke treatment of the skin, boosts the immune response to intradermal vaccination.” PeerJ vol. 4 e2451. 14 Sep. 2016, doi:10.7717/peerj.2451

[2] Kim, Jooyoung et al. “Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application.” Journal of exercise rehabilitation vol. 13,1 12-22. 28 Feb. 2017, doi:10.12965/jer.1732824.412

[3] Arya Nielsen, Nicola T.M. Knoblauch, Gustav J. Dobos, Andreas Michalsen, Ted J. Kaptchuk, The Effect of Gua Sha Treatment on the Microcirculation of Surface Tissue: A Pilot Study in Healthy Subjects, EXPLORE, Volume 3, Issue 5, 2007.

[4] Macginitie, L. A. (1995). Streaming and Piezoelectric Potentials in Connective Tissues. Electromagnetic Fields Advances in Chemistry, 125-142. doi:10.1021/ba-1995-0250.ch008

[5] Ikushima, Kenji, et al. “Electric Polarization of Soft Biological Tissues Induced by Ultrasound Waves.” Physical Review Letters, vol. 123, no. 23, 2019, doi:10.1103/physrevlett.123.238101