As a devoted fan of skincare, at-home spa treatments, and, most recently, face yoga, I’m always on the lookout for new ways to pamper myself. Thus, I couldn’t help but notice the recent uptick in beauty influencers raving about their Gua Sha stones, jade rollers, and similar facial massage tools. Besides the fact that the tool themselves are quite beautiful, the purported benefits had me intrigued.
Gua Sha facial massages supposedly work by enhancing lymphatic drainage in the face and neck, leading to smoother, clearer skin. The lymphatic system plays a central role in immunity, and it also works to clear waste products from your tissues. In the beauty and wellness industries, Gua Sha is frequently promoted as a way to “detoxify.” That term always gives me pause, especially when the detoxifying service in question costs more than my car payment. Futhermore, Gua Sha comes from traditional Chinese medicine, or TCM, and I’m always wary of the American beauty industry co-opting and commodifying traditional practices from other cultures.
At the same time, I do want a well-functioning lymphatic system, and facial massage feels fantastic, so I was motivated to check out this practice for myself. Here’s what I learned.
What is Gua Sha?
Gua Sha is an ancient Chinese medicinal practice in which a practitioner uses a rounded tool to scrape the skin of a person suffering from a malady like heatstroke, common cold, or fever. I say “practitioner,” but throughout history, Gua Sha was primarily a folk remedy. Your grandmother or mother would likely be the one to grab a soup spoon, coin, or bit of horn and set about scraping your back when you fell ill.
The scraping is designed to form petechiae, little pinprick spots under the skin that look like a flat rash. In fact, Gua Sha is variously translated as “scraping petechiae,” “scraping bruises,” or “scraping sand.” In TCM, the color of the petechiae—which might appear as red, pink, purple, or brown—is indicative of the patient’s underlying health problems.
Traditional Gua Sha usually focuses on the limbs, buttocks, back, and neck, and it is specifically used as a medical intervention. The modern beauty trend focuses on the face and is predominantly cosmetic (though the line is blurry when medical-sounding terms like lymphatic drainage are used to promote facial treatments). Both practices employ flat, rounded tools usually made from stone, wood, bone, horn, or ceramic, but that’s about where the similarities end. While traditional Gua Sha usually isn’t painful, it’s also not gentle. The scraping should leave a mark, and you may be sore for a couple days after receiving a treatment. Facial Gua Sha is billed as rejuvenating, the light strokes should not raise petechiae on the face.
For lack of better terms, I’ll use “traditional Gua Sha” and “facial Gua Sha” to distinguish the two for the remainder of this post, although some people argue that the term Gua Sha shouldn’t be used to describe cosmetic facial massage.1
What Benefits Does Gua Sha Offer?
Gua Sha appears in written records during the Ming Dynasty around 1,500 years ago, but the practice is probably considerably older than that. As a traditional remedy, it has long been used to treat all manner of illness or chronic pain.
There’s not a lot of contemporary research on Gua Sha, but a handful of studies validate that Gua Sha can help patients suffering from back and neck pain.2345 Individual studies have also found that Gua Sha can alleviate symptoms of diabetic peripheral neuropathy,6 improve the breastfeeding experiences of new mothers,7 and provide relief for women experiencing perimenopausal complaints like hot flashes and insomnia.8
As for cosmetic applications, facial Gua Sha enthusiasts promise a more youthful and sculpted appearance, glowing skin, and fewer wrinkles. Some bodyworkers claim that Gua Sha techniques can be used to reduce cellulite and bloating. However, the evidence is anecdotal at this point. You’ll have to satisfy yourself with the (admittedly impressive) before-and-after shots on social media. From what I can tell, any cosmetic benefits you derive will probably be short-lived unless you maintain a regular treatment regimen.
How Does Gua Sha Work?
According to TCM, traditional Gua Sha works by balancing qi, the energy or life force that flows through the body. Practitioners scrape Gua Sha tools along certain pathways or meridians to release blockages and move stagnant energy. Acupuncturists sometimes use Gua Sha alongside needling since both practices focus on energy channels within the body.
From a Western medical perspective, the mechanisms underlying Gua Sha’s beneficial properties are not well understood. Gua Sha might work by increasing circulation, exerting anti-inflammatory effects, protecting cells from oxidative stress, modulating the pain response, or all of the above.91011 As with other types of tool-assisted bodywork such as the Graston technique, Gua Sha may also help improve mobility by reducing scar tissue and promoting collagen synthesis.12 However, these proposed effects are largely hypothetical at this point, because the research on Gua Sha is fairly scant.
Can Gua Sha Promote “Lymphatic Drainage?”
“Lymphatic drainage” and “lymphatic massage” are buzzwords in the beauty and wellness spaces, but what do they mean? To put it simply, the lymphatic system circulates a fluid called lymph in much the same way your circulatory system moves blood throughout the body. Lymph sits in the space between cells and acts as a collection system for cellular waste products and debris. Lymphatic vessels drain the lymph and transport it to lymph nodes that act as filters before returning the lymph to the bloodstream to be deposited back among the cells.
I’m oversimplifying a complicated process here, but suffice it to say that your lymphatic system cleans your tissues, so to speak. The lymphatic system also delivers immune cells called lymphocytes throughout your body to fight off foreign invaders. So yeah, it’s pretty important.
The question is: does Gua Sha do anything to help the lymphatic system function optimally? Maybe. In certain acute conditions, lymph fluid can become trapped in the tissue and cause significant swelling, a condition called lymphedema. Left untreated, lymphedema can lead to severe issues like infection. Doctors will sometimes use massage techniques called manual lymphatic drainage to try to push fluid out of the tissues.1314 Theoretically, traditional Gua Sha could exert similar effects if the techniques overlap, but I wasn’t able to find any studies showing that Gua Sha is effective for treating lymphedema.
A couple of studies have demonstrated that Gua Sha increases microcirculation under the skin’s surface, which could lead to enhanced fluid exchange between the blood vessels, interstitial fluid between cells, and lymph vessels.1516 In plain speak, these studies do suggest that Gua Sha promotes the movement of lymph within the lymphatic system, which could be one mechanism by which Gua Sha exerts beneficial effects. More research is needed, though.
The (Dubious?) Claims of Lymphatic Massage for Skin Benefits
Beauty experts will tell you that facial Gua Sha works by improving lymphatic drainage and clearing “toxins” — toxins which are “known” to lead to dryness, blemishes, and all manner of skin maladies. These claims are everywhere on the Internet. The problem is, it’s not clear that poor lymphatic drainage is at the root of skin issues in the first place, nor that facial massage promotes beneficial lymphatic drainage in people with normally functioning lymphatic systems. Some clinicians do use manual lymphatic drainage to help patients with lymphedema of the head and neck, which can occur due to surgery to remove cancerous lymph nodes in the neck, for example. Lymphedema is completely different from having toxins “trapped” in the skin and causing acne or outward signs of aging, though.
It’s not that facial Gua Sha is useless. Plenty of people swear by it and derive a lot of pleasure from including it in their beauty routines. I’m just not sure the benefits are due to lymphatic drainage or anything along those lines. It seems at least as likely that it works by moisturizing the skin (you put oils or serums on the skin to allow the Gua Sha stone to glide), increasing circulation, and promoting relaxation.
Performing Gua Sha at Home
First and foremost, is it safe? Generally yes, as long as you know what you’re doing. However, whenever you have a specific medical concern, it’s always best to consult a trained professional and let them do the work. Gua Sha is not recommended for folks with circulatory problems or wounds, rashes, or other skin issues.
Facial Gua Sha is also safe to perform at home, but again, make sure you know what you’re doing. Don’t pull too hard on delicate under-eye skin and try not to poke yourself in the eye with your tool. Otherwise, as long as you’re gentle, it can be a soothing and relaxing addition to your self-care regimen.
Gua Sha FAQs
What is Gua Sha?
Gua Sha is an ancient Chinese medicinal practice in which a practitioner uses a rounded tool to scrape the skin for healing purposes. It may help alleviate pain and inflammation. Today, Gua Sha stones are also marketed as beauty tools for performing facial massage.
Is Gua Sha safe?
Both traditional Gua Sha performed on the body and facial Gua Sha massage are generally regarded as safe. However, Gua Sha is not recommended for people with circulatory problems, skin issues like rashes or wounds, or recent surgeries unless your doctor says otherwise.
What tools and oils should I use with Gua Sha?
Gua Sha practitioners use rounded tools made from stone, wood, animal bone, horn, or ceramic, as well as household implements like soup spoons and coins. Gua Sha facial stones are often made of semi-precious stone like rose quartz. Almost any oil will work. Jojoba oil is a neutral, hypoallergenic option.
What is lymphatic massage?
The lymphatic system circulates a fluid called lymph, which carries immune cells and clears waste products from tissues. Lymph travels through vessels similar to blood vessels, but it can be trapped in tissue, causing swelling and infection. Lymphatic massage can help relieve swelling and promote lymphatic drainage.
Does Gua Sha work to promote lymphatic drainage?
Proponents claim that it does. However, very little research has been done on Gua Sha, so it’s not clear how Gua Sha works. While Gua Sha may act on the lymphatic system, there are other possible explanations for its beneficial effects. More studies are needed.
Lindsay Taylor, Ph.D., is a senior writer and community manager for Primal Nutrition, a certified Primal Health Coach, and the co-author of three keto cookbooks.
As a writer for Mark’s Daily Apple and the leader of the thriving Keto Reset and Primal Endurance communities, Lindsay’s job is to help people learn the whats, whys, and hows of leading a health-focused life. Before joining the Primal team, she earned her master’s and Ph.D. in Social and Personality Psychology from the University of California, Berkeley, where she also worked as a researcher and instructor.
Lindsay lives in Northern California with her husband and two sports-obsessed sons. In her free time, she enjoys ultra running, triathlon, camping, and game nights. Follow along on Instagram @theusefuldish as Lindsay attempts to juggle work, family, and endurance training, all while maintaining a healthy balance and, most of all, having fun in life.