The basics of Gua sha

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1. What is Gua sha and how does it work?


1. What is Gua sha and how does it Work?

The Marks on your skin


You might have come across a photo of the results of Gua sha on the internet. They normally look something like this. This is a photo of my older brother and the aftermath of being Guashified (Yes, I made this word up) by me while on holiday after a stressful time. I always have some tool on me that can be used whenever wherever, even on a vacation!

So the big question is, what are those nasty looking marks on his back and why does he have them there?

It kind of looks like I had a whip instead of a Gua sha tool but nevertheless that's all I had. We found some oil in the cupboard and with that as a lubricant, I just dragged the spoon across his skin with just enough pressure to pull at the tissue and muscle underneath but not enough to cause any pain.

The changes under your skin


The red marks occur because dragging a blunt object across your skin can sometimes produce changes in the tissue underneath. In order for this to happen, the tissue has to have some vascular impairment in the flow of blood through the muscles and tissue of that area. If so it can react by releasing blood cells as the vascular system in the local area improves. The red marks are where these cells have collected between the layers of your skin. The technical term for this is petechiae. And the process is very different from bruising caused by some kind of trauma. 

The effect on your body


So if petechiae appears on your skin, this means that the blood flow in that area has improved but not only in that area, in others too. Connective tissue, the muscular system and the vascular system are not isolated to one area but are dynamically spread about your body. If you use Gua sha on your back for example, you are not only improving blood flow in the back area but in the body as a whole.   

How the effect is organised


You could just scrape a tool over a place which has blocked tissue and get some relief. A lot of people do this, both professionally and at home, but if you really want to make a difference and really want to know what is going on, you need to delve a little deeper.   


Gua sha did not just appear from nowhere. It developed over thousands of years in the Far East and there are underpinning ideas and theories which turn just scraping along your skin into an adaptable curative technique.

If you can follow the lines and muscle groups which link your connective tissue, organs and functional systems, you have hit the informational jackpot and you can start to understand how your body works.


2. What tools or equipment do you need?


The choices

In order to do Gua sha, you will need a tool but you don´t really need one of those snazzy, ergonomically designed, over-expensive technically-worded Gua sha instruments. If you really want one and it will make you feel better, go ahead and get the latest Guashanator 3000 or the Scraper-easy or the Relax-maker 2 (yes, I just made these up). If gimmicky superfluousness is what will get you to use Gua sha, then go find one online and let's get going.  


If you have read any of my books, you will know that I generally use a Chinese soup spoon for Gua sha treatments which costs 50 cents in the local corner store. Low-tech is the new high-tech! Also if you check out the About Clive section, you will discover that I actually ran a clinic in North Africa for 11 years. So low-tech is the way to go here.


The tools in the photo shown here are all made out of buffalo horn and are popular in China as they are cheap and durable. As you can see, they all have funky shapes which are supposed to be related to the body part you use them on but trust me, you can take that with a pinch of salt. 

Buffalo Horn

The good things

  • They're cheap and don't break when dropped 

  • They come in all sorts of shapes and sizes

  • You can find them easily to buy online

The bad things

  • They bend if left too long soaking in water

  • They degrade over time and the edges sharpen

  • They're difficult to keep clean

Do we like it?  mmmm. Reserved for when If I can't find anything else to use

Chinese soup spoon

The good things

  • They're cheap and accessible 

  • They're easy to clean

  • They have the right shape to use

The bad things

  • They break when dropped

  • They don't look cool

  • They can hurt your wrist trying to cover large areas

Do we like it?  We love Chinese soup spoons


The good things

  • They look the part

  • They're always smooth

  • They have a cooling quality on the skin

The bad things

  • They break when dropped

  • They're more expensive

  • Did I mention they break when dropped?

Do we like it?  I did before they smashed into little pieces on my tiled floor


The good things

  • They are light, strong and you can get weird shapes

  • They are cheap and orangey

  • They don't break easily

The bad things

  • They look cheap and orangey

  • Don't be tempted by the weird shapes

Do we like it?  A great choice for a tool

Where can you buy these tools? Check out this link to find out: Where to buy Gua sha tools


In order not to hurt your skin when you scrape over it, you need some kind of lubricant. This could be in the form of oil, cream, soap ( in the shower) or liniment. There are so many choices but as for oils I have included a simple guide to the most common oils on a blog post: Gua sha oils - which one to choose? and there is also specific mention of retail Gua sha oils in my Gua sha book

3. How to use Gua sha tools


3. How to use Gua sha tools

I have been using Gua sha in my clinic for 20 years and have developed a style which I think has the best clinical application and also can easily be adapted for home use. This style is called Komorebi Gua sha. Here is some of what I do. 

The obvious place to start is the most common technique and which is used for all the big muscle areas. When I am in my clinic I always wear nitrile gloves when I do Gua sha. This is for many reasons but mostly because I need my hands oil-free in order to do other techniques, fast and efficiently.

This technique uses the longer side to drag over the skin.

Skin can have all sorts of variations on its surface area. You need to take these into account when you scrape the tool over the skin. If there is a spot, pimple, mole or any skin feature which would be undesirable to scrape over, you need to cover it with a finger.

While using the wide area of the tool is adaptable to many areas of your body, there are areas where you need to use a smaller surface area. These areas are usually near bones or joints which in most cases you need to avoid scraping directly over (because it hurts!).

When you feel a tight knotted area of muscle underneath the skin, you can press with the side of the tool. You can then continue with a combination of pressing and scraping over the area. 

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Did you know that as well as fixing coughs and colds, you can look younger and change your health with Gua sha?


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©2020 Clive Witham