The basics of Gua sha

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.

Gua sha petechiae Clive Witham guide acupressure stretching
Skin layers Clive Witham Gua sha

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.   

Leg muscles Clive Witham Gua sha guide

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.

Vascular system Clive Witham Gua sha
Human Body Channels Clive Witham Gua sha Guide


Buffalo horn Gua sha tol Cliv Witham

2. What tools or equipment do you need?

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. That's why. And also if you aren't doing a type of Gua sha that can be used with any tool, anywhere, what are you doing? 

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

Aromatherapy Oil

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 Ecological Gua sha. Here is some of what I do. 

3. How to use Gua sha tools

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