Firstly, the disclaimer! If you are a practitioner, please check with the area where you live to see what requirements there are for the cleaning of Gua sha tools which may differ from the information here.
Okay. So if you have a Gua sha tool, the chances are that when you use it on your skin that there may be blood vessel leakage which along with skin cells and all that other skin foliage that accumulates on the tool, has the potential to cross-contaminate. While, if you do Gua sha to yourself with your own tool, this is not much of a worry, in a clinical environment however this becomes rather important, especially when the same tool is used on different people.
The actual risk of catching something with a Gua sha tool is actually very small and I am not aware of any evidence that this has ever happened. I have seen a 2010 study (here) which is sometimes cited as cross-contamination evidence. It is of a Korean patient who caught herpes simplex after having acupuncture and cupping. The report authors conclude, however, that this was either due to a contaminated acupuncture needle or the reactivation of a herpes viral infection due to mechanical trauma on her arm (the cupping). It's not exactly a slam-dunk for cross-contamination with Gua sha.
Having said this, I think it is essential to avoid all possibilities of contamination not just to prevent communicable disease but to have a safe, clean environment around you. Besides, who in their right mind wants to receive Gua sha which has not been properly disinfected from use on a complete stranger. Think of the bits of skin you can see and then how about all the microorganisms you can't. It's not pleasant. And definitely has no place in a clinic environment or when treating other people.
Of course, a solution to this is to just throw away the tool - you can use a lid or a cheap Chinese soup spoon - and then there are no problems of disinfection. But the reality for most people is that they bought Gua sha tools and they use them and they need them cleaned correctly before using them again.
So if you want to disinfect the tool and, like most people, don't have access to an autoclave or hospital-grade disinfectant solutions, this is what you need to do.
Gua sha tools are classified as semi-critical items for the purposes of disinfection which means they have to be cleaned and then disinfected to a high level (they don't need to be sterilized).
A safe procedure is as follows:
1. Wear gloves. I actually wear nitrile gloves the whole time I do Gua sha.
2. Use a disposable wipe to wipe and remove any debris from the tool
3. Soak the tool in warm water with detergent for at least 10 minutes.
4. If you need to wash the tool, do so under the water and not under a running tap.
5. Dry the tool with a paper towel and inspect it for any visible contaminants.
6. Soak the tool in 1:10 household bleach solution for a further 30 minutes. This means for example that for 100ml of bleach, you should add 900ml of water.
7. Discard of the bleach solution and rinse the tool in water.
8. Remove the tool and let it air dry.
If you follow this procedure with buffalo horn tools, they tend to crack after a while and anyway they are difficult to disinfect. So despite the fact that many of the Gua sha tools are made of buffalo horn, they are not what I recommend both in terms of longevity and disinfection.
Jade, resin and porcelain seem to survive better and retain a smooth surface after repeated disinfections. This of course brings me back to my favorite tool, the Chinese soup spoon!
If I have missed something about disinfection, please let me know in the comments below.
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