Gua Sha: Anti-Inflammatory Benefits | Cosmo

Gua sha – the traditional Chinese “scraping” technique – has surged in popularity for its potential health and beauty benefits. From spa facials to physical therapy sessions, this practice is touted to improve circulation, reduce inflammation, and relieve pain. But what does modern science say about how gua sha works? Researchers have begun to uncover the physiological mechanisms behind gua sha’s anti-inflammatory effects, validating many of its traditional uses. In this article, we’ll explore the science of gua sha, including how it boosts microcirculation, triggers the body’s healing responses, and even affects the immune system. We’ll also discuss gua sha’s benefits for lymphatic drainage, how it can reduce skin inflammation, and tips to buy a gua sha tool (the jade scraper stone) safely at home.

What Is Gua Sha? (Traditional Chinese Scraping Therapy)

Gua sha (刮痧), often called “scraping therapy,” is a technique from Traditional Chinese Medicine (TCM) in which a smooth-edged tool is used to massage or scrape the skin. Traditionally, practitioners would use a ceramic spoon, a coin, or a piece of jade to repeatedly stroke lubricated skin in one direction. The word gua means “to scrape” and sha refers to the reddish petechiae (tiny red spots) that appear on the skin after treatment. Essentially, gua sha intentionally produces a mild, temporary bruising as a therapeutic measure.

Originally, gua sha was applied to the body (back, neck, shoulders, limbs) to relieve ailments like fever, muscle pain, or congestion. Today, a gentler version of gua sha is also popular in skincare – using a small jade or stone tool to glide over the face and neck for a facial massage. Whether used as a facial massage or a body treatment, the underlying idea is the same: improving circulation and releasing stagnation to promote healing. Practitioners believe that stagnant energy and blood contribute to inflammation; by scraping the skin, gua sha is thought to “release” this stagnation and reduce inflammatory burden in the body. While the traditional explanation is rooted in “Qi” and meridians, modern science translates these effects into changes in blood flow, the lymphatic system, and immune function.

Boosting Circulation and Microperfusion

One immediate effect of gua sha is a dramatic increase in local circulation. The scraping motion causes superficial blood vessels (capillaries) to dilate and sometimes burst, releasing a small amount of blood into the tissue (this is what forms the sha petechiae). Your body responds by sending more blood to the area, resulting in the characteristic redness. In a controlled study using laser Doppler imaging, researchers found that gua sha caused about a 400% increase in microcirculation (surface blood perfusion) at the treated area, which remained significantly elevated for at least 25 minutes after treatment. In that study, every participant also reported immediate reduction or resolution of muscle pain in the treated area, accompanied by a sense of relief. Increased microperfusion means more oxygen and nutrients are delivered to tissues, and metabolic waste products are carried away more efficiently. This boost in blood flow may help explain why gua sha can speed up recovery in sore muscles or injured areas by fueling cellular repair and flushing out inflammatory waste.

At-home gua sha tool brushed through hair by woman under clear sky.

Importantly, gua sha’s circulatory benefits aren’t confined only to the exact spot scraped. Participants in the microcirculation study reported pain relief even in distal areas that were not directly treated. The blood flow increase was local (only the treated region showed the fourfold perfusion spike), so how could a remote area feel better? Scientists speculate this may be due to reflex neural pathways or systemic immune effects. In other words, the local action of gua sha might trigger a broader response in the body, reducing pain in related areas through nervous system signaling or the release of circulating anti-inflammatory factors. This intriguing phenomenon suggests gua sha isn’t just a localized skin-deep treatment – it can induce beneficial changes throughout the body.

A Controlled Inflammation Triggering Healing

At first glance, causing redness and bruising to treat inflammation sounds counterintuitive. However, gua sha practitioners describe it as “therapeutic microtrauma” – a controlled, mild inflammation that stimulates the body’s healing processes.. When you scrape the skin and cause tiny capillaries to rupture, the body perceives it as a minor injury. In response, it activates an acute inflammatory cascade – essentially pressing the “reset” button on a stalled healing process.

During a gua sha session, as the skin reddens, the body is rushing immune cells to the area. Increased circulation brings macrophages and other immune responders that start cleaning up the extravasated blood and damaged cells. These immune cells release signaling molecules (cytokines) that set off tissue repair and regeneration. In cases of chronic pain or injury, there may be chronic low-grade inflammation or incomplete healing; gua sha’s induced “sterile inflammation” can jump-start a fresh healing response to resolve the issue. In essence, by causing a small amount of acute inflammation, gua sha helps the body clear out old, stagnant inflammation.

It’s important to note that this should be done in the right context. Avoid using gua sha on areas of acute, severe inflammation or injury (for example, directly over a fresh sprain or active rash), as it could worsen those conditions. Gua sha is best applied to subacute or chronic issues – where it can safely provoke a healing response. The redness and sha marks are temporary (fading in 2–4 days) and are considered a visible sign that the technique was effective in drawing out stagnation. Many patients report that along with the bruise-like marks, they feel immediate relief of muscle tension and pain after gua sha, often accompanied by a sensation of warmth in the area due to the increased blood flow.

Heme Oxygenase-1: Gua Sha’s Anti-Inflammatory Enzyme

One of the most fascinating scientific findings about gua sha is its effect on an enzyme called heme oxygenase-1 (HO-1). HO-1 is a protective, antioxidant enzyme that helps calm inflammation in the body. Normally, HO-1 is upregulated when there’s a need to break down heme (a component of blood) or to respond to oxidative stress. Research has shown that gua sha significantly upregulates HO-1 in treated tissues. In a Harvard study using mice, gua sha triggered increased HO-1 gene expression in internal organs (like the skin and spleen) immediately after treatment and lasting for days. This upregulation is a strong clue to gua sha’s anti-inflammatory mechanism.

Why is HO-1 such a big deal? When HO-1 breaks down heme from the bruised blood cells, it produces biliverdin, bilirubin, and carbon monoxide (CO) – all of which have beneficial effects:

Antioxidant and Anti-Inflammatory Action: Biliverdin and bilirubin are potent antioxidants. By neutralizing free radicals, they prevent cellular damage and tamp down chronic inflammation. In fact, increasing HO-1 has been shown to reduce inflammation in conditions ranging from asthma to autoimmune disease.
Immune Modulation: HO-1 activity can shift immune responses. For example, higher HO-1 levels have been found to attenuate allergic inflammation by inhibiting certain pro-inflammatory immune signals (like Th2 cytokines). This suggests gua sha could potentially help balance the immune system in hyperinflammatory states.
Liver Protection: The HO-1 pathway appears to protect the liver. Research indicates that HO-1 can inhibit the replication of hepatitis B and C viruses and reduce liver inflammation by downregulating inflammatory cytokines. This aligns with traditional uses of gua sha for liver ailments – in fact, in China gua sha has been used to help with hepatitis and fatty liver disease, and now we have a possible biochemical explanation.
Pulmonary Support: Gua sha has historically been a home remedy for respiratory issues (like coughs, asthma, bronchitis). HO-1 upregulation in lung tissues may explain this, as HO-1 helps shield lungs from oxidative damage and inflammation. By boosting HO-1, gua sha might increase the lungs’ resilience against irritants and inflammatory triggers.

What’s remarkable is that gua sha achieves this without any drug – it’s the body’s own enzyme responding to the therapy. As the sha (bruised blood) is reabsorbed, the breakdown of hemoglobin strongly induces HO-1 and its byproducts in the area, creating a wave of anti-inflammatory, protective effects. In one case study, a single gua sha treatment for a patient with active hepatitis B was documented to reduce liver enzyme levels (ALT, AST), improve the patient’s immune balance, and significantly increase HO-1 – suggesting a direct hepatoprotective, anti-inflammatory effect. While that was just one case, it complements laboratory evidence and centuries of anecdotal use.

Further research is ongoing to fully map out HO-1’s role and how far-reaching the effects of a gua sha-induced HO-1 boost might be. But current evidence clearly positions HO-1 as a key mediator of gua sha’s anti-inflammatory and immune-regulating benefits. Essentially, gua sha tricks the body into activating one of its own powerful anti-inflammation switches.

Lymphatic Drainage and Detoxification Benefits

Beyond blood circulation, gua sha may also enhance the flow of lymph – the fluid that carries immune cells and removes waste from tissues. The lymphatic system is like the body’s cleanup crew, but it relies on muscle movement and manual stimulation to move fluid (unlike blood, it has no heart pump). By massaging the skin and underlying fascia, gua sha can encourage lymphatic drainage, helping to reduce swelling and clear toxins in the tissues. This is one reason gua sha facials are beloved for de-puffing the face – gentle scraping motions along the jaw, cheeks, and neck can guide excess fluid toward lymph nodes, reducing bloating or edema. When the lymph flow improves, inflammation in that area often decreases as well, since the inflammatory waste products are being swept away more efficiently.

Research specifically quantifying lymph flow changes with gua sha is limited, but related studies on massage and instrument-assisted soft tissue mobilization suggest that these techniques do support lymphatic movement. Many physiotherapists and TCM practitioners observe that gua sha can reduce localized swelling and even help with conditions like sinus congestion (by helping drain the sinus areas). By aiding the lymphatic system, gua sha not only reduces puffiness but also contributes to immune health and inflammation control, since a well-flowing lymph system better removes pathogens and inflammatory molecules.

Another aspect of “detoxification” is the idea that gua sha might help clear metabolic wastes. The scraping pressure on muscle and fascia can help break up adhesions and accumulated metabolites in tight areas. As circulation and lymphatic flow increase, these wastes are flushed out. Some sources even describe gua sha as helping to remove “toxins” – while that term is vague, it likely refers to this combined effect of moving lymph, extravasated blood, and cellular waste out of the tissues for elimination. The result can be less inflammation and a sense of rejuvenation in the area.

In summary, gua sha acts on both blood vessels and lymph vessels. Improved blood circulation brings fresh supplies in, while boosted lymphatic drainage carries garbage out. This one-two punch creates a cleaner, healthier environment in the tissues, which is inherently less inflamed.

Scientific Evidence of Gua Sha’s Anti-Inflammatory Effects

Gua sha’s growing popularity in the West has led to more scientific studies, and while research is still ongoing, results so far are promising. Here are some key findings from studies investigating gua sha for pain and inflammation:

Chronic Neck Pain Relief: In a randomized trial with 48 participants suffering chronic neck pain, one group received a single gua sha treatment while the control group used a thermal heat pad. One week later, the gua sha group reported significantly greater improvement in neck pain and better range of motion than the heat therapy group. This suggests gua sha provided pain relief that not only was immediate but persisted longer, likely due to its anti-inflammatory and circulatory effects (whereas heat’s benefits were shorter-lived).
Chronic Low Back Pain (Inflammatory Biomarkers): A 2017 pilot crossover study compared gua sha to hot packs in older adults with chronic low back pain. Both treatments helped reduce pain initially, but gua sha appeared to have a longer-lasting anti-inflammatory effect. At one-week follow-up, more patients who received gua sha were still experiencing pain relief and improved mobility compared to those who only had heat therapy. Interestingly, researchers measured inflammatory markers and found that after gua sha, the pro-inflammatory cytokine TNF-α (tumor necrosis factor alpha) tended to decrease, correlating with improved physical function. In the hot pack group, levels of these markers bounced back up (“rebounded”) after a week. The gua sha group’s sustained low levels of TNF-α point to a lasting anti-inflammatory response, which aligns with the participants’ sustained pain relief. As the authors concluded, “Gua sha may exhibit a more long-lasting anti-inflammatory effect relative to hot pack” in chronic pain management.
Migraine Headache Relief: Case reports have found gua sha can help in conditions beyond muscle pain. In one case study, a woman with recurring migraine headaches experienced significant relief after gua sha therapy – her migraines decreased in frequency and intensity. While this is anecdotal evidence, it’s noteworthy since migraines have inflammatory and vascular components. Gua sha’s ability to improve blood flow in the neck/shoulder region and reduce overall inflammation may contribute to migraine relief for some people.
Breast Engorgement/Mastitis: Gua sha has even been studied in postpartum women with painful engorged breasts or mastitis (inflammation of breast tissue often related to breastfeeding). A small trial reported that gua sha treatment reduced breast pain and swelling, helping to relieve mastitis symptoms faster than usual care. The mechanism is likely increased circulation and lymphatic drainage in the breast, along with anti-inflammatory effects in the tissue. This use reflects how versatile gua sha’s anti-inflammatory action can be – from muscles to glands.
Liver Inflammation in Hepatitis: As mentioned earlier, gua sha is used in TCM for liver conditions. A case study from Harvard/Mass General documented that after gua sha therapy, a patient with active hepatitis B had a notable drop in liver inflammation markers (ALT/AST enzymes) and an improvement in their immune cell ratios. The researchers attributed this improvement to gua sha-induced HO-1 upregulation, which can protect the liver and suppress the hepatitis virus. While this is just one case, it aligns with Chinese clinical reports and gives hope that gua sha might be a useful adjunct therapy for managing chronic inflammatory liver disease. Naturally, more rigorous studies are needed here.

It’s important to highlight that, although these results are encouraging, scientific study on gua sha is still limited and evolving. Many studies have small sample sizes or are pilot in nature. However, the trend in findings supports the traditional claims: gua sha promotes circulation, reduces inflammation, and can thereby help with pain relief and healing. Conditions with an inflammatory component – whether it’s muscle knots, arthritis, respiratory infections, or even fatigue – seem to respond to this therapy in various cases.

Gua sha set includes jade device used on face during sunset skincare

Another interesting note: gua sha’s impact is not just physical but can be systemic. People sometimes report improvements in general wellbeing, such as better sleep or reduced anxiety, after a gua sha session. This could be related to the release of endorphins and the overall reduction in stress hormones when pain is relieved. It might also tie into the vagus nerve stimulation (since scraping the neck/upper back can activate parasympathetic responses). These holistic benefits are harder to quantify but are part of why gua sha has endured as a healing practice.

Gua Sha for Inflammation & Skin Health

How Gua Sha Reduces Skin Inflammation

One of the hottest trends is facial gua sha, touted to sculpt cheekbones, clear sinuses, and give you a glowing complexion. While the face technique is much gentler (it should not create the intense sha marks on the face), the science behind it overlaps with what we’ve discussed. By improving microcirculation and lymphatic drainage in the facial tissues, gua sha may help reduce inflammation in the skin. For example, people with puffy or inflamed skin (think of under-eye bags, or redness from fatigue) often see immediate de-puffing after using a cool jade gua sha tool to gently massage the area. The improved blood flow can also give the skin a healthier color and might support skin repair processes (useful for blemishes or mild irritations).

Regular gua sha massage on the face could potentially ease inflammatory skin conditions in a complementary way. Some estheticians claim it helps calm acne breakouts or rosacea flare-ups. While gua sha is not a cure for these conditions, its ability to increase circulation without adding chemicals might help the skin’s natural defense and healing mechanisms. Moreover, by relieving tension in facial muscles (for example, in the jaw or brow), gua sha can reduce stress-related inflammation. Stress and muscle tension in the face can contribute to issues like tension headaches, jaw inflammation (TMJ), or just that “tired” look. Gua sha releases that tension, which can indirectly lower inflammatory signals and improve comfort.

There is also a collagen-boosting claim: the gentle stimulation of the dermis might promote collagen production over time, aiding skin elasticity. While more research is needed, one small study did find that a short daily facial massage (not specifically gua sha, but similar stimulation) led to a modest improvement in wrinkles and skin firmness over several weeks. The theory is that increased blood flow and nutrient delivery from regular massage supports the skin’s metabolism. At the very least, facial gua sha is a relaxing self-care ritual that encourages people to slow down and take care of their skin – which has its own anti-inflammatory benefit, given the known link between stress and skin inflammation.

For anyone trying facial gua sha, remember to be gentle: use light pressure, a facial oil/serum for slip, and focus on moving lymph towards the sides and down the neck. The goal is a healthy glow, not bruising! When done correctly, facial gua sha should leave your skin looking slightly flushed and lifted, never deeply red or painful.

Safety and Side Effects of Gua Sha

Gua sha is generally considered safe for most people when done properly. The main side effect is the temporary redness and bruising (petechiae) on the skin, which is expected. These marks usually fade within 2 to 4 days, and with light facial gua sha you may not get visible marks at all (maybe just mild redness). Some individuals might also feel soreness in the treated area for a day or so, similar to how you feel after a deep tissue massage. This is normal and can be alleviated with rest, hydration, or a warm bath.

Because gua sha involves pressure and some capillary breakage, you should avoid gua sha if:

You have a bleeding disorder or are on blood thinners (the scraping could cause excessive bruising or bleeding in such cases).
You have any open wounds, cuts, or active skin infections on the area (you don’t want to further irritate or spread an infection).
You have had recent surgery or have a severe chronic medical condition affecting your skin or blood vessels (always consult a healthcare provider in such situations).

For everyone else, gua sha can be a safe at-home technique or done by a trained practitioner. Just remember that gua sha should not be outright painful. It can be intense on the body (a “good pain” similar to a strong massage), but you should speak up or adjust if the scraping is too uncomfortable. On the face, pressure should be very gentle. After a session, it’s wise to drink water and maybe do some light stretching, as your body will be moving fluids around.

Also, clean your gua sha tool thoroughly after each use (soap and water, or an alcohol wipe). This prevents any risk of infection, especially if you accidentally scrape too hard and the skin gets slightly raw. With these precautions, gua sha is a low-risk modality enjoyed by many.

At-Home Gua Sha Tool: How to Use

One of the great things about gua sha is that you can do it yourself at home with minimal equipment. All you need is a gua sha tool (often called a jade scraper tool or massage stone) and some oil or lotion. Gua sha tools are widely available – you can even buy gua sha tool kits online that include various shapes or a matching face roller. When you order a facial massage stone or jade scraper, look for a tool made of a smooth material (such as jade, rose quartz, or stainless steel) with no rough edges. The tool should feel comfortable in your hand. There’s no single “best jade scraper” brand, but the best tool for you is one that is authentic (many prefer real jade for its cooling feel), well-crafted, and suits the contours of the area you’ll treat. Many gua sha sets online come with instructions, but we’ll outline the basic steps here.

Steps for an At-Home Gua Sha Routine:

Prepare Your Skin: Start with clean skin. Apply a few drops of facial oil, serum, or moisturizer to the area you plan to scrape. This is crucial – the oil provides slip so the tool glides easily. Never do gua sha on dry skin, as that can cause irritation.
Hold the Tool Correctly: Grip the gua sha tool firmly but gently. Most tools have a curved edge – place that against your skin. Hold it at about a 30-45 degree angle relative to your skin (almost flat, not perpendicular) so that a broad area of the tool is in contact.
Use Gentle, One-Way Strokes: Press lightly and drag the tool in one direction (not back and forth). For example, on the neck you might stroke downward towards the collarbone to encourage lymph drainageccatcm.ca ccatcm.ca. On the face, common motions include sweeping from the center of the chin along the jawline toward the ear, or from the side of the nose across the cheek toward the temple. Each stroke is usually about 5–10 times in the same line. Remember to keep the pressure moderate on the body and light on the face. If it hurts or if deep redness appears on the face, you’re using too much pressure.
Follow Lymphatic Flow: A good rule is to move outward and downward on the face. Outward motions (toward the ears or temples) and then downward (down the neck) help move fluid to the lymph nodes. For the neck, you can do gentle strokes downward from the jaw to the base of neck. This helps drain excess fluid and reduce swelling.
Be Mindful of Sensitive Areas: Around the eyes, for instance, use the smallest corner of the tool and ultra-light pressure. Gently sweep from the inner corner of under-eye toward the outer corner (temple). The skin there is delicate, so do it just 1–2 times softly. For the throat, avoid scraping directly on the throat area; stick to the sides of the neck.
Finish Up: After you’ve gone over your areas of focus (maybe 5-10 minutes of gua sha is enough for a beginner session), clean your tool with mild soap and water. Pat your skin with any remaining serum or apply a bit more moisturizer. You might notice some redness – that’s fine – but there should not be intense bruising from a gentle facial session. If working on the body, some petechiae marks might appear, and that’s expected if you were targeting a tight spot on the shoulders/back.
Hydrate and Rest: Drink a glass of water afterward. This helps flush out any released waste via the lymphatic system. Enjoy the relaxed, warm sensation that often follows a gua sha routine. You can do gua sha a few times a week or even daily if your skin tolerates it well. Pay attention to how you feel and adjust frequency and pressure as needed.

By following these steps, at-home gua sha can become a simple self-care ritual. It’s an excellent way to wind down in the evening or to de-puff in the morning. Plus, it connects you with your body – as you glide the jade stone, you become more aware of areas of tension or swelling, and you can literally feel those melt away over time.

Gua sha may be an ancient practice, but modern research is finally illuminating why it’s so effective for pain and inflammation. By inducing a controlled microtrauma, gua sha kick-starts a healing cascade in the body – boosting circulation, releasing tight fascia, and modulating the immune system. Key scientific insights, like the discovery that gua sha upregulates the anti-inflammatory enzyme HO-1, show that this traditional scraping therapy has a real biochemical impact. The result is a reduction in inflammatory markers and relief from symptoms in a variety of conditions, from muscle knots to fevers and migraines. Gua sha essentially helps the body heal itself: it creates a brief, localized inflammation that leads to longer-term anti-inflammatory and analgesic effects once the body responds and recovers.

Jaw relaxation massage tool used on cheek by woman in bathroom mirror.

For the general public, the appeal of gua sha is also in its simplicity. A small jade gua sha tool can be purchased inexpensively – you can buy a gua sha set online or at a wellness store – and with proper technique, anyone can use it to support their well-being. It’s empowering to have a hands-on method to address aches, boost circulation, or just relax after a long day at the computer. Of course, gua sha is not a magic cure-all, and it shouldn’t replace medical treatment for serious conditions. But as a complementary therapy, it offers a drug-free way to mitigate inflammation and pain.

In the end, the science behind gua sha’s anti-inflammatory effects also underscores a broader lesson: our bodies sometimes need a nudge to initiate healing. Whether we frame it in terms of “releasing stagnant Qi” or “inducing a beneficial immune response,” gua sha exemplifies how a time-honored traditional remedy can align with modern biomedical understanding. It bridges the gap between Eastern wisdom and Western science – demonstrating that improving flow (be it blood, lymph, or energy) and carefully engaging the immune system can bring about real, tangible health benefits. For those seeking a natural approach to reduce inflammation or simply to unwind, gua sha is a technique worth considering – now with scientific validation to back up its reputed benefits.

Sources:

Nielsen, A. et al. (2007). Gua Sha increases microcirculation and reduces myalgia. Explore (NY), 3(5), 456-466 pacificcollege.edu pubmed.ncbi.nlm.nih.gov.
Nielsen, A. (2015). The Science of Gua Sha. Pacific College of Health and Science pacificcollege.edu pacificcollege.edu.
Kwong, K. K. et al. (2009). Bioluminescence imaging of heme oxygenase-1 upregulation in the Gua Sha procedure. J Vis Exp, (30) pacificcollege.edu.
Yuen, J. W. M. et al. (2017). Gua sha vs. heat therapy for chronic low back pain in older adults: A pilot study. Complement Ther Med, 32, 25-32 pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov.
Healthline. (2024). Gua Sha: Benefits and Side Effects healthline.com healthline.com.
Chan, S. et al. (2011). Guasha-induced hepatoprotection in chronic active hepatitis B: A case study. Clin Chim Acta, 412(17-18), 1686-1688 pacificcollege.edu.
Mark Parzynski, DAOM, L.Ac. (2023). The Science of Gua Sha: Understanding Its Biomedical Mechanisms, AcuArtistry Blog acuartistry.com acuartistry.com.
CCATCM. (2024). Does Gua Sha Work? – Benefits of Gua Sha, Canadian College of Acupuncture & TCM ccatcm.ca ccatcm.ca.
Cosmo Wellness. (2024). Science Behind Cupping & Gua Sha cosmo.la cosmo.la.