| Gua sha | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
 Skin showing characteristicpetechiae after gua sha treatment | |||||||||||||||||||||||
| Chinese name | |||||||||||||||||||||||
| Chinese | 刮痧 | ||||||||||||||||||||||
| Literal meaning | "scrapingsha-bruises" | ||||||||||||||||||||||
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| Vietnamese name | |||||||||||||||||||||||
| Vietnamese alphabet | cạo gió | ||||||||||||||||||||||
| Chữ Nôm | 𠜯䬔 | ||||||||||||||||||||||
| Literal meaning | to scrape wind | ||||||||||||||||||||||
| Indonesian name | |||||||||||||||||||||||
| Indonesian | kerokan | ||||||||||||||||||||||
Gua sha orscraping therapy is a type ofpseudomedicine in which an object is used to scrape the skin, for claimed wide-ranging therapeutic benefits. Such claims are not supported by evidence.[1]Gua sha is rooted intraditional Chinese medicine (TCM) and has been used for centuries acrossEast andSoutheast Asia.
The practice is known by various names in English, such as "spooning," "coining," and in French astribo-effleurage (friction-stroking).[2] While it is widely practiced for pain relief, relaxation, and treating symptoms like colds or fatigue,gua sha can cause adverse effects, ranging from mild skin irritation to rare but severe complications.
The termgua sha derives from Chinese:gua (刮) meaning "to scrape" andsha (痧), referring to the petechiae or "bruise-like" marks that appear on the skin post-treatment. In TCM,sha is associated with stagnation or blockages in the body’s energy (qi) and blood, which practitioners aim to release.[citation needed]
The practice is originally from China and spread from there to neighbouring regions, such as Vietnam, where it is calledcạo gió ("to scrape wind"). In Vietnamese culture, illness such as colds or fevers is often attributed to "catching wind" (trúng gió), a concept linked to theShanghan Lun, a foundational Chinese medical text from circa 220 CE that discusses cold-induced illnesses.[3]
Gua sha traces its origins to ancient China, with evidence of similar scraping techniques dating back to the Paleolithic era, where stones were used to alleviate pain or illness. Its formalized use in TCM emerged during the Ming Dynasty (1368–1644), when texts began documenting the technique as a method to treatsha syndromes—conditions believed to result from environmental factors like wind or cold stagnating in the body.[4]
Gua sha involves applying firm, unidirectional strokes to lubricated skin using a blunt, smooth-edged tool. Common tools include ceramic spoons, coins, jade stones, water buffalo horn, or specially designed instruments. The skin is typically prepared with massage oil, balm, or even rice wine infused with ginger (used traditionally for fatigue or colds). Strokes are applied along muscle groups or acupuncturemeridians, each stroke spanning 4–6 inches, untilsha (petechiae) appears.
The technique is often combined with other TCM practices likefire cupping, which also aims to relieve stagnation.[5] Practitioners may vary the pressure based on the condition being treated—lighter for cosmetic purposes (e.g., facialgua sha) and firmer for musculoskeletal issues. In professional settings in China,gua sha is offered in hospitals, clinics, and massage parlors, reflecting its widespread acceptance and affordability.[citation needed]
Gua sha is apseudomedicine.[1][6] Proponents make a wide range of claims for its supposed effectiveness for conditions including infection, constipation, and respiratory disease.[7] There is no good evidence to support these claims.[7]
Gua sha can cause tissue damage.[8] It nearly always causes minor skin trauma, including redness, bruising, or dermatitis.[6]
The negative side effects ofgua sha range from minor ones – includingdermatitis, burns andblood in the urine – to rare major ones includingbleeding in the brain and severe injuries requiringskin grafts.[8]
The risk of infection is a significant concern if tools are not properly sterilized or if open wounds are present. While no documented cases of blood-borne pathogen transmission (e.g., hepatitis) have been directly linked togua sha, the potential exists, particularly in informal settings.[9]
In immigrant communities, particularly among Vietnamese, Cambodian, and Indonesian diaspora,gua sha (or its local variants) remains a common home remedy. In the United States, healthcare providers in areas with large Southeast Asian populations, such asOrange County,California, frequently encounter patients withsha marks.[10] However, these marks have been mistaken for signs of physical abuse, leading to legal and cultural misunderstandings.
In the 1980s, Vietnamese immigrants in the U.S. expressed distrust toward Western medical providers, partly due to fears of being reported for child abuse when practicingcạo gió on their children.[11] U.S. physicians are legally obligated to report suspected abuse, regardless of cultural context, complicating cross-cultural healthcare interactions.[12]
Gua sha has appeared in various media, reflecting its cultural significance and occasional controversy. The 2001 Hong Kong filmThe Gua Sha Treatment explores a Chinese-American family’s struggle when a welfare agency misinterpretsgua sha marks on a child as abuse. The film highlights cultural clashes and differing definitions of care versus harm.[13]
In 2021–2022,gua sha surged in popularity onTikTok, driven by beauty influencers promoting facialgua sha for lymphatic drainage and skin rejuvenation.[14]
In the United States, gua sha is one of many types of traditional medicine included in certain states' licensing laws under an umbrella recognition oftraditional Chinese medicine.[15]
