Gua Sha: How To Use, Is Gua Sha Bad, What It Is Good For

Although gua sha has been around for centuries as a Chinese medicine technique, #guasha in 2021 refers primarily to facial gua sha techniques, typically with a facial oil and a gua sha stone. In this regard, gua sha is used to naturally contour the jawline, de-puff undereye bags, and to help improve the texture of the skin. Gua sha also theoretically helps to increase skincare’s effectiveness. Gua sha does this by promoting lymphatic drainage, which helps the lymphatic system re-absorb interstitial fluid that may be trapped under your skin.

All over Instagram, you can search “#guasha” and find numerous users who have reported less facial puffiness, improvements in skin texture and tone, increased brightness, fewer lines and wrinkles, and improved contouring and sculpting of facial features. Some even report improvements in dryness, adult acne, and TMJ.

In terms of Eastern or Chinese medicine, gua sha is intended to address stagnant energy, called chi, in the body that practitioners believe may be responsible for inflammation. Rubbing the skin’s surface is thought to help break up this energy, reduce inflammation, and promote healing. (More on this later, in “What is Bad About Gua Sha?”, below.)

In terms of Western medicine, the benefits of gua sha seem to primarily come from the massage-like technique. As with massage, therapeutic benefit is attributed to an increase in blood circulation, which tends to last for the duration of the treatment, and a shorter period (typically minutes) thereafter (Acupuncture Today).

In addition, there is a therapeutic benefit because people are, quite frankly, relaxed during the treatment. Taking the time for self-care and experiencing it like a spa treatment or type of meditation may alter your body chemistry (i.e., hormones) enough to help you actually feel and, yes, look better. There is a reason, after all, people report massage as a go-to treatment for acute and chronic pain (Acupuncture Today).

Is Gua Sha Bad?

I wouldn’t go so far as to say, “Yes, gua sha is bad for certain conditions,” but I would say that there are considerations when you’re thinking about adding gua sha to your skincare routine.

1.) You want to be gentle, or you can stretch, scratch, or break the skin.

Traditional gua sha is done on the body with a technique known as the Graston Technique® in the physical therapy industry. Where the muscles in the body bulge up, you essentially break up adhesions of tight tissues by applying the tool in different directions and with varying amounts of pressure, and a pretty fast rate of speed. In this technique, you’re promoting qi and blood circulation and helping to break up stagnation within the body.

However, the musculature of the face is very thin by comparison, and the muscles don’t bulge up like the muscles of the body. Instead, with gua sha for the face, you have to use a lotion or serum so the tool glides across the skin. And you want to be very gentle with pressure, go slowly, and you want to keep moving in one direction (Cleveland Clinic). Otherwise, you can burst tiny capillary beds close to the surface of your skin and end up with bruises on your face, or, even worse, broken capillaries visible through your skin.

2.) Gua sha is proven to work best if you have more severe skin damage.

In the scientific literature, facial gua sha has been shown to have more effects if you have more fine lines and wrinkles and irregularities in skin texture than if you are someone who has fewer fine lines, wrinkles, and irregularities (Gale). In persons who don’t have severe skin damage, you may notice some improvements in skin contouring, but you’re not likely to notice the effects of, say, a quality prescription retinoid or an injectable treatment.

“There’s a limitation to the results you can get with gua sha,” confirms Julia Tzu, M.D., a clinical assistant professor at NYU’s Ronald O. Perelman Department of Dermatology, who recommends fillers, such as Restylane Lyft, for longer-lasting tightening (source).

3.) Gua sha is not recommended for anyone with rashes, sunburns, blood coagulation issues, blood thinners, or surgery within the past six weeks.

Gua sha is not recommended for those with rashes or sunburns, as you’re irritating tissues in the midst of healing. Gua sha is also not recommended for those with blood coagulation issues, as you can incite bruising.

How to Do Facial Gua Sha

No more than once a week, start by applying a facial oil or serum with a thicker texture, such as Vintner’s Daughter Active Botanical Serum. (This isn’t a plug or an ad, this is just an oil I’ve used that I find to work well for facial gua sha!) As a general rule of thumb, you want something with enough slip that will let you really work the product into your skin, without too much pulling or dragging.

Then, gently sweep the stone up the neck working your way towards your hairline, focusing on your cheekbones and jaw. Use slow, smooth strokes. Never do gua sha over open skin, such as blemishes or scratches.

What To Look for in a Gua Sha Stone

The main differences between gua sha stones are the materials they are made from, the shape, and the quality.

1.) Material matters — somewhat.

For people who tend to get redness in their skin, or who have sensitive skin in general, materials like nephrite jade or amethyst have cooling properties, which can help them stay cooler during the gua sha facial treatment process.

For people who have more resilient skin types, rose quartz has a packed crystal structure, meaning that it’s very dense and doesn’t absorb ingredients. It retains heat, so it may help with the absorption of ingredients into the skin as it glides across the skin.

However, you’re talking about really small differences. If you’re a beauty perfectionist, who wants the best of everything, absolutely invest in a nephrite jade or amethyst stone for sensitive skin, or a rose quartz for more resilient skin. But for everyone else, a regular gua sha stone is fine.

2.) Shape can help reach certain areas of the face.

I tend to get puffy eyes, so I like using a tool like Elizabeth Trattner’s Genuine Jade Gua Sha around the eyes, because it’s small enough to reach the area.

3.) Quality matters.

First, you want a stone that isn’t going to chip or break. According to clinical acupuncturist Tim Sobo, “There’s no clinical difference between one [gua sha stone] versus the other. You just want to get a tool that you can easily clean and maintain. And if it chips or breaks, which it shouldn’t do but it can, you’ll want to stop using it. If you get a little gash in a jade gua sha face tool, you don’t want to rub that all over your face.” (Cleveland Clinic)

Secondly, you want a tool that isn’t dyed and going to bleed and irritate your skin. According to New York City facialist Britta Plug, ”Because everyone is so into crystals right now, a lot of online stores are selling what are really acrylic tools dyed to look like crystal,” she explains. “This is happening more in China, but I’ve had people come to me with skin irritations because they are putting weird dyes on their face — I always try to get a certificate of authentication from vendors I use.” (Vogue)

Bottom Line

Gua sha is trendy right now. Studies show it’s worth it for you if you have more signs of aging, such as fine lines, wrinkles, and uneven skin texture than if you have healthier or more even-toned skin to begin with. The research also shows that its benefits are primarily due to increased blood circulation and relaxation. Overall, this is a subtle treatment for most, one that’s not going to have the same effects as, say, prescription retinoids, in-office glycolic acid treatments, or injectables. However, as long as you get a stone that isn’t going to chip or break, isn’t artificially dyed (the dyes can irritate the skin), and use gentle pressure on closed skin, there isn’t a lot of risk in trying it out.

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