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Gua Sha vs. Facial Gua Sha: Understanding the Differences

Updated: Nov 13, 2023

Women giving a gua sha treatment

It is easy to confuse traditional gua sha done as a medical procedure with facial gua sha used for beautification. This is mainly a problem when reading articles online that do not differentiate between the two. Traditional gua sha is an ancient Chinese healing technique that has been used for centuries to treat muscular issues and internal illness. It involves rubbing a specialized tool over the skin to stimulate circulation and invoke a healing cascade. While traditional gua sha has been used for centuries, facial gua sha has recently become popular for improving skin health and appearance.

In this article, we will discuss the differences between traditional gua sha and facial gua sha and the benefits of each. You will learn about the key elements of traditional gua sha, facial gua sha, and the differences in technique and tools. This article will give you a better understanding of gua sha so you can avoid the confusion created by two different modalities with the same name and be better able to understand conflicting information you may see online.

Key Elements of Traditional Gua Sha: A Healing Practice from Neolithic China

Traditional gua sha is a healing practice that dates back to neolithic China. It is a non-invasive therapy used to treat muscle-skeletal problems and various internal illnesses, often involving the lungs or liver, such as asthma or the common cold, as well as hepatitis or cirrhosis. Gua sha has been used for centuries to help reduce pain, stimulate blood circulation and improve overall health. However, it is gaining popularity in the modern world due to its ability to provide quick relief without the need for medication.

A key element of traditional gua sha is the expression of a red rash-like response known as sha. In western terms, sha results from the extravasation of cellular material and the reabsorption of metabolic waste into the body and the resulting healing cascade. In eastern terms, sha indicates the release of pathogenic influences from the body known as xie qi (evil qi). Learn about the history of gua sha here.

Facial Gua Sha: The Latest Trend in Holistic Beauty Treatments

Woman doing facial gua sha on herself

Facial Gua sha is very different from its traditional counterpart. With traditional gua sha, the red rash-like discoloration called sha is expected as part of the healing process. However, with facial gua sha, it is to be avoided since facial gua sha is primarily a beautification technique.

Facial Gua sha has recently grown in popularity because it offers a gentler, more natural way to achieve a youthful, glowing complexion. Unlike its traditional counterpart, facial gua sha does not produce sha. Instead, facial gua sha relies on gentle techniques to stimulate circulation and lymphatic drainage and increase collagen production.

Technique Differences: Facial Gua Sha vs. Traditional Gua Sha

Traditional gua sha technique involves firm pressure with a tool held at a steeper angle. This procedure can be utilized with or without lubrication; although the lubricated method is more prevalent in the western world, unlubricated gua sha is common in Asia. This technique can initiate a localized healing cascade, decrease systemic inflammation, break up scar tissue, and improve circulation.

One of the critical elements of this technique is the production of a rash-like pattern known as sha. Sha serves as a visual cue to practitioners, indicating areas where xie qi has been released from the body and the healing cascade has been initiated. In addition, sha acts as a form of diagnosis, allowing practitioners to analyze treatment progress and asses the underlying cause of the problem being addressed. This helps them better understand and customize treatments and achieve better patient outcomes. Learn more about gua sha as diagnoses here.

Gua sha treatment on a women's back.

The techniques in facial gua sha are designed to provide gentle but effective exfoliation and massage of the face. Using the tool at a shallower angle with light but even pressure helps stimulate blood flow and lymphatic circulation, reduce muscle tension, and improve skin tone by increasing collagen production. To ensure optimal results, it's essential to use a high-quality lubricant for the treatment. Balms and serums designed to moisturize and add to skin health are the best choices for this technique.

It is also important to note that some contraindications that apply to traditional gua sha are less of a concern with facial gua sha. For example, because traditional gua sha creates sha, it is contraindicated for patients on blood thinners and should not be used over acne. However, with facial gua sha, the technique is gentle enough that blood thinners should not be an issue, and it can be used to reduce acne. Of course, you should seek advice from your healthcare professional to determine if either type of gua sha is right for you.

Gua Sha Tools: Facial vs. Traditional

Facial gua sha tools are often lighter and slightly smaller than traditional gua sha tools, making them easy to use on delicate facial skin. However, despite their smaller size, they should still be large enough to be comfortably held in the hand so that users can get the most out of their experience. To ensure optimal results, facial gua sha tools should be designed in a way that is aesthetically pleasing, functional, and easy to use. The contours of a facial gua sha tool should hug the curves of the face as opposed to a traditional gua sha tool primarily designed for the contours of the back, arms, and legs. In addition, these tools should be made from materials that are comfortable on the skin while providing a pleasant massage sensation. Metal tools are a good choice since the edges can be brought to a high polish.

A copper gua sha tool being used on a women's face.
Copper is a naturally antimicrobial material making it perfect for gua sha tools.

Maintaining a clean facial gua sha tool is essential for preserving healthy skin. An insufficiently cleaned gua sha tool can contribute to clogged pores and worsen skin conditions. Metal tools such as copper and steel have nonporous surfaces that will not crack or degrade over time, unlike stone or porcelain. In addition, copper is a naturally antimicrobial material that can help protect against bacteria and viruses, making it the ideal choice for a facial gua sha tool. Not only does copper have this added benefit, but when made correctly, it provides a smooth and gentle surface that glides over the skin without causing irritation or damage.

Traditional gua sha tools are usually slightly heavier and larger to allow for firmer pressure, as with facial gua sha tools, the edges should be smooth polished metal. Traditionally gua sha tools were often improvised with items found around the house, such as Chinese soup spoons or dishes. After all, this was largely folk medicine used in the home. However, porcelain and stone tools can chip or develop microfractures over time. These small fissures are a great place for bacteria to hide. However, modern purpose-built tools made from metal instead of stone or porcelain have several advantages. They can be sanitized more effectively, created in more ergonomic shapes, and are much more durable. In addition, gua sha tools made from copper are naturally antimicrobial. One can get away with using stone or porcelain tools for traditional gua sha for a single person in a home setting, but for a clinician who is using the same tool on multiple patients, metal provides the safest and easiest surface for sanitizing.

Choosing the Right Gua Sha Technique for Your Needs

Gua sha is an ancient Chinese healing technique that has been used for centuries to treat internal illnesses and muscle issues. Traditional gua sha is a non-invasive therapy that uses firm pressure and produces a red rash-like discoloration called sha, an essential part of the healing process. Facial gua sha, on the other hand, is a relatively new practice primarily used for beautification and improving skin health. It is a gentler technique that does not produce sha. Both traditional and facial gua sha can be beneficial, but it's essential to understand the differences between them since they are different modalities with different purposes.

About the Author

Mark Parzynski. DAOM, L.Ac., is a licensed acupuncturist and educator with a diverse background in the field. He has studied in the United States, Japan, and China and uses a range of unique therapeutic approaches to create personalized treatment plans for his patients. Dr. Parzynski has over a decade of experience as a clinical supervisor and has taught graduate students and clinicians.

In addition to his work in acupuncture, Dr. Parzynski is also a skilled craftsman and silversmith. He began making teishin and gua sha tools as an acupuncture student. His passion as an artisan has continued, and for over a decade, he has been making tools for practitioners worldwide, including some of Japan's most renowned masters.

Dr. Parzynski is also a Chinese internal martial arts practitioner, which he incorporates into his acupuncture practice and daily life. He was a senior student of the late Sifu Gregory Fong and has taught Taiji Quan, Yi Quan, and Qi Gong since 2006.

For acupuncture tools and classes provided by Dr. Parzynski, visit

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