Gua Sha History




With its origins in treating abscesses in the Warring States period (475-221 BCE) of ancient China, Gua Sha has been a mainstay as folk medicine since antiquity. Theories of ‘sha’ disease gradually developed based on the premise that a pathogen was to be cleared and dispersed from the body, and this was combined with a scraping technique, initially involving a hemp rope rubbing method using water or sesame oil in the Yuan dynasty (1271-1368 CE). This was developed in the Ming dynasty (1368-1644 CE) with innovations such as an arched hemp tool and willow branches on the back to treat typhoid fever.

And by the Qing dynasty (1644-1912 CE), the method of scraping had become more precise and expanded away from only on the limbs, using copper coins and buffalo horns. A working framework with the treatment of sha was also developed at this time, which enabled a more comprehensive application of scraping and included instructions for headaches, numbness of the face and head shaking, and the combination of scraping with bleeding, heating, and pinching to treat ‘sha’. Ancient doctors rarely recorded the specific methods, time, and treatment of Gua Sha but in the 20th century, with the work of Jiang Jingbo and later Lu Jiru, Gua sha was reinvigorated, and an adapted, modernized style of Gua Sha therapy within Chinese medicine was promoted. As Professor Li Jingwei of China Academy of Chinese Medical Sciences concurs, the development of Gua sha has been far from being static and is constantly reborn, developed, and improved on throughout its history.

This is a Chinese word that is pronounced as Gwah-Shah is defined in two parts — “Gua” means “scrape” while ‘Sha’ is said to mean “sand” by some people, while others seem to give it “redness of the skin.” So we could say it is a method of scraping away disease, fever, or some sickness from the body generally. However, other words for the term “Gua Sha” are skin scraping, spooning, coining.

It is a healing procedure copied from traditional East Asian medicine. It used to be a traditional natural therapy involving a “spatula” made from buffalo horns to massage the skin.

The Gua Sha tool has been adjusted and modernized and made from more refined materials such as jade or rose quartz to massage the appropriately lubricated area of the body surface in upward strokes or in a swift and gentle but vigorous scraping motion to relax stiff muscles while relieving pain and tension, treat certain illnesses, as well as improve blood circulation.

It creates minor bruises that appear as purple or red marks known as “Petechiae” or “sha”.

Many Holistic category finalists have used gua Sha in The Skin Games as part of their treatment modality. I see on social media that this treatment has already become extremely popular, and I assume that promotional campaigns run by companies such as The Marketing Heaven stand behind it.


GuaSha Massage has been widely used by the ancient Chinese for a long while now as a folk therapy. Between 1368 and 1644, the procedure was scientifically computed into major medical records in the Ming Dynasty. Although the period of the practice of Gua Sha is assumed to be much older, its first computed record dates back to about 700 years ago, during the era of the Ming Dynasty.

Historical records on GuaSha date back to the Paleolithic Age. When people fell ill or entered a coma, hands or stones, and household materials such as coins or tins were used to massage parts of their body to help reduce the side effects and symptoms of their illnesses.


Gua Sha Techniques

Gua Sha is a technique on its own, and it is just one tool amidst many others in the Traditional Chinese Medicine (TCM) tool kit. The GuaSha Massage technique is used to unblock and restore the flow of Qi in the area to which it has been applied.


Basic Technique to Gua Sha:

  1. Apply a reasonable amount of thick lubricant or oil to the skin.
  2. Make sure your upper body is fine and calm.
  3. Hold the Gua Sha instrument firmly and properly in your hand between 30-45 degrees angle towards the area you are about to scrape.
  4. Begin to scrape in one direction – down, away from the head, or sideways, away from the spine.
  5. Scrape the first few strokes for some time before applying a little more pressure.
  6. Maintain consistent pressure. Don’t go too hard or too soft.
  7. Apply long and continuous strokes between 15cm – 20 cm or 6 – 7 inches.
  8. Be consistent with scraping in just one direction. Don’t injure your client by changing directions while scraping on a particular area of the skin.
  9. Each stroke should be applied about 10 to 30 times before proceeding to the next area.
  10. Spend a little more time on an area that has more sha, and move to the next skin area when there is no more she.
  11. Cover up treated areas immediately with a towel to keep it warm.

    General Technique to GuaSha Massage:

    This technique can be applied to the fine muscles of the head and face but with tender strokes. However, it is generally advised that you use a fine tool that can easily get into the angles and follow the outlines of the skin area to be treated.

    1. Carefully scrape and lift the skin from the forehead up towards the hairline using the smooth edges of the right tool. At that point, you move to the side of the nose and the facial structure and scratch outward and up towards the ears and afterward scratch downwards on the face sides.
    2. Proceed along these lines until you’ve covered all the painful parts and blocked areas that need to be treated. The lucky person who receives this treatment is likely to experience immediate pain relief, feel lighter, and a nearly “unplugged” sensation as though the skin has been unblocked somewhere inside.
    3. After the Gua Sha session, you can give your ‘client’ a “room temperature” (not iced) glass of water to avoid unhealthy effects on the internal organs.
    4. Allow your client to rest for some time cause the body must have gone through a lot during the procedure though it may not seem like it.
    5. Your client should not be allowed to shower or bathe directly for about an hour or more after treatment.
    6. They should avoid the natural breeze of air and should be wrapped to keep warm instead.

        Benefits of Gua Sha

        1. Improves the movement of lymphatic fluids and breaks down tension in muscles and knots in the face, neck, and shoulders.
        2. Reduces facial lines and can be used almost like a gentle, natural face-lift, resulting in less puffy eyes and sharper cheekbones.
        3. Increases blood circulation while lifting and firming the skin.
        4. Gives the face a smoother complexion and more sculpted features.
        5. Reduces hyperpigmentation on the treated surface area of the skin.
        6. Because it may decrease inflammation on the skin, it is frequently used to treat sicknesses that cause chronic pains like arthritis and fibromyalgia and those that trigger muscle and joint pains.
        7. Relieves the side effects of conditions such as Migraine headaches, Neck pain, Perimenopausal syndrome, Hepatitis B, Breast engorgement, Tourette syndrome, etc.


        In Mandarin Chinese, the pronunciation is guāshā, which has a high-level tone on the ‘a’ sound. This is a steady high sound, produced as if it were being sung instead of spoken. The ‘sh’ is similar to English. When the ‘sh’ is pronounced ‘s’, it signifies a regional accent, usually in the south. Both pronunciations are correct, with the most popular being standard Mandarin.



        Facial Gua Sha

        According to Wang Donghai, Deputy Chief Physician at the TCM Dermatology department in Baofeng Hospital of TCM, it has only been in the 21st century that Chinese medicine has been used extensively in the beauty industry. Indeed, there is very little in the history of Gua sha which appears to refer to scraping as a cosmetic technique. It was not until the Song dynasty (960-1279 CE) that anything resembling the practice of cosmetic scraping appears in jade rubbing to treat facial scars in the Northern Song era. Many of the ideas behind facial Gua sha have been influenced by traditional Chinese cosmetology, which from the Warring States and Qin and Han Dynasties, came ideas of how the human body and skin color changes are directly related to changes in people’s temperament, age, health, and qi and blood. Also, the development of the “three courts and five eyes” ideal facial proportions still influences aesthetics and modern cosmetic surgery today. Modern facial Gua sha ideas were developed in the 1990s and 2000s by proponents of Gua sha like Zhang Xiuqin, who popularized holographic beauty Gua sha through the Chinese media, and Shimada Sumiko developed a Japanese version of Gua sha, which was translated and published in Korean and Chinese.


        Post Script: Cecily Braden Spa & Wellness and Cecily Braden Spa & Wellness Academy are committed to providing well-researched and responsible training programs. Our research is ongoing, and we will continue to work with Historians, TCM Practitioners and Professors to unearth the history of Gua Sha and follow its evolution into its modern-day application in the Esthetic Industry, which has been heavily influenced by Dr. Ping Zhang and the introduction of Cecily Braden’s Gua Sha Facial Fusion protocols, which combine Gua Sha and TCM theory with multiple facial massage modalities and techniques using a variety of facial massage tools. They include but are not specific to Gua Sha or TCM theory and practice.


        Southeast Asia

        This scraping therapy is over two thousand years old. Therefore, it is uncertain if this technique originated in China. Still, in Chinese scriptures of approximately 200 BC, there was already talk of a scraping method to scrape complaints and diseases from the body.

        This method can not only be found in China but in entire Southeast Asia. In countries such as Vietnam, Laos, Cambodia, Thailand, Malaysia, and Indonesia. In Vietnam, this scraping technique is known as Cao Gio, in Laos as Khoud Lam, in Cambodia as Kos Khyol, in Thailand as Hak, and in Indonesia as Kerik.

        In most countries mentioned above, copper, the coin, is used as a scraping instrument. But another material is also used for scraping. It is folk therapy, which means that everybody scratches what is present. For example, in China, people used and still use Chinese porcelain spoons. The rounded shape of these spoons makes it to be a good scraping instrument. But also, the horn is a material that can easily be worked to make it into a scraping instrument. And horn was plentiful because even in rural China, a lot of buffalos were present. Also, wood and bamboo and even lids of jars were used.


        Most villages in rural China and other Southeast Asian countries have their guasha-therapist. But for many of the minor discomforts, they or a family member used the scraping instrument themselves. Scraping not only takes place when complaints or diseases occur but also to prevent. Every day, the head, arms and legs, and sometimes the chest is treated to avoid complaints.

        After some time, special Guasha instruments are developed, from the horn that the farmers take from the horns of their water buffalos into jade (for those who could afford to do this), the stone to which the Chinese ascribe “healing” powers. In any case, jade is a stone that conducts the energy (Chi) well.

        The scraping technique from Indonesia (the one with the copper coin) is best known. The skin is rubbed with warm oil, and the copper coin is used to scrape (Kerik or Kerok) and often used as a means against colds and fevers, muscle ache, and several other complaints.

        In many countries like Indonesia, this technique was used as a home remedy and passed on from generation to generation. So there would always be someone in the family that took the coin in case of disorders and disease.


        The scraping of the coin is best known as the scraping method in Indonesia and other countries such as Cambodia, Laos, and Thailand; the copper coin is most often used for scraping.

        In countries such as Vietnam and Cambodia, oils with menthol or camphor-containing oils are used, which can sometimes cause burn marks.

        When many Asians from these countries settled in the United States in the seventies, significant misunderstandings arose between the two cultures. For example, many children were taken from their homes by government bodies because the parents were charged with and convicted for child abuse, while the real reason was a Guasha-treatment.


        In 2000 a movie was made in China with the title “The Guasha Treatment,” telling the story based on these misunderstandings. An impressive movie, wanting to bring clarity to the phenomenon of Guasha, with which many Americans had a problem when many thousands of immigrants came to the United States and brought this technique with them.

        In the early Ming dynasty (1368-1644), Chang Ching Yueh described some examples of these methods in his book and explained in simple terms the working them. “The inside of the body is connected to the surface. That is why diseasing factors will move downward if one strikes downward. That poisonous material moves upward, is disreputable, and the unnatural. That they move downward is natural. To convert disreputable (unnatural) to a natural process is that what heals the disease.”


        Professor Lu Chi Ru from Taiwan has examined this method, passed on from generation to generation, deepened this through medical study and practical utilization, and placed it on a medical, scientific level. Thus, it became possible to follow an education in the Guasha techniques.

        Currently, Guasha is very popular again in China and is utilized in many treatment centers and clinics.


        Arya Nielsen

        In 1976 Arya Nielsen, a famous American acupuncturist came in contact with Gua Sha. She learned the three techniques from the Chinese doctor James Tin Yao So to bring the Sha to the surface: gua sha (scrape, scratch), Pak Sha (slap, splash), and Tsien Sha (pinch, push). The most popular method is Gua Sha.

        Arya Nielsen was so impressed with Gua Sha that she started teaching this technique to everybody who wanted to learn it. In 1995 she published her first book about Guasha outside of China. Indeed because of this book and by her school, Arya Nielsen brings Guasha to the attention of many people, both in the US and in Europe.

        These days, you can find the Guasha-therapy in many countries of Europa.


        Zhang Xiuqin

        In 1991, Prof Lu Chi Ru moved from Taiwan to China. After many years of studying, she discovered a way to combine the centuries-old scraping therapy (Gua Sha) with meridian teachings. With this combination, more and more people were treated successfully. In China, her findings were checked, and people were enthusiastic about the results.


        From the moment she began her career as a physician, Prof Dr. Zhang Xiuqin had always been very interested in Traditional Chinese Medicine. Specifically, she felt drawn to scraping therapy. Prof Lu Chi Ru’s study results further ignited her enthusiasm for this field, and decided to research scraping therapy.


        Through literature search in ancient Chinese books and writings, she concluded that the first recordings of this scraping technique dated back to the 17th century. She met with many experts, physicians, and professors in Chinese medicine employed at excellent hospitals.

        To understand the effects of the scraping technique better, she studied various theories on micro-circulation. Also, she explored age-old methods of scraping therapy and combined them with modern (health) sciences and techniques to develop a new method for the scraping technique.


        She expounded further on the combination of Prof Lu Chi Ru’s scraping technique and meridian teachings. In 1955, by the grace of much research and testing by practical experience, she introduced a new avenue of scraping therapy based on reflexology and meridian teachings, named: ‘Holographic Meridian Scraping Therapy’. This new form of scraping therapy is a combination of three-in-one: treating complaints/disease, making a diagnosis simultaneously, and preventative treatment.


        In 1995, together with Prof Hao Wanshan of the Beijing University of Traditional Chinese Medicine, she published the book ‘Holographic Meridian Scraping Therapy’. The bookmarks a tremendous improvement in the world of Gua Sha because, until that time, very few books had been published with regard to the new developments in scraping techniques.

        She did this in order to learn more about Chinese techniques, such as acupuncture, moxa, and Chinese massage, as well as new technological developments concerning studies and therapies in the hospitals. As a result, the methods described by Dr Zhang Xiuqin offer new possibilities for drug-free therapies. Nowadays, many people use her methods, and the simplicity and ease by which this therapy can be done increase its popularity. Partly because of this popularity, Holographic Meridian Scraping Therapy is significantly valued by medical authorities in China.


        By the efforts of Dr. Zhang Xiuqin, her research, development, and applications, scraping therapy has been sophisticated and brought to a higher level. A technique capable of allowing Qi and Blood to flow through the body again will lead to better health.