For those who choose Gua Sha to regulate their bodies due to heavy internal cold and dampness, there are some common questions: “Is it better to have more petechiae?” “Is petechiae just subcutaneous bleeding?” “Feeling very tired after Gua Sha, does that mean I have depleted my Yang Qi?” “Does Gua Sha only drain and not replenish?” Today, I will clarify several confusions regarding Gua Sha.Gua Sha can both drain and replenishAccording to traditional Chinese medicine (TCM) treatment methods, ancient texts record four methods: “Bian (Gua Sha), needle, moxibustion, and medicine.” Gua Sha therapy, also known as “Bian Fa,” has a history of several thousand years. “Bian” refers to the physical treatment methods of Gua Sha and massage. Since it does not require special tools or materials, only hands or a Gua Sha board, those who understand medical principles and meridians can treat people anytime and anywhere, making it the most convenient treatment method, thus it was regarded as the foremost of the four methods by ancient people.“If there is deficiency, then replenish; if there is excess, then drain” is one of the basic principles of TCM treatment and also the treatment principle of Gua Sha therapy.Although Gua Sha does not directly introduce substances that replenish or drain into the body, it relies on the techniques of replenishing and draining to stimulate certain areas on the body surface, thus promoting bodily functions or suppressing excessive bodily activity. The essence of these effects falls within the categories of replenishing or draining.The replenishing and draining effects of Gua Sha are certainly related to the therapeutic effects of acupoints, but they mainly depend on factors such as the intensity of the technique, the speed of the strokes, the duration of the treatment, the direction of the strokes, and the frequency of Gua Sha. The completion of these actions relies on the techniques of replenishing and draining. Therefore, Gua Sha is not solely about draining; it can also replenish.Replenishing Gua Sha refers to methods that can invigorate the body’s Zheng Qi (correct energy), restoring diminished functions. This involves light pressure, superficial action, slow speed, gentle movements, a smaller area of treatment, a requirement for light red petechiae, and shorter stimulation time, or scraping in the direction of the meridian flow.Draining Gua Sha refers to methods that can expel pathogenic factors, restoring normal functions. This involves heavy pressure, deep action, fast speed, vigorous movements, a larger area of treatment, a requirement for dark red and abundant petechiae, longer stimulation time, or scraping against the direction of the meridian flow.As the ancients said: “Although the methods are fixed, the application is flexible.” The application of replenishing and draining techniques is not rigid; in clinical practice, it can be flexibly selected based on the patient’s condition and constitution.The process of petechiae formation can detoxify

Many people have the question: Gua Sha causes subcutaneous bleeding due to damage to capillaries, so why are there areas that do not form petechiae? Why does the amount of petechiae decrease with each scraping?

TCM believes that during Gua Sha, pathogenic factors in the body overflow from the meridians and accumulate under the skin, forming petechiae that can appear as granular shapes, scattered, dense, patchy, or fused, known as “Sha,” also referred to as “Sha toxin.” Sha is blood that has leaked from the meridians containing a large amount of toxins, and the process of petechiae formation is a detoxification process.Western medicine believes that during many diseases, due to the invasion of bacteria and viruses, toxins and toxic substances are produced, or when the functions of bodily tissues and organs decline, metabolic waste cannot be expelled in time, leading to varying degrees of retention within the body, becoming internal toxins that harm health. These toxins cause abnormal permeability of capillaries, leading to congestion or the appearance of petechiae under the mucous membranes and skin, which aligns with TCM’s understanding.Clinical observations have found that healthy individuals generally do not form petechiae after scraping, while some individuals who feel well but have latent diseases may form petechiae after scraping. Patients will generally have different petechiae locations, colors, and shapes depending on the affected area, severity of the condition, and duration of the illness.For the same condition, the locations, colors, and shapes of petechiae also exhibit certain regularities, which are directly related to the flow of meridians, the distribution of reflex zones, and the pathological states of organs and meridians.Gua Sha does not necessarily produce petechiae

Some people believe that Gua Sha must produce petechiae to be effective. Is it better to have more petechiae?

During Gua Sha, we require a technique that is “gentle and harmonious,” using a method that penetrates the skin to the bone, with a rhythm akin to “slow-cooking pig trotters,” achieving clinical effects through a calm and strong penetration. It is crucial to avoid using violent force to forcibly produce petechiae, but it is also important to avoid using insufficient downward pressure, merely scraping the skin’s surface. This not only fails to achieve therapeutic effects but can also cause repeated friction, leading to epidermal edema and skin damage, harming the patient.The correct scraping technique should always maintain pressure, with each scraping done at a uniform speed and stable force, avoiding sudden changes in pressure or uneven application.In clinical practice, individuals who are overweight, muscular, or deficient in Qi and blood may find it difficult to produce petechiae, and areas such as the abdomen and face may also not easily produce petechiae. Therefore, one should not blindly apply excessive force during Gua Sha. The so-called Gua Sha instruments used in beauty salons, which leave the entire body red with identical petechiae in every area, and do not differentiate based on symptoms or follow the meridian pathways during scraping, are all inadvisable. The principle of Gua Sha is to adapt to each person’s skin tolerance, ensuring no injury occurs.Correct Gua Sha does not harm Yang QiAfter Gua Sha, many people feel tired and sleep very well, leading them to believe this is a sign of Yang depletion. Gua Sha therapy aims to mobilize one’s Yang Qi to achieve the purpose of strengthening the body and expelling pathogens. For example, after running 1000 meters, when all your Qi and blood are mobilized, you will also feel tired; does that mean you have depleted your Yang Qi? The treatment focuses on “unblocking.” As the saying goes, “Flowing water does not rot, and a door hinge does not get eaten by worms.” The wisdom of Da Yu in controlling water is to use unblocking methods to allow water to have an outlet and return, thus achieving governance. The human body has systems such as the nervous system, circulatory system, and lymphatic system; various blockages can lead to various diseases. If we can ensure that the meridians, blood vessels, lymphatic system, and nerves are all unblocked, then all pathways in the body will be opened, and diseases can naturally be resolved.Appendix: Clear skin impurities, Gua Sha for skin beautification!

▉ Step 1: Gua Sha around the eyes and faceGua Sha around the eyes and face is a very safe method to expel heat toxins and wind toxins. Blurred vision, dry eyes, discomfort in the eyes… these are actually manifestations of liver Qi rising.The main functions of the liver are “to regulate and store blood.” The liver stores blood and relies on its regulating function to distribute it throughout the body. The classic text states: “The liver receives blood and enables vision.” Therefore, generally speaking:Liver blood deficiency: dry eyes, lack of nourishment leads to dry and blurry vision, or night blindness; liver fire excess: red eyes with bloodshot, blurred vision; liver meridian wind-heat: red, itchy, painful eyes; liver fire rising: red eyes with opacity; liver Yang rising: dizziness; internal wind of the liver: eyes deviating upwards, etc.Liver blood deficiency and excess liver fire are mainly related to staying up late, accumulated negative emotions, or excessive alcohol and tobacco use.Specific operation:Prepare aloe vera gel, facial cream or eye oil, and a small, smooth fish-shaped Gua Sha board for the eye area.After washing your face at night, first apply a layer of aloe vera gel, then a thick layer of facial cream or Gua Sha oil, and you can start scraping in the direction indicated by the arrows in the image below.

If you want to remove dark circles and bags under the eyes, focus on Gua Sha around the eyes, applying slight pressure on the acupoints shown in the image below. Scraping the brow bone feels particularly refreshing, as if all the day’s worries are scraped away.If there are areas that feel lumpy, that indicates meridian blockage, so scrape those areas a few more times.During Gua Sha, the face may feel warm, which is due to the Yang Qi in the body generating heat, softening the stratum corneum, and metabolizing waste on the face. For those with acne, the heat can open the pores, allowing small acne particles to be scraped out. After Gua Sha, you will noticeably feel your skin is more refined and elastic.Scrape the entire face for about 15 minutes, and do not rush to wash your face immediately after scraping; wait half an hour before washing with warm water (do not use cold water, as it may cause broken capillaries). Also, apply a mask half an hour after Gua Sha; applying a mask immediately after will cause the pores that have just opened to close suddenly, preventing the toxins from being expelled.Clearing impurities and mobilizing skin Qi and blood begins with the facial Gua Sha mentioned above, followed by neck Gua Sha.▉ Step 2: Neck Gua Sha (Allowing clear Qi to rise and turbid Qi to descend)The neck is the only passage connecting the organs and the head. Scraping the neck from top to bottom will allow turbid Qi and fire to descend while clear Qi rises, providing a pathway for the wind-heat and liver-gallbladder fire in the face to dissipate.Specific method:Evenly apply Gua Sha oil on the back of the neck and shoulders, first scrape the first line, from top to bottom along the Du Meridian from Fengfu to Dazhui (as shown in the image); then scrape along the Bladder Meridian from Tianzhu to Dazhu, one line on each side; finally, scrape from Fengchi to Jianjing on the shoulders, one line on each side, scraping from Fengchi down to the neck and from Jianjing outward.This is beneficial for those who engage in mental labor (including those who think too much or daydream) to restore clarity and cognitive function.▉ Step 3: Gua Sha on the Lung Meridian (Replenishing Lung Qi and Unblocking Deep Stagnation)The lungs govern the skin; if there are skin issues, it is often necessary to address the Lung Meridian for root treatment.“All Qi belongs to the lungs.” Therefore, replenishing Qi deficiency, regulating Qi counterflow, expelling turbid Qi, and nourishing clear Qi can all be achieved by regulating lung function.However, the Lung Meridian is also the most easily injured meridian. For example, catching a cold from wind-cold indicates lung Qi deficiency, unable to resist external pathogens. By using Gua Sha to protect the lungs, one can treat colds and also have a certain effect on skin beautification and complexion adjustment.

Gua Sha on the Lung Meridian is actually very simple; the image above shows the pathway of the Lung Meridian, starting from Zhongfu and scraping downwards. Scrape more on areas that feel sore until no new petechiae appear.Girls who exercise less generally have some lung Qi deficiency. I have personally experienced that the area along my upper arm where the Lung Meridian runs often hurts, and Gua Sha in that area significantly improves the condition.Additionally, the Lung Qi has a major gathering point on the back called Feishu (Lung Shu) point, where issues such as colds, asthma, cough, and skin problems can be treated by scraping or pressing this point. The Feishu point is located 1.5 inches lateral to the spinous process of the 3rd thoracic vertebra.

Regarding Gua Sha, a relatively simple method for unblocking and detoxifying, it is best to perform it once every season, totaling 24 times a year. This consistency acts like continuously renewing the body, expelling stagnation, and stimulating its vitality.

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