Part 3 of 6 in the "what is cupping" series. Part 1 is what cupping is; part 2 is what happens in one session; part 4 is the marks; part 5 is which situations to tell your practitioner about; part 6 is aftercare.
Of the methods listed in part 1, these three are the ones readers tend to run together. The difference is not "which is better" — different things happen in the skin, and what is required of the operator differs with them.
The short version
- The dividing line between the three is whether the skin is broken. Cup retention and sliding cupping do not break it; wet cupping does, and there is blood in the cup.
- The WHO's standard terminology for TCM gives each of the three a one-line definition, and this part sets the three lines side by side.
- Sliding cupping adds one thing: lubricant. China's national TCM administration's infection-control guideline adds exactly one requirement for it — the lubricant must be kept clean.
- Wet cupping adds a whole further layer: the skin disinfected first, needles one person one use, and a cup that has held blood disinfected at a higher concentration.
- These are standards for medical institutions, not a checklist to run at home. Their one use at a consultation is to ask.
First, the things that cannot wait
If burns, blisters, broken skin, severe pain, or signs of infection develop at the cupping site, please contact your practitioner. If you experience fever, dizziness, or difficulty breathing, call 999 now, or go to the nearest hospital emergency department.
If you are experiencing seizures, loss of consciousness, or high fever, call 999 now, or go to the nearest hospital emergency department, rather than considering cupping.
The full list, and the reason for each, are in part 5. TCM and Western medicine complement each other; it is not a choice between them.
A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.
I. The three methods, one line at a time
① Cup retention — what people usually mean by "cupping". The WHO standard's definition of cup retention is one line: leave the cup in place after suction.
The Taiwan folk-practice manual spells out the end point: the cup is left on for a period, until the local skin flushes or the stasis under the skin turns purple-black, and then removed. The skin is not broken; what is left afterwards is the mark described in part 4 — the mark is blood under the skin, and the skin itself is not broken.
② Sliding cupping. The WHO standard's definition of sliding cupping: lubricate the cup mouth and the selected area first, then slide the cup up and down while retaining its suction. The same manual's requirement is even pressure, so the cup does not lose its seal and drop off, sliding until the local skin is slightly flushed.
Cleveland Clinic calls it running cupping: lotion or oil goes on the skin before the cups do. The skin is likewise not broken; one thing is added — the lubricant.
③ Wet cupping. The WHO standard's definition of wet cupping: prick the area to be treated with a three-edged needle or lancet, then suck out blood with a cup. Of these three, it is the only one that breaks the skin and leaves blood in the cup.
💡 Remember: the dividing line between the three is whether the skin is broken.
II. What each requires of the operator
China's national TCM administration's infection-control guideline writes the cupping techniques up separately, and the requirements for the three stack upwards.
The baseline for every cup. Cups must be cleaned and disinfected after each person — that is the guideline's basic requirement for cups.
Sliding cupping adds one line. The same guideline adds exactly one requirement for sliding cupping: the lubricant used must be kept clean.
Wet cupping adds a whole layer. The same guideline's requirements for it go beyond the two above:
- The skin is disinfected before the needle.
- Needles are one person, one use: a disposable needle goes straight into a dedicated sharps container as injurious medical waste after use, and reuse is strictly prohibited; a reusable needle must be sterilised for each person.
- A cup that has held blood the guideline calls a blood cup (血罐). When disinfected by hand in a chlorine solution, it needs four times the concentration required for an ordinary cup — 2000 mg/L available chlorine against 500 mg/L; the guideline also allows other methods, such as moist-heat disinfection.
- After the cups come off, any broken skin is covered with a sterile dressing.
Why the logic runs this way. The guideline's reference list includes the national standard on occupational protection against bloodborne pathogens. Why the needle and the blood cup carry more requirements than plain retention — this is the article's reading, not the guideline's sentence — comes down to one word: blood.
These are standards for medical institutions, not a checklist for you to run at home. Their one use at a consultation: if the practitioner mentions wet cupping, ask "Are the needles single-use? Are the cups disinfected?"
III. The three side by side
| Cup retention | Sliding cupping | Wet cupping | |
|---|---|---|---|
| What the cup does | Stays in place after suction (WHO standard) | Slides over lubricated skin while keeping its suction (WHO standard) | The skin is pricked with a three-edged needle or lancet first, then the cup draws blood out (WHO standard) |
| Is the skin broken? | No | No | Yes, with blood in the cup (WHO standard) |
| What more is required of the operator | Cups cleaned and disinfected after each person (the national TCM administration's guideline) | The same, plus the lubricant kept clean (same guideline) | The same, plus skin disinfected first, needles one person one use, blood cups disinfected at the higher concentration (same guideline) |
| What you usually see afterwards | The mark (part 4) | Local skin slightly flushed (the Taiwan manual) | Any broken skin covered with a sterile dressing (same guideline) |
💡 Remember: if wet cupping comes up, two questions worth asking: are the needles single-use, and are the cups disinfected?
The words in this part
All four come from the sources quoted above.
- Cup retention (留罐法) — leave the cup in place after suction. That is the WHO's standard terminology for TCM. It is what "cupping" usually means.
- Sliding cupping (走罐法; also moving cupping) — lubricate the cup mouth and the selected area first, then slide the cup up and down while retaining its suction. The same standard's definition. Cleveland Clinic calls it running cupping.
- Wet cupping (刺络拔罐) — prick the area to be treated with a three-edged needle or lancet, then suck out blood with a cup. The same standard's definition. Of the three, only this one breaks the skin.
- Blood cup (血罐) — a cup that has held blood. That is the term China's national TCM administration's infection-control guideline uses for it, and it sets a separate hand-disinfection concentration for it. You are unlikely to hear the word, but it explains why wet cupping's equipment rules are stricter.
Frequently asked
Which is better, sliding cupping or cup retention? Neither source makes that comparison, and this article does not either. The difference is in the operation: cup retention leaves the cup in place after suction, sliding cupping slides it over lubricated skin — both are the WHO standard's definitions. Which one to use is the decision of the practitioner who has seen you.
Can I ask my practitioner to use single-use needles? You can ask. China's national TCM administration's infection-control guideline requires, for wet cupping, that a disposable needle be handled as injurious medical waste after use and never reused, and that a reusable needle be sterilised for each person. The guideline sets standards for medical institutions; asking is reasonable.
Do not: take the concentration figures from the guideline and mix a disinfectant yourself. Those are an operating standard for medical institutions, not home instructions.
The other five parts
- Part 1: What cupping is: negative pressure, four common methods, and what TCM theory says
- Part 2: What actually happens in one session: minutes, cups, and what it feels like
- Part 4: The marks: what they are, why they fade, and how long they last
- Part 5: Situations to tell your practitioner about first, or to see a doctor about first
- Part 6: Aftercare: showering, air-conditioning, and the day after
👉 If you are unsure whether cupping is suitable for your situation, you are welcome to book an online consultation with HansMed, where a practitioner registered under the T&CM Act 2016 can assess it with you. Cupping is an in-person procedure; the in-person service is coming soon.
Sit with a licensed TCM practitioner from wherever you are.
HansMed Modern TCM
For general wellness education only — not medical advice. Consult a registered TCM practitioner for personal guidance.
Sources
- World Health Organization, WHO international standard terminologies on traditional Chinese medicine, 2022 — https://www.who.int/publications/i/item/9789240042322
- Taiwan Ministry of Health and Welfare, Department of Chinese Medicine and Pharmacy, operating manual for guasha and cupping in the folk-conditioning trade, page updated 18 December 2025 — https://dep.mohw.gov.tw/docmap/cp-4389-39605-108.html
- Cleveland Clinic, Cupping Therapy: Definition, Types & Benefits, last updated 06/07/2023 — https://my.clevelandclinic.org/health/treatments/16554-cupping
- National Administration of Traditional Chinese Medicine and National Health and Family Planning Commission (China), Guideline for the prevention and control of infection related to TCM medical techniques (trial) — http://www.natcm.gov.cn/bangongshi/zhengcewenjian/2018-03-24/838.html
