A question that comes up often is: "Is gua sha supposed to hurt more for better results?" and "Does more sha mean a bigger health problem?" These questions are common, but they also reflect a number of misunderstandings about gua sha. This article explains what gua sha is, what actually happens during a session, and what you should consider before receiving one.

What It Is

Gua sha is a traditional therapeutic technique within TCM. During a session, a practitioner uses a smooth-edged tool (commonly made from buffalo horn, ceramic or stainless steel) with a medium such as massage oil or herbal balm, and repeatedly scrapes the skin in specific directions. Gua sha belongs to the same family of TCM external therapies as cupping and acupuncture. It is not a treatment for any specific disease, nor is it a method of "detoxification."

In TCM theory, gua sha is understood as a way of "unblocking the meridians" (疏通经络) and "promoting the flow of qi and blood" (行气活血). It should be noted that meridians and qi are part of the theoretical framework of TCM, and are not the same as anatomical blood vessels or nerves.

The Process

In a TCM clinic that offers this service, the general process is as follows:

1. During the consultation, the practitioner will ask about your health history, current medications and any ongoing conditions, to assess whether gua sha is suitable for you.
2. If suitable, the practitioner will ask you to expose the area to be treated (commonly the back, neck, shoulders or limbs).
3. The practitioner applies a medium to the skin, then uses the scraper at a specific angle and pressure to scrape the area repeatedly.
4. During the process, red or dark red marks may appear on the skin surface. These marks are called sha (痧).
5. After the session, the practitioner will explain how to care for the treated area.

This clinic currently operates through online consultations only, and in-person services have not yet been launched. The process described above reflects the common practice of TCM clinics in general, and does not specifically describe this clinic's on-site operations.

The physical action of the tool is straightforward — a scraper is moved repeatedly across the skin, and sha marks may appear on the surface. This is visible and verifiable. As for what this means in TCM theory, that belongs to the framework of meridians and qi, which is not the same as a modern physiological explanation.

What It Feels Like

The sensation during gua sha is often described as "warm," "tingly" or "slightly sore." Tolerance to scraping pressure varies from person to person. If you experience unbearable pain during the session, tell the practitioner immediately.

After the session, sha marks may appear on the treated area. The depth of colour varies from person to person. The time it takes for the marks to fade also varies — if they persist or do not improve, contact your practitioner.

Safety, Hygiene and What to Tell Your Practitioner

Gua sha is a relatively non-invasive therapy, but safety and hygiene still matter. In clinics that offer gua sha, disposable scrapers are commonly used, or reusable scrapers are cleaned and disinfected between sessions. If you have concerns about this, ask when booking your appointment.

During the consultation, be sure to tell your practitioner if you:

• Have any skin conditions (such as eczema, psoriasis or open wounds)
• Are taking any medication, including over-the-counter products or TCM proprietary medicines (do not stop any medication on your own — discuss it with your doctor first)
• Are pregnant
• Have a bleeding disorder or any blood-related condition
• Have a cardiac pacemaker
• Have a chronic condition such as diabetes, heart disease or hypertension

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.

Possible Reactions After the Session and When to Contact Your Practitioner

Sha marks appearing on the treated area are a common skin reaction after gua sha. The depth and amount of sha are influenced by several factors, including skin thickness, scraping time and pressure. They are not a measure of how serious your condition is, and cannot be used to judge the state of your body. The popular claim that "more sha means more toxins" lacks reliable evidence.

After a gua sha session:

• The treated area needs proper care. Avoid rubbing or scrubbing it vigorously.
• If blisters, broken skin or significant swelling develop, contact your practitioner.
• If you feel dizzy, nauseous or experience palpitations after the session, contact your practitioner.

When Gua Sha Is Not Suitable

Common precautions listed in TCM literature include: do not scrape over areas with broken skin, infection or inflammation; avoid the abdomen and lower back during pregnancy; and individuals who are frail or taking anticoagulant medication should be assessed by a registered TCM practitioner before receiving gua sha.

The following situations are not within the scope of gua sha. Call 999 or go to the nearest emergency department:

• Loss of consciousness or seizures
• Persistent high fever
• Severe injury or fracture
• Chest pain or difficulty breathing

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.

The 5 Things to Note (Recap)

1. Tell your practitioner beforehand: skin conditions, chronic conditions, medications (especially anticoagulant medication), and pregnancy.
2. Hygiene: check that scrapers are disposable, or cleaned and disinfected between sessions.
3. Aftercare: care for the treated area properly and avoid rubbing it vigorously.
4. When it is not suitable: areas with broken, infected or inflamed skin; see the situations listed above for the rest.
5. When to get help: contact your practitioner if blisters, broken skin, significant swelling or ongoing discomfort develop; in an emergency, call 999 or go to the nearest emergency department.

Common Questions

Q: Is gua sha the same as the facial gua sha tools seen on social media?

A: The name is the same, but the usage and purpose differ. Gua sha in a clinical setting is a TCM external therapy performed by a registered TCM practitioner on specific body areas. Facial gua sha tools on social media are mostly home-use beauty tools. They are not the same thing.

Q: Does more sha mean better results?

A: No. The amount and depth of sha are influenced by skin thickness, scraping pressure and duration. It is not a scorecard for results. Scraping until the skin breaks or causes significant pain is not correct practice.

Q: Can gua sha help with weight loss?

A: Gua sha is not a weight-loss method. Weight management involves diet, physical activity and overall lifestyle habits. If you have weight-related goals, it is advisable to seek comprehensive advice from nutritional and medical professionals.

Q: Can I shower after gua sha?

A: The treated area needs proper care. Specific advice on showering depends on individual circumstances and the practitioner's instructions. Ask your registered TCM practitioner directly.

Q: How often should I receive gua sha?

A: Frequency varies from person to person, depending on individual circumstances and the practitioner's assessment. It is best to follow the advice of a registered TCM practitioner.

Q: Can gua sha replace medical treatment?

A: No. TCM and Western medicine complement each other; it is not a choice between the two. Gua sha is a traditional TCM therapy, not a treatment for any specific disease. If you are receiving medical treatment, do not stop or interrupt your medication on your own. Inform both your doctor and your TCM practitioner about all treatments you are receiving.

👉 If you are unsure whether gua sha 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.

Sit with a licensed TCM practitioner from wherever you are.

HansMed Modern TCM

不少读者常问：「刮痧是不是越痛越好？」「痧出得多是不是代表身体问题很大？」这些疑问很普遍，但也反映出坊间对刮痧有不少误解。这篇文章用平实的语言说明刮痧是什么、一次刮痧实际会发生什么，以及您在接受刮痧前应该注意哪些事。

这是什么

刮痧是中医外治法的一种。操作时，医师用边缘光滑的刮板（常见材质包括牛角、陶瓷或不锈钢），配合介质（如按摩油或药膏），在皮肤表面以特定方向反复刮动。刮痧与拔罐、针灸一样，属于中医传统疗法的一部分，不是针对特定疾病的治疗手段，也不是「排毒」的管道。

在中医理论中，刮痧被理解为「疏通经络」「行气活血」的一种方法。需要说明的是，经络与气血是中医的理论框架，不等同于解剖学上的血管或神经结构。

过程

在提供这项服务的中医诊所，一般流程如下：

1. 看诊时，医师会先询问您的健康状况、过往病史与当前用药情况，判断是否适合进行刮痧。
2. 若适合，医师会请您露出需要刮拭的部位（常见部位包括背部、肩颈、四肢）。
3. 医师先在皮肤表面涂抹介质，再用刮板以一定角度和力度反复刮动。
4. 刮拭过程中，皮肤表面可能出现红色或暗红色的点状或片状痕迹，称为「痧」。
5. 刮痧结束后，医师会告知您后续护理的注意事项。

本诊所目前仅提供线上问诊，亲诊服务尚未推出，因此上述过程描述为一般中医诊所的常见流程，并非特指本诊所的现场作业。

器具本身的操作是物理性的——刮板在皮肤表面反复刮动，局部皮肤可能出现痧象——这个过程是看得见、可验证的。至于这样做在中医理论中的意义，属于经络与气血的理论框架，与现代生理学的解释不是同一回事。

感受

刮痧时的感觉，常被描述为「热热的」、「刺刺的」或「有点痛」。每个人对刮拭力度的耐受程度不同，感受也会因人而异。若过程中出现难以忍受的疼痛，请立即告知医师。

刮痧后，刮拭部位的皮肤可能出现痧象，颜色深浅因人而异。痧象消退的时间也因人而异，若持续不退或情况没有改善，请联络您的医师。

安全与卫生，以及看诊前该主动告知医师的事

刮痧属于侵入性较低的疗法，但仍需注意安全与卫生。在提供刮痧服务的中医诊所，一般会使用即弃式刮板，或对重复使用的刮板进行清洁消毒。若您对这一点有疑虑，可以在预约时主动询问。

看诊时，请主动告知医师以下事项：

• 是否患有皮肤疾病（如湿疹、牛皮癣、开放性伤口）
• 是否正在服用任何药物，包括非处方药与中医成药（切勿自行停药，请先与您的医生讨论）
• 是否怀孕
• 是否有出血倾向或血液相关疾病
• 是否装有心脏起搏器
• 是否患有糖尿病、心脏病、高血压等慢性疾病

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

之后可能出现的反应，以及什么情况该联络医师

刮痧后，刮拭部位出现痧象是常见的皮肤反应。痧象的颜色与深浅受多种因素影响，包括皮肤厚度、留刮时间与刮拭力度，并不等同于身体状况的严重程度，也不能用来判断身体状态。坊间流传「痧出得多代表体内毒素多」的说法，这个说法缺乏可靠依据。

刮痧后需要注意：

• 刮拭部位需要妥善护理，避免用力搓揉。
• 若刮拭部位出现水泡、破皮或明显红肿，请联络您的医师。
• 若刮痧后出现头晕、恶心、心悸等不适，请联络您的医师。

不适用的情况

中医文献一般列出的注意事项包括：皮肤有破损、感染或炎症的部位不宜刮痧；孕妇的腹部与腰骶部不宜刮痧；体质虚弱或正在服用抗凝血药物的人士，是否适合刮痧需由注册中医师评估。

以下情况不属于刮痧的适用范围，请立刻拨打 999 或前往最近的急诊部：

• 意识不清或抽搐
• 高烧不退
• 严重外伤或骨折
• 胸痛、呼吸困难

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

5 个注意事项（重点整理）

1. 看诊前主动告知：皮肤状况、慢性疾病、用药（尤其抗凝血药物）、是否怀孕。
2. 卫生：留意器具是否为即弃式，或在使用后彻底清洁消毒。
3. 护理：刮拭后妥善护理，避免用力搓揉。
4. 不适用的情况：皮肤破损、感染或炎症的部位不宜刮痧；其余不适用情况详见上文。
5. 联络时机：出现水泡、破皮、明显红肿或持续不适，请联络您的医师；紧急情况请立刻拨打 999 或前往最近的急诊部。

常见问题

问：刮痧和社交媒体上的脸部刮痧板是一样的吗？

答：名字一样，但用法与用意不同。诊所的刮痧属于中医外治法，由注册中医师操作，针对特定部位进行刮拭。社交媒体上的脸部刮痧板多为居家美容工具，使用方式与力度不同，两者不宜混为一谈。

问：痧出得越多，效果越好吗？

答：不是。痧象的深浅与多少受皮肤厚度、刮拭力度与时间等因素影响，不是效果评分表。刮到破皮或明显疼痛不是正确操作。

问：刮痧可以减肥吗？

答：刮痧不是减重的方法。体重管理涉及饮食、运动与整体生活习惯，若有减重需求，建议寻求营养与医疗专业人员的综合建议。

问：刮痧后可以洗澡吗？

答：刮痧后的部位需要妥善护理。关于洗澡的具体时间建议，因人因操作而异，建议直接询问您的注册中医师。

问：刮痧多久做一次比较合适？

答：频率因人而异，取决于个人状况与医师的评估。建议由注册中医师根据您的具体情况给予建议。

问：刮痧可以取代西医治疗吗？

答：不可以。刮痧属于中医传统疗法，不是针对特定疾病的治疗手段。中医与西医是互相补位的关系，不是二选一。若您正在接受西医治疗，切勿自行停药或中断治疗，并主动告知您的医生与中医师您正在接受的治疗。

👉 如果您不确定「以我的情况，到底适不适合刮痧」，欢迎透过汉方中医的线上问诊，由依 2016 年 T&CM 法令注册的医师为您评估。

无论身在何处，与持证中医师对坐。

汉方现代中医