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Gua Sha Order and Direction

The genera] order of gua sha is as follows:


1, upper parts before lower parts;
2, back and lower back before chest and abdomen;
3, trunk before the limbs;
4, yang meridians before yin meridians.

To save patients the trouble of taking off and putting on clothes repeatedly, scrape exposed areas first, then the trunk, lower limbs and feet.

Scraping direction: scrape from top to bottom on the back, abdomen and limbs (reverse the direction with edema of the limbs, varicosities or organ prolapse) and medial to lateral on the face, shoulders and chest.

Three-Step Treatment Procedure

Rooms with good ventilation and moderate temperature are best for gua sha therapy. If the temperature is too high and an air conditioner or fan must be used, avoid having air blow directly on the patient. The proper room temperature is above 18 degrees Celsius.

1, Step one: Position the body properly

The patient should be in a position that allows gua sha to be performed easily and the areas to be treated exposed. An appropriate body position will relax the muscles and improve compliance.

The sitting position is suitable for scraping the head, neck, shoulder, limbs, chest, back and lower back. Patients should straddle the chair with their chests against the back of the chair.


Lying face down is suitable for scraping the occiput, back, waist and back of the legs. Place a pillow under the patient’s abdomen to provide support and relax the muscles of the lower back.

This position is suitable for scraping the sides of the head, chest, back, waist, hip and lateral legs.

Lying face up is suitable for scraping the forehead, vertex, temples, face, chest and abdomen.



2, Step two: Select the acupoints and body parts to be treated, apply guasha oil or cosmetic lotion, and begin scraping The areas to be treated are selected based on the patient’s constitution, disease and treatment strategy.

Use paper to protect the clothes from oil and apply guasha oil on the holographic zones and acupoints to be treated. When treating the face, apply cosmetic lotion before scraping.


3, Step three: Wipe off oil, instruct the patient to keep warm and covered, and give him/her some warm water to drink