Gua Sha is a traditional treatment method that involves pressured strokes being applied to lubricated skin to produce petechiae

One of the first western scientific studies of gua sha took place at the University of Duisburg-Essen in Essen. A small sample (eleven) of “healthy but stressed” doctors and nurses who reported myalgia at the Kliniken Essen received gua sha treatment. They were then scanned using laser Doppler imaging, having first obtained a baseline scan for each patient prior to treatment. They were scanned ten times, once every 2.5. minutes following the treatment with a follow-up scan two days later.

A 400% increase in microperfusion (surface microcirculation of blood) was found for 7.5 minutes following gua sha, and there was a significant increase retained for the full 25 minutes of scanning. Two days later with the follow-up scan, this had returned to baseline. All subjects reported a decrease or resolution of pain and increased sense of wellbeing.

(Nielson et al. The effect of gua sha treatment on the microcirculation of surface tissue: a pilot study in healthy subjects. Explore (NY), 2007; 3(5) (October); 456-66)

Practitioners know that gua sha can reduce a fever, alter the course of acute infectious illness, and reduce inflammatory symptoms in chronic illness. A group at Harvard using bioluminescent imaging with a mouse showed that gua sha upregulates gene expression of heme oxygenase-1 (HO-1), an enzyme that is anti-oxidant and cytoprotectant, at multiple internal organ sites immediately after treatment and over the following days.

HO-1 and its catalysates (bilirubin, biliverdin, and carbon monoxide) is known to be anti-oxidative and anti-inflammatory, and it plays a protective role in allergic disease in part by inhibiting Th2 cell-specific chemokines. Thus we can see from this work that gua sha can provide an immediate and sustained immune response in the healing of internal organ and inflammatory problems.

(Kwong et al. Biolumiscence imaging of heme oxygenase-1 upregulation in the Gua Sha procedure. J Vis Exp. 2009

HO-1 is a very interesting enzyme with great practical application. It regulates cell cycle and anti-smooth muscle hyperplasia, thus providing protection against problems such as asthma, inflammatory bowel disease, experimental autoimmune encephalomyelitis, and organ transplant rejection. (Kwong et al. The role of heme oxygenase-1 in T cell-mediated immunity: the all encompassing enzyme. Curr Pharm Des. 2008; 14(5); 454-64). Induction of HO-1 also results in decreased hepatitis C virus replication. (Zhu et al. Heme oxygenase-1 suppresses hepatitis C replication and increases resistance of hepatocytes to oxidant injury. Hepatology, 2008; 48(5) November) ; 1430=39). A 2014 study demonstrated that up-regulation of HO-1 acts as an anti-viral factor for pig reproductive and respiratory syndrome virus infection, inhibiting the virus from replicating, suggesting wider anti-viral properties (Xiao et al; Heme oxygenase-1 acts as an anti-viral factor for porcine reproductive and respiratory syndrome virus infection and over-expression inhibits virus. Antiviral Res. 2014; 110 (October) 60 – 9)

The therapeutic petechiae that occurs with gua sha represent blood cells that have extravasated in the capillary bed, which can be measured as increased surface microperfusion. As this blood is reabsorbed, the breakdown of haemoglobin up-regulates HO-1 with its anti-inflammatory, cytoprotective, anti-oxidant, and anti-viral properties.

There have been further studies published in western peer-reviewed journals (as well as masses of published case studies in China) suggesting gua sha’s effectiveness in treating migraine, post-herpetic neuralgia, mastitis, neck pain, and neck and back pain.

More information on gua sha can be found on this page:


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