What Social Media Gets Wrong about Gua Sha: Sandra Chiu, L.Ac explains the history of Gua Sha.

Amidst cultural appropriation and the misuse of the term “Gua Sha,” it’s essential to understand the medical and cultural history behind the practice. So, what is Gua Sha? Well, contrary to popular belief, it is not a “lymphatic drainage technique.” Gua Sha is a scientific practice rooted in Chinese medicine, culture, and tradition. In this interview, we spoke with Sandra Lanshin Chiu, L.Ac. a licensed acupuncturist (LAc) and Chinese medicine practitioner. She is also the founder of Lanshin, a traditional Chinese medicine and dermatology brand. Here, she debunks common myths about Gua Sha and explains the beautiful history of Chinese medicine practice. 

Hi, Sandra! Can you tell us what trends tend to get wrong about Gua Sha?

Sandra: “The most common misconception is that Gua Sha is simply a lymphatic drainage technique.  I encourage people to think outside of the lymphatic drainage concept when they think of Gua Sha. Manual lymphatic drainage techniques usually use a pumping or pulsing technique that's done very lightly and superficially, whereas Gua Sha connects all the way down to the muscle layer. Gua sha is also a one-directional stroke as opposed to a back-and-forth movement. 

While Gua Sha does improve lymphatic circulation, we don’t see that as the sole benefit. Based on the fundamentals of traditional Chinese medicine (TCM), Gua Sha should be understood as a practice that improves the circulation of blood, fluids, and qi, (vital life force energy) as well. It also relaxes tight muscles and fascia. 

Gua Sha is technically not a form of massage either. Massage movements are different than the hallmark single direction stroking of Gua Sha. 

We should try to define Gua Sha in terms of Chinese medicine and practice. Gua sha is Gua Sha. This is important to note because understanding what it is and isn’t will help you be more effective using it.” 

As Gua Sha has risen in popularity, what does cultural appropriation look like?

When it comes to Gua Sha, you see a lot of influencers making a name or a business out of selling Gua Sha tutorials and/or tools. But, if you look at their website, they don't have much knowledge of the practice itself. Some don’t even credit it to East Asian medicine. 

In addition to my TCM colleagues and I, many people of Asian descent have fought very hard for the recognition of Gua Sha as a practice from the East Asian medicine system. Early on, I saw brands claiming things like, “We designed the first Gua Sha system" without mentioning at all where the practice came from. Immediately, my TCM colleagues began to call them out. After more and more people began to confront cultural appropriation, brands learned the importance of crediting Gua Sha back to its East Asian roots. 

Recognizing Gua Sha as an Asian modality is an important first step in stamping out cultural appropriation.  But, I’m still concerned about the brands that don’t have a connection to Chinese culture. Perhaps they’re saying the right words to look good on the surface, but in reality, they’re just being performative. 

On the other hand, there are many Chinese medicine professionals who truly foster a connection to Chinese culture. I have colleagues and teachers who are Western but have immersed themselves in Chinese culture. They’ve  taken  time to learn the language, travel to Asia, learn about the culture, and learn directly from Asian teachers. I haven’t seen any non-Asian Gua sha brands operate like this. But, there are plenty of diverse TCM practitioners who respect the cultural roots of TCM enough to appreciate it, as opposed to using it for their own market success. 

One way to tell appropriation from appreciation is when people  who are not licensed Chinese medicine practitioners claim to be an authority on Gua Sha. Cultural appropriation is trying to claim ownership and authority over something you don't actually have extensive knowledge of. For example, if a brand claims to offer the “first Gua Sha system,” it implies the belief that they came up with the first system of Gua Sha, and it overlooks the fact that it’s actually been around for thousands of years. There are countless leaders throughout history and modern-day China who have written and practiced Gua Sha extensively – long before it landed in the West.

I’ve also seen some estheticians and massage therapists make it seem like they’re a Chinese medicine teacher by claiming knowledge of TCM. But, if you look closely, they never trained in TCM. When unqualified people inaccurately represent and speak for TCM, I think this is dangerous to both consumers and harmful to the TCM field.

Unfortunately, there was a time when TCM was less familiar to Westerners and unfairly labeled a pseudoscience. As TCM practitioners, we have fought hard for the validity of our field, and we must keep it elevated, high quality, and accurate. So, I call upon consumers to understand who the true TCM practitioners are. 

One of the biggest ways to distinguish this is to see if there are licensed acupuncturist (L.Ac. or D.Ac.) credentials behind a practitioner’s name. Rarely will an Acupuncturist print their name without their credentials, and we’ll often talk about where we trained. As an important side note, you don't have to be Asian to practice TCM. However, you definitely have to be trained and licensed and hopefully respect the home culture of TCM. 

Many often don’t realize that TCM training takes a minimum for 3-4 years to complete. It’s no joke! Chinese medical practitioners have done a lot of work, spent a lot of money on education,  and have clinical experience. We have put forth a tremendous effort to provide the practice in a safe, effective way. So, it’s not easy to become a Chinese medicine practitioner. 


What are some stigmas around Gua Sha?


When I first started practicing almost 20 years ago, TCM practices faced more stigma. I remember searching for acupuncture online, and the first search result for a while was a site called “Quack Watch.” Fortunately, our profession has come a long way in the last 20 years. There are fewer western medicine practitioners broadly calling our modalities pseudoscience. 

While we’re no longer considered “quacks,” there are still medical professionals who freely share their opinions about Gua Sha or other TCM practices, but they don't truly understand Chinese medicine. Most Western medicine doctors don’t train in TCM, but are frequently asked by editors and press for comment on our modalities like Gua Sha. Sure, they are free to give their opinion, but recognize they are opinions from a Western medical perspective. I believe it’s important to also get the TCM viewpoint on TCM practices from actual TCM practitioners. 

Not long ago I saw a Forbes article questioning the validity of our practice of Cupping, stating there isn’t enough evidence of efficacy or safety. While I recognize the importance of evidence-based research in medical practice, I also recognize that it requires resources to double blind, randomize, and control test our modalities. Unlike new drug interventions that must pass these tests for safety and efficacy, modalities like Acupuncture, Cupping, and Gua sha have been practiced for centuries and served as the dominant medical practice for Asian cultures longer before allopathic medicine even existed. 


When was Gua Sha first introduced to The West?

As more Asians began to immigrate to the West around the 70s, Gua Sha came with the growth of Western interest in Acupuncture. While Richard Nixon’s visit to China in the 1970’s spurred U.S. interest in Acupuncture, it only became legal state-by-state starting in the 1980s. Most people first came to know the practice of needling called acupuncture. But actually, when you see an acupuncturist in the West, not only do we work with needles, we utilize a whole family of techniques and tools that include Cupping, Gua Sha, Moxibustion, etc. So, as Acupuncture became available, so did Gua Sha. 

Secondly, Asian immigrants brought the practice of Gua Sha with them.  When not feeling well, this is a modality commonly shared amongst family members. There are instances of parents using Gua Sha on their children as a healing technique for fighting colds and flus. As this was foreign to Americans, such families were often called to Child Protection Services because people conflated and confused it with abuse. This was a traumatic shame that fell on well-intentioned Asian families that is part of the history of Gua Sha in the West.  As Gua Sha gains popularity among famous athletes and celebrities, many don’t know about this today.

How far back does Gua Sha go?

Like all Chinese medicine, it goes so far back that it's difficult to trace its exact time origin. It’s said to be somewhere up to 5,000 years old. There are really old historical records that indicate how ancient practices like Acupncture are. Many records suggest Gua Sha goes back to paleolithic times and is even older than Acupuncture. The first record of Gua Sha is in a book that was unearthed in Changsha, Hunan province, and is actually called the Prescription for 52 Diseases. It's thought to have been compiled from 1065 BCE to 771 BCE.  This was during the Shang Zhou era.

The fact that there are historical records of Chinese medical techniques that go so far back make it unbelievable to me when people, especially physicians, question the validity of Gua Sha or calli it "cap." It’s important to understand that there is a long and deep history of medicine used by Asian cultures. So, people should be mindful when calling something with that much history false. 

Gua Sha is not only an important healing technique used through the centuries, it is also a special tradition for many people from Southeast and East Asia. People will write to me when I talk about Gua Sha and say excitedly, “Oh, I have such fond memories of my grandma and mom doing Gua Sha on me when I was little!" Because it's a cultural tradition, used within the family unit, many Asians share fond memories and special moments with this healing technique from their youth. It reminds us of our families, and it connects us to our ancestors.


Tell us about what drove you to create Lanshin.

I createdLanshin to share the incredible concepts and practices of Chinese medicine for skin health. I believe there is a gap in knowledge of effective care of our skin and body in the Western view, and TCM fills in the missing pieces. 

Nothing makes me happier than to see how many people love the traditional Chinese Medicine practices, and to see how much better and more relaxed it makes people feel. Gua sha is a way to appreciate your body and connect with yourself.

When I designedour Gua Sha tools I wanted people to get as many results as they could with one tool so they didn't have to buy ten. I looked for materials that support results. Our hero tool,the Lanshin Pro Gua Sha tool is an internationally patented design, which came out of my clinical experience using Gua Sha on my patients to get them results.