Gua sha is a smooth-edged stone tool you glide across the skin to boost surface circulation, move lymphatic fluid, and release muscle tension. For the face, that shows up fast as less puffiness and a more defined jawline; for the body, it reaches tight spots stretching alone misses. Beginners need three things: a glide balm, light-to-medium pressure, and strokes aimed toward your lymph nodes.
That's the whole method in a paragraph. Below is everything that makes it work: what the research actually shows, step-by-step technique for face and body, how to choose your stone, and what to glide with so the tool helps your skin instead of dragging it.
Written with Dr. Doug Strobel, MD, a board-certified neurologist and adventure athlete who formulates Dr. Doug's Balms.
"People think a gua sha is about the stone. It isn't. It's about moving fluid and releasing tension, and doing it gently enough that skin cooperates. The glide you use matters as much as the tool."
- Dr. Doug Strobel, MD, board-certified neurologist
What is gua sha, and why the TikTok version is different from the original
Gua sha (pronounced gwah-shah) comes from Traditional Chinese Medicine and has been practiced for centuries. In TCM, blood and energy were thought to stagnate in the tissues; practitioners used firm, repeated strokes with a smooth-edged stone to move that stagnation.
The version on TikTok is a much gentler adaptation. Facial gua sha uses light, fluid strokes that work with the lymphatic system rather than deep muscle. The face doesn't have thick muscle to work, and its delicate skin needs a lighter touch, think of it as lymphatic drainage with a precision tool. Body gua sha sits in between: firmer than facial work, lighter than clinical treatment on large muscle groups.
Both are valid. They just work different systems at different depths.
What does gua sha actually do? The science
The mechanism is better studied than most people assume. Three pathways explain the results:
It increases surface circulation, measurably. A pilot study in Explore (Nielsen et al., 2007) measured blood flow in skin tissue after gua sha and found a roughly fourfold (about 400%) increase in surface microcirculation at the treated area, which stayed elevated well after the session. More circulation means more oxygen and nutrients reaching skin cells and faster clearance of metabolic waste, the "glow" people notice afterward.
It may trigger a protective, anti-inflammatory response. Researchers have proposed that gua sha's benefits come partly from upregulating heme oxygenase-1 (HO-1), a cytoprotective enzyme. Kwong et al. (2009, Journal of Visualized Experiments) imaged HO-1 upregulation following the gua sha procedure. A 2017 randomized crossover pilot in Complementary Therapies in Medicine found gua sha was associated with improved symptoms and shifts in inflammatory biomarkers in older adults with chronic low-back discomfort.
It moves lymphatic fluid. Applied with light pressure in the right direction, gua sha encourages lymph, the fluid that carries waste and immune cells, to drain toward your lymph nodes. On the face, that's why puffiness visibly softens: fluid that pooled overnight gets redirected and cleared.
There's even clinical support for the tension angle: a randomized controlled trial in Pain Medicine (Braun et al., 2011) found gua sha reduced pain and improved function in people with chronic neck tension versus a control.
The honest version: gua sha doesn't restructure your face or melt anything. What it reliably does, improve circulation, move fluid, release muscle tension, is enough to change how your face and body look and feel. That's the real mechanism, and it's plenty.
Which stone should a beginner use? Bian stone vs jade vs rose quartz
Most guides only compare jade and rose quartz, the two Western skincare favorites. They skip the stone gua sha was originally made from: bian stone.
| Bian stone (the original) | Jade | Rose quartz | |
|---|---|---|---|
| Tradition | The classical TCM material; bian stone tools predate the jade and quartz beauty adaptations | Popular modern facial stone | Popular modern facial stone |
| Feel and weight | Dense and heavy, so it glides with less hand pressure, easier on delicate skin | Lighter, warms fast against skin | Dense, stays cool longer |
| Temperature | Holds a neutral, steady temperature | Heats up quickly | Stays cool, nice for puffiness |
| Durability | Very durable, doesn't chip easily | Softer, slightly porous, can chip over time | Durable |
| Best for | Beginners who want the authentic tool and an effortless glide on face and body | Warm, energizing facial rituals | Cooling, calming facial rituals |
Why weight matters for beginners: the single most common beginner mistake is pressing too hard. A denser stone like bian does more of the work for you; its weight provides the pressure so your hand doesn't have to, which means less tugging and less risk of over-pressing. That's exactly why Dr. Doug's Bian Stone Gua Sha is cut from bian stone rather than following the jade and quartz crowd.
The truth every honest pro will tell you: the material matters less than the shape, the weight, and your technique. Look for curved edges that fit your jawline and cheekbones, and enough weight that the tool glides with minimal effort.
What to apply before gua sha: the glide medium matters more than you think
The balm or oil you glide with isn't just lubricant, it decides whether the tool supports your skin or drags it. Dry skin plus a dry tool equals tugging, which stretches skin instead of moving fluid. You want a glide medium that gives sustained slip without evaporating mid-session, nourishes while you work, is free of alcohol and synthetic fragrance, and absorbs well enough that you're not left greasy.
Organic beeswax-based balms are ideal. Beeswax lays down a protective layer that locks in moisture and keeps the friction of the tool from compromising your skin barrier. Combined with organic coconut oil, shea butter, and olive oil, it gives the stone the perfect resistance: smooth movement, no dragging.
What our founder Natalie actually uses: two balms, depending on the job. On the body and for recovery, Dr. Doug's Magnesium Balm. It's built on organic olive oil, coconut oil, beeswax, and shea butter with magnesium chloride and a touch of peppermint and lavender (no arnica; that's our separate Recovery Balm). The beeswax base makes the bian stone glide beautifully, and the peppermint gives a light cooling finish over tired muscles. On the face, the Ageless Expression Balm from the Skin Sequence Collection, Tracy Anderson's collaboration with Dr. Doug. It's a facial balm built for exactly this kind of work, organic shea, coconut, sunflower and rosehip oils plus hyaluronic acid and niacinamide, so it gives the stone a smooth glide while it hydrates the skin above the jaw.
"I use my Magnesium Balm with the body gua sha and the Ageless Expression Balm on my face. Same ritual, two balms, five minutes."
- Natalie, founder
If you'd rather keep it to one tool and one balm, start with the Magnesium Balm + Gua Sha Ritual Set, the balm and the bian stone were made to work together.
How to use gua sha on your face, step by step
Three rules decide your results: always glide first, always use light pressure on the face, always stroke toward the nearest lymph node.
- Prep. Start with clean skin. Apply a facial balm generously enough that the stone glides with zero resistance.
- Open your lymph nodes first. With two or three fingers, press gently in small circles at the base of your neck just above the collarbone, both sides. Hold five seconds. Repeat along the sides of the neck and behind the ears.
- Collarbone sweep. With the flat edge, sweep outward along the collarbone from neck to shoulder. Light pressure, five to seven times each side.
- Neck. Hold the tool nearly flat (about 30 to 45 degrees). Stroke down from behind the ear along the side of the neck toward the collarbone. Five to seven strokes per side.
- Jawline and chin. Nestle the curved notch along the jaw and stroke from chin to earlobe. Follow with a downward stroke from earlobe to collarbone to clear what you moved.
- Cheekbones. Flat face of the tool, stroke outward from beside the nose toward the temples, then down toward the node behind the ear.
- Under-eye and brow. Switch to your ring finger under the eye, that skin is too delicate for most tools. Glide gently from inner to outer corner, then down toward the ear.
- Forehead. Stroke from center outward to the temples, then sweep down toward the ear and collarbone.
- Finish at the collarbone. End with several more collarbone sweeps to clear everything down. A full sequence takes five to ten minutes.
How to use gua sha on your body
Body gua sha uses more pressure than facial work, you're reaching fascia and surface muscle. Apply your glide balm generously, hold the tool more vertical (about 60 to 80 degrees), and go slower and firmer. Always stroke toward the heart, that's the direction lymph drains.
- Back and shoulders. Work either side of the spine, never directly on it. Stroke down from the base of the neck toward the mid-back; for shoulders, out from neck toward the joint.
- Legs. After workouts, stroke up from knee toward hip on the quads and outer thigh; for calves, ankle toward knee.
- Arms. Stroke from wrist toward the armpit.
Redness is normal on the body, it signals increased circulation. Significant bruising means too much pressure or not enough glide; ease off and reapply your balm.
How often should you use gua sha?
Face: daily or every other day. A five-minute morning session softens overnight puffiness. Sensitive skin? Start every other day and watch how your skin responds over two weeks. Body: after workouts, on rest days, or when tension builds, most people do well with two to four sessions a week. Results compound: the people who see the most change are the ones who stick with it for two months or more.
The right Dr. Doug's tools for this
- Bian Stone Gua Sha, Face & Neck ($75)
- Bian Stone Gua Sha, Body ($100)
- Complete Face + Body Set ($150)
- Magnesium Balm + Gua Sha Ritual Set ($135)
Made in the USA by a brand founded by a board-certified neurologist.
Frequently asked questions
Does gua sha actually sculpt your face?
Not by changing muscle or bone. What it does, reliably and measurably, is reduce fluid retention, boost circulation, and release the facial tension we hold unconsciously, especially in the jaw. The result looks like sculpting because puffiness drops and definition increases, but the mechanism is drainage and tension release, not structural change.
What stone is best for a beginner, bian stone, jade, or rose quartz?
Any of them works; technique matters more than material. For beginners, a denser stone like bian stone has an edge because its weight supplies the pressure for you, so you're less likely to over-press and tug. Bian stone is also the original TCM material, not a modern beauty adaptation. Jade runs warm; rose quartz stays cool.
What should I put on my skin before gua sha?
A nourishing glide medium so the tool never drags. A beeswax-based balm is ideal, it protects the skin barrier and holds its slip. Avoid anything with alcohol or synthetic fragrance.
What angle should I hold the tool at?
Face: as flat as possible, about 15 to 30 degrees, the flatter the angle, the lighter the contact, which is what facial lymphatic drainage needs. Body: 60 to 80 degrees to reach fascia and surface muscle.
Can I use gua sha with rosacea or sensitive skin?
Check with a dermatologist before working over active rosacea, broken capillaries, or highly reactive skin, and do not pass the tool over inflamed areas. Gentle neck and collarbone drainage on surrounding skin may be fine; start there and watch your response.
Why is my face puffier the day after?
Usually a sign you pressed too hard, overworked one area, or skipped the collarbone drainage at the end. Ease up on pressure, always finish with the collarbone sweeps, and it typically settles within a day.
How often should beginners do it?
Face: daily to every other day, about five minutes. Body: two to four times a week or after workouts. Consistency beats intensity, and most visible change shows up after about two months.
Sources
- Nielsen A, Knoblauch NTM, Dobos GJ, et al. The Effect of Gua Sha Treatment on the Microcirculation of Surface Tissue: A Pilot Study in Healthy Subjects. Explore (NY), 2007.
- Braun M, Schwickert M, Nielsen A, et al. Effectiveness of Traditional Chinese "Gua Sha" Therapy in Patients with Chronic Neck Pain: A Randomized Controlled Trial. Pain Medicine, 2011.
- Kwong KK, et al. Bioluminescence imaging of heme oxygenase-1 (HO-1) upregulation in the Gua Sha procedure. Journal of Visualized Experiments (JoVE), 2009.
- The effects of Gua sha on symptoms and inflammatory biomarkers associated with chronic low back pain: a randomized active-controlled crossover pilot study in elderly. Complementary Therapies in Medicine, 2017.
This article is for general education and is not medical advice. Gua sha is a wellness and skincare practice, not a treatment for any medical condition. Dr. Doug's balms are cosmetic products.