Amid all the high-tech microcurrent devices, LED masks, and ultrasonic spatulas that have hit the market, certain lo-fi skin tools have maintained longstanding popularity. Gua sha, for one, is a centuries-old practice that has since inspired hundreds of thousands of posts on Instagram and more than one billion views on TikTok.

Choose one of those posts at random, though, and you might see someone using a gua sha stone or tool completely wrong. It’s impossible to understand the full scope of gua sha’s history, purpose, and technique in one bite-sized clip. If you’d like to get some background on the practice and learn how to use a gua sha tool at home, keep reading.

What Is Gua Sha?

While gua sha might seem like a new trend through the lens of social media, it first emerged as a cultural practice in traditional Chinese medicine in the Paleolithic age, says Paige Yang, a doctor of acupuncture and Traditional Chinese Medicine and founder of Yang Face, a brand that sells traditional Chinese facial tools.Practitioners use a flat tool to scrape the skin repeatedly, leading to a blemish (this doesn’t mean acne) without creating an abrasion in the skin, according to an article published in the journal Explore. “Gua” means “to scrape or scratch,” while “sha” translates to “sand, sharkskin, or ‘red, raised, millet-size rash,'” referring to the resulting blemishes, according to the article.

“[Gua sha] originally was used to help with internal illness,” says Yang. “So, for things like febrile disease, cold, flu, muscle aches, and pains, gua sha was applied to the body with really fast, strong strokes in order to help dispel any internal pathogens or body aches and pains.”

It wasn’t until Dowager Cixi, an empress in China, “really popularized gua sha for aesthetics,” that facial gua sha became a thing. “She started to repurpose gua sha tools using precious stones such as jade and started applying it to her face for aesthetics, and then this became really popular amongst the upper-class elite in China,” explains Yang. “One hundred twenty years later it’s made its way to the west.” Compared to body gua sha, facial gua sha uses “more intentional, gentler, slower strokes,” she adds.

What Are the Benefits of Gua Sha?

The human body has more than 2,000 points that are connected by meridians (channels), and an energy force referred to as Qi flows through those meridians, according to traditional Chinese medicine, as Shape previously reported. Gua sha is intended to help keep Qi moving throughout those channels. “You’re opening up the meridians, which are included within traditional Chinese medicine,” says Yang. “You’re increasing the flow of Qi and blood, and you’re helping to open up and communicate with the spirit.” The goal is to avoid stagnation along the meridians, which is thought to result in negative health outcomes, to put it broadly.

Apart from generally promoting health, you can tailor your sessions to your desired gua sha benefits. That could mean releasing tension resulting from craning your neck to look at your phone, boosting your circulation in the morning, or calming your nervous system at night by lighting a few candles and gliding the tool slowly across your skin, says Yang. No matter your focus, gua sha is an opportunity to show yourself some love. “I believe that skin care is a form of self-care,” says Lin Chen, founder of the brand Pink Moon, which sells gua sha tools and other beauty and wellness goods. “A daily gua sha practice can truly make an impact on your mental and emotional wellbeing as well as your skin and overall health.”

The aim of gua sha has been widely misrepresented, says Yang. “In the west, there’s a lot of predatory marketing around gua sha where it’s like ‘erase still wrinkles, decrease your lines, get rid of your double chin,'” she says. “Traditionally, the intention of the practice doesn’t have anything to do with erasing yourself. In fact, Chinese medicine says that if you change your face, you change your fortune. So the main purpose is to begin a communication stream as a way to speak to yourself and your face and understand, ‘Okay, what are some things that I want to work on or improve, what happened in my life that got me to that place?’ And most of the time it’s unresolved emotions.”

You might, for instance, notice “11 lines” between your eyebrows which can result from frowning, and reflect on whether you have unresolved anger, says Yang. Gua sha can then be a way to “communicate with [yourself] and sit with it and try to transform it and soften it,” she says. “And once you start that dialogue between your spirit, your face, and yourself, then your spirit comes through. When your spirit comes through, it really shines passed any imperfections. And then you move into a place of ease with aging or with your face.”

And so despite a popular claim, gua sha isn’t a Botox alternative, in fact, the two treatments are worlds apart, says Yang. While Botox relaxes your muscles for wrinkle prevention — which can limit your ability to make facial expressions related to your emotions — gua sha is about processing your emotions, she says. “When you compare the two, it is a disservice to the indigenous practice because [gua sha is] not Botox,” says Yang. “When it doesn’t perform like Botox — it can’t freeze your muscles — then people are left to believe that Chinese medicine doesn’t work.”

How to Choose a Gua Sha Tool

Gua sha tools are easy to come by at brick-and-mortar stores and online marketplaces that sell beauty products. However, you ideally want to be choosy about where you buy a gua sha stone, says Yang. “It’s important to support brands that are connected to the medicine and the culture and the history, and that should help people not participate in the cultural appropriation and the commodification of the facial tool.”

The tools are often made with different types of stones (e.g. obsidian or jade) or stainless steel. A great option is a gua sha stone made out of rose quartz, as some of the darker stones are “more coveted” and therefore can be subjected to potentially unethical procurement practices, says Yang. Additionally, you can ask where a brand sources its materials. “Smaller mines adhere to more ethical standards, and general rule of thumb is the darker the stone, the more coveted [it is and] the more conflict surrounds its mining,” says Yang. While you should do your homework to shop ethically, “the main focus isn’t the stone but the intention of your practice,” says Yang. “[Thinking] that you need all these different stones can be a distraction from what you want to achieve with a practice, which is communicating with yourself and your spirit.”

How to Use a Gua Sha Stone

To get the most out of your gua sha practice, you should prep your skin beforehand and use gentle pressure.

Apply a face oil or balm.

Before using a gua sha stone or tool, it’s key to wash your hands and face then apply a face balm or about five drops of face oil to create a slick surface for the tool to glide across, says Chen. “Sometimes high-quality facial oils can absorb really quickly, so you won’t have a slick for very long,” says Yang. “That’s why I personally love to use balms because they’re a little bit thicker and they’re going to stay on for longer for you to have a longer practice.”

Warm up the tool, if desired.

You can soak the tool in warm water or warm it up between your palms before using it, though that’s not essential, says Yang. “[Chinese medicine favors] warmth, because warmth moves Qi and blood,” she says.

Glide the tool across your skin at an angle.

When using a gua sha tool, you should hold the tool at a very slight angle, almost parallel to your skin, says Yang. “A lot of times I see videos of tools being held perpendicular to the skin, and that actually cuts into the meridians, like a knife cutting through bread,” she says. “For Chinese medicine, you’re trying to move with the meridians [to] help them open.”

You should use “light and gentle” pressure, says Yang. “When you’re too hard on the face, the meridians are actually going to close to protect themselves because it’s a very intelligent system,” she says.

Start from your neck then move to your face.

During a session, you want to start from your neck and work your way up. “I think a lot of people want to go straight to the face because they think that’s where they’re trying to get the results, but actually releasing the neck and chest first and foremost” is important, says Yang. “The neck is the bridge between the face and the body, so it’s going to help with that circulation. [Plus], your neck is so tight that when you skip over it, you won’t get a good result on your face. The muscles in the neck, which are quite strong, can pull down on the face, causing a droopiness or leading to a sad expression.”

You can use a gua sha tool as frequently or infrequently as you like, opting for quick or lengthy sessions, depending on how you feel. “That’s the beauty of this practice,” says Yang. “It meets you where you are.”

Where to Use a Gua Sha Stone

Below, Chen demonstrates how to use a gua sha stone at home. Complete the entire sequence on one side of your face and neck, then repeat each of the motions on the opposite side.

Neck

1. Sweep gua sha tool up your neck from your collarbone up to earlobe.
2. Repeat closer to the center of your neck up to your chin.

Jawline

1. Sweep the gua sha tool from under the center of your chin toward your earlobe, along your jawline.
2. Gently wiggle the tool at the end to release jaw tension.
3. Sweep it from the bottom of your chin starting from the corner of your mouth, along the jawline, up to your earlobe.

Cheek

1. Sweep the tool underneath your cheekbone, toward your hairline to pick up stagnant fluid and energy.

Under Eye

1. Gently sweep the gua sha stone under your eye, doing quick flicks out to your temple.
2. Sweep the tool over your eyebrow out toward your hairline and up from the brow bone (sweeping it up your forehead).
3. Sweep the tool from between your eyebrows over your third eye (located in the middle of your forehead) and up to your hairline.

Forehead

1. Sweep the gua sha tool from the middle of your forehead horizontally out to your hairline.