I’m sure you’ve seen those images online of bright red backs after someone has Gua sha. They look horrific. One of the things you see time and again online in China and Taiwan is advice from medical experts telling people that the harder you perform Gua sha, it doesn’t necessarily mean the better the results. They are often referring to this belief that in order to do Gua sha properly, you have to scrape deeply and painfully. There is a place for strong, hard treatments when you’re fighting disease, but outside of this, most of the time, it would be inappropriate, and sometimes unsafe, as you can hurt someone.

You also have to factor in the landscape of the body. The big difference between what I do with Gua sha and what others do is the application of the ancient Chinese ideas of the natural world applied to the body and face, so landscape is something that is a major part of how I see the body. Very much as you might stand at a high place and survey the land around, or look out at the earth from a plane window. I quite literally am thinking of the same things in the body. But you don’t have to think about the same natural landscape. Think about bones and muscle and tissue. If you scrape over bones, it can hurt so you have to factor that in with your scraping. You need a technique which is aware of the area around where you treat. This both makes your results better and makes it a whole lot safer for the receiver.

You can easily recognise Gua sha from the marks left on the skin on some parts of the body, and whether or not it looks okay to you, it’s usually signifying that something positive is happening beneath the skin in the area affected. But there are some areas where you don’t want the red marks of sha to appear on the surface of your skin.

The face is an obvious example. This is why facial techniques are different from body techniques. And to anyone who believes Facial Gua sha isn’t Gua sha perhaps didn’t really understand Gua sha in the first place. There are many techniques involved in Gua sha but with all of them, exactly the same principle is involved. This is so important to understand but unfortunately so few people actually do.

It is possible to bring sha on your face, especially in some areas such as between your eyebrows. So you have to be aware of this and treat accordingly. And then there are other areas such as the neck and shoulders where it is very common for sha to appear and these may be visible to other people when not covered by clothing. If you were to treat someone in this area and they had a significant event to attend a few days later such as a wedding or they might want to go to beach, they might not be too happy with you.

So in order to play safe, informed consent is the key. Which basically means you tell them what you’re doing and the risks involved, before you do it, and they agree to it.

For safety, there are some areas of your body where you don’t use Gua sha unless you really know what you’re doing. One of these is the front of your neck. This is the area of your Adam’s apple, the laryngeal prominence, which is the protrusion of the front of the thyroid cartilage that surrounds the larynx. It’s rare to come across reports of injuries caused by Gua sha but this is one area that has appeared several times.

Avoiding sensitive areas such as your eyeballs and be aware that any area which doesn’t have a bony structure to provide support, such as the abdomen, is unlike areas that do such as the back. You need to change your technique.

If you have Gua sha and your back and there are lots of areas of sha making it look like you’ve had a nasty accident, guess what your partner/parent/friend is going to say when they see it. Or guess what the teacher/students are going to say when they see the marks on your child changing for their gym class. I think it’s pretty obvious how they might react if they don’t understand what just happened.

How do you make it safe for you? You tell everyone what happened. Education is one of the important things about Gua sha. Most people who do Gua sha, don’t know what is going on under the skin so you don’t need to explain tin great detail. Just the basics of what you do and the result is sufficient.

It’s just as important to know what Gua sha can do as what it can’t do. I come across all kinds of claims of Facial Gua sha which make promises about the results of treatment that I don’t think they can keep. It’s the same with the body, it’s easy to think that Gua sha is for every illness and disorder. But of course, like every treatment modality, while you can do so much, there are limits. But if you don’t know where the limits are or are not even aware that there were any, then this is where the safety line is.

And I think that perhaps an extension of this is know your limits. If you’re not trained to diagnose other people, then don’t do it. Stay within the boundaries which make you and the person you’re treating safe.