Tip #3: Guasha for Upper Respiratory Health

This is the third and last of a series of posts outlining some simple Chinese medicine-inspired practices to do at home to keep you and your loved ones healthy while on quarantine. The first post was on the use of warming moxa for digestive and immune support and overall strengthening. The second post was on the qi gong tapping technique in order to open our lungs and expand our hearts. This post will be on the use of guasha for upper respiratory health which can be used not only as a preventative measure but is also a great tool to help treat mild upper respiratory ailments.

Some of you may have heard of guasha since the explosion of popularity of facial guasha for smooth, glowing skin. Guasha is a technique where you use a flat, smooth instrument, such as a jade flat tool or a Chinese ceramic soup spoon, to rub or scrape along the skin surface in order to stimulate and increase circulation of qi, blood and body fluids. It can be used therapeutically all over the body for muscle spasms, congealed fluids, congestion, and/or to release constrained heat in the system, to name a few uses.

Guasha literally translates to ‘scrape up sand,” which refers to the bright red spots that appear on the surface of the skin from the broken superficial blood vessels which sometimes results from this technique. While this may seem alarming to some, the technique never actually breaks through the skin’s surface. Instead, the breaking up of the superficial vessels forces the body to pump more blood to the area, increase circulation and promote healing. For our purposes in this post, you don’t need to rub till you get these red spots for it to be effective. But you may notice your skin pinkening or flushing up which is a sign of correct application.

Guasha is one of our favorite techniques aside from acupuncture since it has so many uses and benefits. We use it on the oh-so-common knots along the shoulders and upper back from stress and tension. We often use it to help lower a fever, especially for our pediatric patients. For our facial acupuncture patients, it’s an important tool to move blood, lymph, qi and other vital fluids in the face release tension along the SCM (sternocleidomastoid muscles of the neck) and jaw, and massage the small muscles of the face thus reducing fine lines and sagging skin.

But one of our favorite uses and what this post will describe in more detail, is the use of guasha for upper respiratory health. Because the nose, mouth, ears and throat (and eyes) are our body’s main openings to the outside world, we need to make sure we keep these areas in great health–not too dry, not too moist, smelling, breathing, hearing, tasting, and swallowing clearly. And because in Chinese medicine we understand that essential to health is the even flow of qi, or vital force, through the channels of our body, we can help ensure that qi is circulating smoothly with techniques like guasha.

As a preventative measure or if we feel like we are about to ‘come down with something’, guasha can be used as a first line of defense. Oftentimes, when we are at the beginning of an illness, we may start to notice some nasal congestion, sinus pressure, post-nasal drip, a scratchy throat, fluid in our ears or throat, and/or difficulty hearing. These are signs that pathological fluids are starting to build up in our mucus membranes. We can diminish the accumulation of these fluids through the use of guasha.

Prevention, however, is key. If you can make a daily habit of facial, throat, scalp and neck guasha, not only will you be preventing illness, but you’ll also be giving yourself the gift of a daily massage and smooth vibrant skin! 🙂 What is there to lose? You can keep your guasha tool by your bathroom sink and make a habit of doing it when you first get up or before bed.

Common Upper Respiratory Symptoms That Can Be Treated with Guasha:

  • Nasal congestion
  • Runny nose
  • Post-nasal drip
  • Sinus pressure and sinus headaches
  • Ear infections, ear pressure, clogged ears
  • Sore throat
  • Swollen glands
  • Swollen lymph nodes
  • Stiff neck
  • Headache
  • Tight muscles


Guasha tool: You can use a jade or rose quartz guasha tool, a Chinese soup spoon, or anything else similar in shape and smoothness (one of our patients uses a bone paper scorer)! Just make sure you don’t use anything too rough or with sharp edges that may irritate or break through the skin.

Liniment: You’ll want a lotion, cream, oil, or liniment to apply to the skin before using the tool. This will ensure the smooth, gentle and comfortable application of this technique. We like to use a base of massage oil plus a few drops of White Flower Oil which adds an aromatic, orifice opening element to the mixture. White Flower Oil is particularly therapeutic if your ears, sinuses, or nasal passages are clogged, if you have a headache or muscle tension or if you have a sore throat or swollen glands on your neck.

Bottle of White Flower Oil for Guasha treatment


  • Hold the guasha instrument in the palm of your hand between the thumb and the rest of your fingers.
  • Use a downward or outward motion in long, quick strokes with a bit of a flick up at the end of the stroke.
  • Remember to keep your shoulders, upper and lower arm relaxed and moving in one fluid motion but utilize your wrist for that fanciful flick at the end.
  • Repeat the strokes in the same area anywhere from 5-20 times for best results.
  • Start off with very mild pressure and check in with yourself or whomever you are performing it on to make sure the pressure is ok. Increase as desired.
  • If you find the tool is getting caught on the skin, add more oil or liniment.
  • Whenever you locate a tender spot while doing guasha, spend a little time on these areas. They are a sign from your body of where it would like some attention.


    1. Guasha Bi Tong: Bi Tong is an acupuncture point between the cheekbone and the opening of the nose. It’s a tender spot at the top of the nasolabial groove that, like the name of the point, makes sure the nasal passages open through. Instead of long strokes, you may want to use a small edge of the guasha tool to make gentle rubbing circles in this area. You can hang out at this point for a minute or two especially if you are congested.

Guasha on Acupuncture Point Bitong

    1. Guasha the cheekbones, the eyebrows and forehead: Your sinus cavities are located along these areas. Starting close to the nose, guasha across the bottom of the cheekbones to the hairline, across the eyebrows to the temples, and from the center of the forehead to the temples. You’ll notice some tender spots along the way. This feels wonderful and helps to move fluids that may be accumulating in the sinuses. It will also help your face glow!
    2. Guasha the scalp: There are meridians that run along the length of the scalp from the forehead and temples to the occiput at the base of the skull. It’s important to keep the qi in these channels flowing for upper respiratory health. Start at the temple and stroke down behind the ears towards the base of the skull. Continue from the hairline of the forehead and down to the base of the skull as you move across the entire scalp to the other side. Pause at the tender spots at the base of the skull and give some attention there.
    3. Guasha the throat: Using long strokes, guasha downward on the front of the neck. Be careful not to press too hard on the glands as they may be particularly sensitive if they are swollen. Guasha on this area will move fluids through the glands and lymph nodes of the neck. Swollen lymph nodes are a sign that your body is fighting something. This is also a great technique for sore throats.
    4. Guasha behind the ear down the SCM: Many people experience clogged ears, ear pressure or ear infections when they get sick.  Keep the fluids from accumulating in the ear canal and guasha from behind the base of the ear down the sternocleidomastoid (SCM) muscle of the neck.  This is a great area to focus on for kids who tend to get ear infections.

Guasha treatment on the front of the neck

  1. Guasha the back of the neck: This area can get very tight or painful with the onset of a cold. It might present as a stiff neck or occipital headache. The shoulders can also get quite tight and sore. There are also some acupuncture points at the base of the skull that when stimulated, will help reduce post nasal drip and nasal congestion. Like rubbing at Bi Tong, you can hang out at these spots and give a good rub. Then stroke down the neck towards the shoulders. If you’re like most of us, you’ll have no problem finding some tender spots to concentrate on. At the highpoint of the shoulders where many of us hold tension, you can really dig in and if they are very tight and congested, you might bring up some ‘sha’!

Guasha treatment on the back of the neck

Try it out. We’re sure you’ll find this technique both easy and incredibly helpful. Our kids even ask us for it whenever they have a sore throat! If you missed it, check out our previous post on dietary, supplement and lifestyle advice to stay healthy in the era of Covid-19.

Please share with others so we can all find ways to help ourselves and each other. And stay tuned for a future post on all our seasonal allergies tricks-of-the-trade.

Let us know if you try this out and what you think!

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