Facelifts are up! Data released by The American Society for Aesthetic Plastic Surgery shows that in 2017, non-surgical skin tightening increased by 15.1 percent. Face lifts ranked sixth in the surgical category, up 21.8 percent from 2016. So, how can aestheticians’ services be a part of this trend? Since many clients prefer less invasive face-lifting options, it is important to make some changes in facial offerings – and, one particularly exotic, yet effective, trend is taking the beauty world by storm: gua sha.
Pronounced “gwah sha,” this surgery-free treatment comes all the way from traditional Chinese medicine. It has been proven to firm, lift, and sculpt facial contours, while improving blood circulation, decreasing inflammation, and minimizing stress. Although gua sha has been around for thousands of years, it is currently re-establishing a new foothold in the beauty industry, helping clients look and feel years younger.

RUBBING, SCRATCHING, AND SCRAPING, OH MY
What exactly is gua sha? The origins of gua sha are evident from its name. In Chinese, “gua” translates to “scratch or scrape” and “sha” means “heat or rash.” Put together, they describe the ancient Chinese treatment of scraping the skin’s surface. It is a natural detoxification that starts with increasing circulation, clearing out blockages, and improving the flow of the body’s life energy, known as “qi.”
To perform traditional gua sha, a smooth tool is used to press-stroke the skin over targeted locations, called meridian points, and in specific directions known as meridian lines or pathways. This process can intentionally and therapeutically produce temporary petechiae, or red colorations on the skin, due to blood cells being pressed out of underlying broken capillary vessels.
The roots of gua sha lie in meridian theory, the foundation of traditional Chinese medicine. Meridian theory is based on qi, which flows through 670 meridian points that are similar to those used in acupuncture. These points are located along 20 major meridian pathways that connect different parts of the body, from the governing vessel at the top of the head, all the way down to the toes.
On the face, there are 60 meridian points that each correspond to another part of the body, including internal organs. Ten of these facial meridian points are fundamental to gua sha meridian facial massage.
In gua sha, also known as meridian massage, the hands and gua sha tools are used to clear qi blockages by performing specific strokes through the meridian points and meridian lines that flow through the body, like an energy highway. Stroking along those energy lines clears qi and tightens and firms the area, leading to improved circulation, a glowing complexion, and an increased feeling of well-being. This ancient wellness treatment has even been corroborated by recent scientific studies. Research performed at Harvard University has shown a 400 percent increase in microcirculation within seven and a half minutes after gua sha has been performed. Other studies have shown that meridian massage directly correlates to a decrease in inflammation. In fact, meridian pathways have been mapped electronically, radioactively, and thermally. An experienced aesthetician well-versed in meridian massage may actually feel these energy pathways while performing a treatment.
Facial gua sha meridian massages can be described as “exercise for the face,” since it increases oxygen uptake, keeping skin radiant, toned, and healthy-looking. Before and after images show how after just one treatment, facial contours are firmer, more lifted, and more defined. In facials, gua sha is not limited to the face. The strokes cross the décolleté and also extend down the neck, since moving lymphatic drainage and improving circulation are key. Advanced gua sha meridian facial techniques will reduce wrinkles and sagging by smoothing out underlying fascia and clearing lymphatic pathways, which ultimately improves overall bodily health.

PROBLEM AND SOLUTION
What conditions can gua sha meridian massage treat? When blockages occur in the body’s natural flow of energy, the body shows signs of imbalance, stagnation, and even pain or illness. Performing gua sha along meridian pressure points, which are similar to acupuncture points, will clear those blockages and detoxify the system, restoring a balanced and healthy flow of qi.
After gua sha meridian facial massage, skin dullness and blotchy tone immediately look more radiant and healthy, while facial contours look lifted and more defined. Signs of stress that mark up the face are minimized because the underlying muscle tension is reduced. The lymphatic system drains away impurities. Blood flow is increased, transporting oxygen and nutrients to the skin. The result is reduced puffiness with improved tone and texture. The face looks more relaxed and shows fewer wrinkles. The neck looks longer and thinner. Facial contours are sleeker and more defined. Clients feel relaxed and energized at the same time, which will keep them coming back for more.
For younger skin types, gua sha meridian treatments improve blemish-prone skin by helping to minimize inflammation, flush out toxins, and improve overall tone. However, in these cases, do not perform gua sha directly over the face; perform the strokes from the ear down to the neck only.
For mature skin types, gua sha meridian treatments recontour sagging skin, reduce the appearance of fine lines and wrinkles, create a youthful-looking radiance, and improve the skin’s natural ability to absorb nutrients.

GUA SHA TOOLS
What materials are needed to perform gua sha meridian massage? Gua sha is performed with hands as well as with unique tools. Traditionally, Asians used water buffalo horns. The primary choice for gua sha treatments in medical offices still includes water buffalo horns, as well as smooth boards made of jade or spoon-shaped tools made of silver or copper. According to Chinese culture, jade in particular is known as healing and energizing and contains many beneficial minerals and trace elements that include copper, cobalt, iron, manganese, and calcium. Other newcomers to the array of gua sha tools include crown-shaped celadon tools with scalloped edges and smooth rose quartz, which is associated with energy and healthy circulation. In the treatment, the tool alternates with hands moving along meridian points and meridian lines in order to lift, firm, and tighten the skin, while improving circulation, clearing blockages, and moving out toxins.

BASIC PROTOCOL
To perform gua sha meridian facial massage, the aesthetician should always begin at the scalp, at the governing vessel. In traditional Chinese medicine, the governing vessel is located on the middle of the head and is the source of the main meridian line running through the body. Starting a facial massage at the scalp opens up the meridian lines and improves circulation because there is a direct correlation between what is going on up in the scalp and the clarity, lifting, and inner glow that will be taking place in the face.
As an added bonus, the experience of being touched releases the feel-good hormone, oxytocin, which is a neuropeptide hormone secreted by the pituitary gland. Levels of oxytocin increase during meridian facial massage, which not only helps reduce stress, but also helps mediate cell growth, reduce inflammation, and combat oxidative stress for overall well-being.
Step 1: Governing Vessel – Press scalp along the governing vessel and meridian pathways on the scalp to release energy blockage, using two to five pounds of firm, but gentle, pressure. Always ask the client if the pressure is too strong. The more stressed they are, the more they will feel the pressure.
Step 2: Scalp Oil – Use fingers to apply scalp massage oil into skin along meridian lines on the occipital region and crown of the head. Be sure to prevent oil from dripping onto the eye areas.
Step 3: Scalp Massage – Press fingers along the meridian pathways on the scalp, then press and rotate the scalloped edges of a round meridian tool along the same pathways.
Step 4: Ear and Neck – After the scalp massage, wrap the head with a towel. Use fingers to relieve inflammation and blockages in the front of the ear area. From the back of the ear, stroke down the side of the neck, draining impurities down lymphatic lines. Repeat this movement three, five, seven, or nine times.
Step 5: Double Cleanse – Cleanse the facial area using an oil-based cleanser to remove makeup, then a bubbly cleanser to remove dirt, debris, and excess makeup residue. Pat dry.
Step 6: Décolleté – Apply facial oil or facial balm to the face, neck, and décolleté. Work with hands moving downward over the décolleté, along the center line. Alternate using a jade tool and one hand, performing strokes down the décolleté and from the center outward.
Step 7 – Face: Starting from each of the primary 10 meridian points on the face, use the jade tool to perform strokes, moving through the points and along the facial meridian lines, the chin, and the jawline. After point 10, work on the forehead with the tool, then hands, moving impurities and blockages down lymphatic pathways.
Step 8: Neck – Finish by gliding the tool down the side of the neck to push toxins downward and clear energy flow. The arm can also be lifted to drain toxins through the underarm.
Step 9: Mask – Apply a sheet mask to cool down the temperature of the skin. While the mask is on, apply lotion to the client’s hands and arms. Use a round, scalloped meridian tool to massage the palm, rotating and pressing upward over the palm, along the arm, and up to the shoulder. While the mask is on, jade tools may also be used to perform strokes over meridian lines. After 15 minutes, remove the mask.
Step 10: Products – Apply a mineral-based toner, serum, moisturizer, and sun protection. Layer at least two serums, because cleansers and moisturizers are not going to impact the collagen structure in the skin. Skin cells turn over every three months after the age of 40, so for those older clients, serums should definitely contain antioxidants, peptides, and a growth factor, which is a stem cell precursor that will help skin cells regenerate faster.

ADVANCED GUA SHA MERDIAN FACIAL RESCULPTING
More advanced resculpting techniques include fascia-firming meridian massage, which focuses on the superficial fascia, the connective tissue located underneath the skin. Smooth stroking over the fascia and along meridian lines will help smooth out wrinkles and creases in the underlying fascia.
Advanced techniques include rolling and pressing along the chin and jawline to sculpt facial contours, avoiding vigorous or tugging pressure. Also, using the thumb and forefinger to make slight pinching movements along the eyebrows will help reduce the look of puffiness and drooping eyelids, while brightening the eye areas.
To maximize the experience, the jade stone can be placed into cold water and cooled. Warm hands on top of a hot towel, then work with the cold stone and hot hands. Immediately after, reverse the order by using a hot jade stone and follow with cold hands. Clients love the way this feels, and an improvement in skin clarity is noticeable right away.

TECHNIQUES AND TRAINING
What about training? Many people are performing gua sha on themselves, based on videos they find on the internet. However, that is not the answer. Thousands of years of meridian theory cannot be translated into a two to three minute video. It is about deeper knowledge. Skin should not be treated as if it is a flat sheet of paper. In fact, there are approximately 19,500,000 skin cells in just one square inch of skin and the key is understanding what goes on beneath the surface.
In the United States and in Europe, massage focuses on muscles, the circulatory system, and the lymphatic system, using manual techniques that include effleurage, tapotement, petrissage, or friction massage. Therefore, it is essential to have studied and understood the underlying structure of the skin. Think of the fascia lying between the skin and the muscle, which is where the lifting and sculpting occur. How does the fascia hold the muscles? How do the muscles connect? How does the circulatory system work? Where are the lymphatic pathways?
It is also critical to know and understand the locations of meridian points and meridian lines. Simply moving the gua sha tool back and forth without tracking along meridians will not benefit the client and might actually do damage by moving toxins in the wrong direction. Classes and hands-on training with a meridian expert is essential for aestheticians who truly want to hone their craft, add to their spa offerings, and increase their bottom line. By expanding knowledge, professionals can use their hands to slow down and alter the signs of aging, while promoting wellness for clients – who will fall in love with the results.

GETTING GUA SHA OUT THERE
Once gua sha has livened up the spa menu, what are some ways to spread the word in order to increase income?
When doing marketing for gua sha services, never underestimate the importance of gift cards for spa revenue. A 2018 United States spa industry study carried out by Pricewaterhouse Coopers (PwC) shows that 83 percent of spas offer gift cards, which end up generating nine percent of total revenue – translating to an average of $86,200 per spa. Make it easy for clients to let their friends know about their amazing gua sha experience. Offer them gift cards for birthdays or special occasions.
Let social media do its work to spread the word. The visible results of gua sha facials are immediate and also long-lasting. Ask clients if they can be photographed on a tablet or iPad before and after the treatment. With the client’s permission, post the pictures on Instagram, so other clients will see how this exotic new service truly provides remarkable results.

DON’T FORGET THE ADD-ONS
Gua sha meridian massage may be added to the beginning of an existing treatment with machines. Conversely, existing facials can offer an add-on scalp massage, eye lift, ear and neck clearing, or hand and arm massage, which is particularly recommended for those who work at computers all day.
The important take-away is to expand the range of choices for clients. Create new spa menus. Offer new add-ons. Take advantage of the popularity of exotic and unusual treatments that will increase bottom line and professional expertise.
Trending techniques in gua sha meridian facials can change how professionals do regular facials. Learn how to incorporate the lymphatic system, the circulatory system, the muscular structure, the fascia, and, most importantly, the meridian lines into facials. Remember that touch releases oxytocin to help manage inflammation and oxidative stress.
Aestheticians have the power to actually change people’s lives. Their treatments have an amazing impact on the face a client sees in the mirror first thing in the morning, throughout the day, and at night. Even more, these treatments can literally transform a client’s feeling of overall wellness.

CHANGE IS GOOD
It is important to be aware that retailers in international chains of personal care and beauty stores are seducing clients with professional products. Consultations are offered at the beauty counter of major retailers. Do-it-yourself videos on the internet are just a touch away. The result? It has become easier and easier for clients to do their own treatments in the comfort of their home.
However, it is very important to make clients aware that gua sha stroking is not just scraping back and forth. There is a definite method to performing the strokes, which must follow the distinct meridian points and pathways in order to move toxins out of the system. Indiscriminate massage stroking movements can actually cause serious issues. There is power in those meridian points and pathways. Qi must not be underestimated.
How can professionals keep clients and attract new ones? Clients want a totally different experience that they will become addicted to, like gua sha. And since they obviously cannot take the professional’s hands home, they become hooked. These facials can be a gold mine if one learns the techniques, understands the underlying anatomy, and is willing to change.
Aestheticians have the unique role of providing hands-on, customized answers to each client’s skin care challenges and, even more, understanding how skin care and wellness are connected. Unlike chain stores and YouTube videos, the aesthetician has the personal relationship with their clients and can teach them what happens as skin ages through the years and how to prevent and repair damage for overall beauty and wellness.

Gua sha meridian facials are changing the way clients experience treatments. Embrace that change, expand knowledge, and always be open to something new.

Founder, formulator, and CEO of Le Mieux Cosmetics and PurErb Herbology-based Skincare & Aromatherapy, Janel Luu has over 35 years experience in the beauty industry as an educator, researcher, and formulator. She has taught over 37,000 skin care professionals and physicians on topics ranging from antiaging cellular technology to centuries-old meridian techniques.