Gua sha may leave dark marks on dark skin if the scraping irritates or bruises it. Keep the pressure very light and skip inflamed skin. Don't wait for redness to tell you when to stop, because on deeper skin it often won't show.
If you've watched tutorials where the skin flushes pink and the creator calls it circulation, you may have looked in the mirror and seen nothing. So you pressed a little harder. A week or two later, there's a faint brown shadow along your jaw or cheekbone that wasn't there before.
No study has tested facial gua sha and pigment directly. The risk comes from what's well established about how darker skin heals, and that part of the evidence is solid.
Can Gua Sha Cause Hyperpigmentation?
It may, indirectly. When skin is irritated or injured, it can make extra melanin as it heals. That leftover pigment is called post-inflammatory hyperpigmentation, or PIH.
The American Academy of Dermatology says many everyday things can trigger extra melanin in people with darker skin tones. Its list includes a wound healing and skin or hair products that irritate your skin. A clinical review on the NIH's bookshelf says PIH is more prevalent among individuals with darker skin tones, particularly Fitzpatrick skin types IV to VI. It adds that the darker the skin, the more intense and persistent the extra pigment tends to be.
A 2022 review in Clinical, Cosmetic and Investigational Dermatology, written partly by researchers at a cosmetics company's lab, goes further on why. Its authors write that in darker skin, pigmentation is more severely enhanced by inflammatory processes such as acne. They list mechanical injury among the outside triggers, alongside procedures like chemical peels and dermabrasion. Hard scraping is a form of friction, so the same logic plausibly applies, though no study has tested it.
Gua sha has two very different forms. Body gua sha, the traditional form, can leave small reddish-purple spots on the skin. Cleveland Clinic describes these as tiny spots of bleeding under the skin caused by broken capillaries. It also warns that scraping too hard can cause bruising or skin discoloration.
Facial gua sha is meant to be done with very light pressure, according to the same Cleveland Clinic page. Put those facts side by side and the problem is clear. A bruise or a patch of sha is a small injury, and on darker skin a small injury is exactly what PIH follows.
Why Redness Is the Wrong Signal on Dark Skin
Many tutorials treat a pink flush as the cue that you've done enough, or too much. On deep brown skin, that cue may never appear, or it may look like something else.
In a 2021 letter in the British Journal of Dermatology, a group of dermatologists argued against relying on the word "erythema" (redness) at all. They pointed out that inflammation can show up as purple, gray, brown or black changes as well as, or instead of, red. They added that these changes can be subtle in darker skin, so clinicians should look for other signs of inflammation.
The same advice works in your bathroom mirror. Instead of waiting for pink, check for these:
- warmth that lingers after you stop
- tiny raised dots you can feel with a fingertip, even if you can't see them
- a dusky, purplish or grayish patch where the tool spent the most time
- tenderness when you touch the area the next morning
- swelling, even slight puffiness that wasn't there before you started
- stinging, especially if you used an active ingredient the night before
Any of these means your skin is irritated. Ease off and leave that area alone until it settles.
How Hard Should You Press for Gua Sha on Dark Skin?
Lighter than the one recent trial did. The guidance on this is less settled than it looks.
Cleveland Clinic says facial gua sha uses very light pressure. The most recent trial, published in 2025 in the Journal of Cosmetic Dermatology, told its participants something firmer. They were to press firm enough to grip and move the superficial tissue, but not hard enough to cause discomfort or bruising.
That trial followed 34 women aged 20 to 50, recruited around Seoul, for 8 weeks. Half used the gua sha side of a tool for 10 minutes, five times a week, over a small amount of facial oil. The researchers didn't record skin type or pigment. They also didn't present any data on side effects, so it can't tell you how that pressure plays out on deeper skin.
Until someone tests it, the lighter end makes more sense. Your skin can't show you redness as an early warning, and a mark costs you months.
The trial's one useful detail is the oil. A layer of oil or a slippery serum lets the stone glide instead of drag. Cleveland Clinic suggests a lotion or serum for the same reason.
For the strokes themselves, how to use gua sha on your face correctly walks through holding the tool flat and which direction to move. On darker skin, it's sensible to make fewer passes over each area. Don't keep working one spot to chase a flush that won't come.
Which Skin Should You Skip?
Skip anywhere that's already inflamed. That covers more of your face than it sounds like.
Start with active pimples. Acne is a well-known PIH trigger, and the 2022 review says it boosts pigment more in darker skin. Dragging a tool over a pimple adds friction to inflammation that's already there. Work around it, and read why acne marks last longer on dark skin if old ones are still hanging around.
Eczema and psoriasis count too. Cleveland Clinic lists both as reasons gua sha may not suit you. The AAD also names a clearing psoriasis patch as a cause of dark spots.
So does skin that stings from actives. The AAD's melasma advice says a product that burns or stings when you use it is irritating your skin. That irritation may darken dark spots. Don't scrape a face that's stinging from a retinoid or an acid.
Using retinol on dark skin without irritation covers how to space those out.
Leave broken skin, rashes and sunburn alone as well. They're wounds in progress, and the AAD names a healing wound as a PIH trigger.
There's a gap worth knowing about. The 2025 trial excluded anyone with a diagnosed facial skin condition such as eczema, severe acne or rosacea. It also excluded anyone using facial medications or treatments, and pregnant or breastfeeding women.
So the only recent evidence comes from women whose skin was calm and untreated to begin with.
Some reasons to skip it have nothing to do with pigment. Cleveland Clinic advises against gua sha if you take blood thinners, are pregnant or are having chemotherapy. It also lists circulation problems and diabetes. If any of those apply, ask your doctor first.
