Does gua sha on the arm go up or down?

Both, depending on the area. The outer forearm goes up, wrist toward elbow. The inner upper arm goes down, armpit toward elbow. Each line follows its own meridian, so the direction is not the same everywhere on the arm.

Why does the inner upper arm go downward?

Because the heart meridian runs from the armpit down the inner arm and into the little finger. Scraping with the line, toward the hand, is the traditional direction.

Is there anything on the arm I should not scrape?

Yes. Do not scrape over the armpit itself, over the elbow joint, or over any skin that is broken, inflamed or infected. On the inner upper arm, keep off the artery — use light pressure along the inner edge of the biceps rather than the middle of the arm.

How often should I scrape the arm?

Two or three times a week on one area, and wait for any marks to fade before doing the same strip again. Scrape each area for three to five minutes, and never scrape back and forth.

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Traditional practice · educational

Gua Sha for Arms and Hands: Two Areas, Opposite Directions

Free page, and it stays free. The arm is the one place where "up toward the heart" is not the whole rule — the outer forearm goes up, the inner upper arm goes down. Getting that backwards is the most common mistake here.

Two areas on the arm are worth doing. Each follows its own line, and the lines run opposite ways. Here is which is which, the pressure, and the four places on the arm to leave alone.

The direction — it is not the same on both sides

Area	Line	Direction	Path
Outer forearm	Triple burner meridian · 手少阳三焦经	Up	Wrist crease → elbow
Inner upper arm	Heart meridian · 手少阴心经	Down	Armpit → elbow

The outer forearm is a three-yang meridian: it runs from the little finger up the outside of the arm and continues to the head, so the scrape goes toward the body. The heart meridian is a three-yin meridian: it starts at the armpit and runs down the inside of the arm into the little finger, so the scrape goes toward the hand. Same rule as the inner forearm and the neck — follow the line the meridian actually takes.

Four places on the arm to leave alone

These four are not preferences

The armpit itself. Start below it, on the upper arm. The hollow is delicate skin and it rubs.
The elbow joint. Bone and tendon sit right under the skin on the inside of the elbow. Circle it gently, never scrape straight over it.
The artery on the inner upper arm. Scrape on the inner edge of the biceps with light pressure, not up the middle of the arm.
Anything broken, inflamed or infected. Skin damage, an active rash, a fresh injury — leave it entirely.

Three steps

The short version

Warm the oil between your palms before every area. Three to five strokes over the same strip, then move on — do not go back and forth over the same line.

See the detail for each area below.

Step 1

Outer forearm — upward

Triple burner meridian · 手少阳三焦经

Turn the palm away so the outside of the forearm faces you. Start at the wrist crease, in the middle of the flat of the forearm, and scrape up toward the elbow in short strokes. Three to five over the same strip.

The line runs up the centre of the outer forearm, over the wrist crease and past the elbow.
Stop at the elbow. Do not carry this stroke up over the shoulder — that is a different area.
It should feel like a slow drag, not a scrub.

Upward · wrist to elbow

Step 2

Inner upper arm — downward

Heart meridian · 手少阴心经

Let the arm hang loose. Start just below the armpit, on the inner edge of the biceps, and scrape down toward the elbow. Three to five short strokes, same strip each time.

Stay on the inner edge — the line runs along the inside of the arm, not up the middle.
Keep the pressure light. This side carries the artery.
If you lift the arm to reach it, prop the elbow instead of holding it up.

Downward · armpit to elbow

Step 3

The elbow

Where the two lines meet

Both lines finish at the elbow. Rather than driving the tool into the joint, circle the area lightly with the rounded edge, then stop for the day.

Small circles, light pressure — the point of the elbow bone and the tendons there are close to the surface.
Three to four circles is plenty.

Circles only · no scraping over the joint

How hard, and how often

Pressure

Too light

Right — skin warms slightly

Firm

Too hard — stop

Nothing happensLight redness is normalDiscomfort, not painSharp pain

Marks that look like bruising are the normal result and fade on their own over about a week. Start lighter than you think you need. Chasing marks is what causes skin damage.

Area	How long	How often
Outer forearm	3–5 min	2–3 times a week
Inner upper arm	3–5 min	2–3 times a week
Elbow	1–2 min	Daily is fine

Wait for any marks to fade before you scrape the same strip again. Do both arms in one session, then leave it alone for a couple of days.

Step-by-step routine

Free step-by-step routine

This page covers two areas. The full routine covers the arm, neck, back, face and legs in the order they are actually done, with the timing for each.

See all four areas on the main gua sha page →

Want the whole routine, not just the arm?

The 21-Day Ritual gives you every area, in order, with the pressure and timing written out — plus the cheat-sheet PDF.

Get the 21-Day Ritual — $59 Or start with the $12 Starter Kit

Educational reference only — not medical advice. Do not use this to replace advice from your doctor. If you have a bleeding disorder, are pregnant, or have a skin infection, do not scrape without asking a clinician first.

More areas: main gua sha page · face and jawline · legs and ankle · neck and drainage · safety and contraindications