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Dry Brushing, Body Scraping, Gua Sha
source:The New York Times 2022-09-19 [Health]
Lymphatic Health Is All the Rage

These wellness practices — which center on one invisible network of vessels and nodes — have soared in popularity in recent years. Should you try them?


Scroll through TikTok and Instagram for long enough and you’ll likely find someone scraping, brushing or massaging their skin in pursuit of better health or an enhanced appearance. Testimonies abound — about body scraping to loosen stiff limbs, gua sha for a sculpted jawline, vibrating facial massagers to reduce puffiness, dry brushing for “detoxing.” Such posts have amassed tens of millions of views on TikTok in recent years, with celebrities like Gwyneth Paltrow and Elle Macpherson attesting to their effectiveness.

All of these trendy techniques center on the same concept: promoting the circulation of a colorless, watery fluid called lymph, which ferries white blood cells to and from the body’s organs and transports waste from cells and tissues to the lymph nodes, where it is filtered and fed back into the bloodstream. The sweeping movement of dry brushing — in which you’re supposed to whisk a stiff-bristled brush in small circles all over your body — and the pulses of a vibrating facial massager are supposed to gently knead out any potential blockages in lymphatic flow. Gua sha, in which you scrape a stone or metal tool along the contours of your face; body scraping, which is a full-body version of gua sha that uses similar tools; and jade rolling, in which you roll a rounded stone tool over your face, are techniques intended to physically push, or drain, lymphatic fluid toward the lymph nodes, where it is filtered and then moved back into the bloodstream.

Missing from the testimonies are answers to some key questions: Do these practices actually stimulate lymphatic flow? And if so, what results can you really expect to get?

How the lymphatic system works

In many ways, the lymphatic system is the underappreciated sibling of the circulatory system, less well-known and less researched than its counterpart, said Shan Liao, associate professor of immunology at the University of Calgary in Alberta, Canada. But it is essential for proper immune function and cellular health. Lymph naturally builds up in the body’s tissues and then travels through an intricate network of vessels into lymph nodes, which act as a filtration system before the fluid returns to the bloodstream, Dr. Liao said.

Lymph isn’t pumped like blood — “we don’t have a lymphatic heart,” she said, though lymph vessels do pulse a little. They can also piggyback off the pulse of blood vessels, using that force to help with movement. But lymph flow is mostly generated when we breathe, stretch and move.

When lymphatic fluid does not move through vessels correctly, it can accumulate in the body’s tissues, resulting in swelling, or lymphedema, Dr. Liao said. This can lead to tightness or heaviness in your limbs, a restricted range of motion and changes in skin thickness or coloration. Lymphedema is mostly a problem in cancer patients and people coming out of surgery, since lymph vessels can be blocked by tumors or damaged by radiation therapy, and surgical incisions can sever their connections. Additionally, about one in 100,000 people have genes that lead them to develop chronic lymphedema in childhood or early adulthood. Swelling from any kind of lymph accumulation can make people more prone to recurring infections, especially when left untreated, Dr. Liao said, since immune cells cannot efficiently travel to their targets.

For most people in generally good health, sufficient lymph flow will carry on whether you take measures to care for your lymphatic system or not.

Nonetheless, generations of alternative-medicine practices — from traditional Chinese medicine to naturopathy to Ayurveda — have used lymphatic massage techniques for “restoring balance” to the body and bolstering immune function in healthy people. While they’re not strictly necessary for most people to maintain health, these methods are a way for you to become attuned to the natural fluctuations of your body, said Dr. Melissa Ventimiglia, an assistant professor of family medicine at the New York Institute of Technology College of Osteopathic Medicine in Old Westbury, N.Y. They can also have immediate, albeit temporary, effects on the appearance of your skin.

What the experts say about lymphatic drainage

References to lymph in traditional Chinese medicine go back 2,000 years, said Yumi Ridsdale, a Chinese medicine practitioner in Ontario, Canada. “They of course didn’t use the words ‘lymphatic’ system — they didn’t have such a word,” but traditional Chinese medicine emphasized the importance of lymph circulation, and contemporary practitioners of traditional Chinese medicine often incorporate gua sha, body scraping and dry brushing into their treatments.

Academic studies on how well these techniques work are scarce, and tend to be limited by small sample sizes. The existing research suggests that a related technique called manual lymphatic drainage massage, in which therapists lightly rub and tap certain body parts to encourage lymph movement and drainage, are effective for reducing swelling in cancer patients. Other research, while also limited, suggests that gua sha and facial massage rolling could increase blood circulation and the delivery of oxygen to the skin, which is necessary for new cell growth.

Massaging your lymph can help restimulate its flow and prevent a feeling of “bodily congestion,” Dr. Ventimiglia said — especially after sleeping or sitting for long periods of time. You may also notice immediate changes to your skin and face — a reduction in puffiness or a more sculpted look — with gua sha or similar techniques, Ms. Ridsdale said, though these effects only last a few hours at most.

The keys to keeping lymphatic health in balance are the same ones that apply to your health generally: moving your body, healthy eating, deep breathing. When it comes to lymphatic drainage, and all the related massage tools and techniques, use them if you enjoy them, Dr. Ventimiglia said.

How to try it yourself

You can massage your face and body with just your fingertips, knuckles or the palms of your hands, or with rollers, scrapers or dry brushes. The best rule of thumb for the body is to start from your toes and fingertips and move toward your core. When dry brushing, use small circular motions all over your limbs and abdomen.

When massaging your face, work from the midline of your face and move up and out. Some people pull their knuckles across their jawline or cheekbones, others recommend pushing the heels of your hands by the sides of your mouth and rolling them up toward your temples (imagine your hand is doing the worm as it pushes up toward your ears).

Since lymphatic vessels have one-way valves, the whole network can only circulate in one direction, Dr. Ventimiglia said, so you should massage in the same direction as your existing lymph flow. Massaging against the natural flow is not necessarily harmful, she said, but it isn’t helpful either.

If you’re not sure which direction to massage in, “you can easily learn about lymphatic maps from YouTube or books, it’s not that hard,” Ms. Ridsdale said. Even Martha Stewart’s website has a guide. But keep in mind that “more is not better,” she added. Ten to 20 minutes on any one area is more than enough to get things flowing.

There are also a few big lymph nodes that you can help drain by applying a little pressure, Ms. Ridsdale said: In the armpits, above your collarbones, in your groin and the space under your ear and behind your jaw. Helping your lymph along is one way to take a moment to think about how your body is feeling at any given time, Ms. Ridsdale said, adding that in her view, “everybody should do it.”