Cupping Therapy: Benefits, Marks and What to Expect

Cupping therapy places cups on the skin, usually on the back and shoulders, and uses suction to lift the skin and the tissue beneath it. It leaves round marks that fade over a few days to two weeks. Many people find it eases tight muscles for a while, but the research is limited. This guide explains the types of cupping, what the marks mean, what a session is like and who should avoid it.

What is cupping therapy?

In cupping, the therapist creates suction inside a cup and places it on the skin, which is drawn up a little way into the cup. The cups stay in place for 5 to 10 minutes, or are glided over oiled skin. Cups can be made of glass, plastic, silicone or bamboo.

Cupping is old and found in many cultures. It is part of traditional Chinese medicine, and in the Middle East and the Muslim world wet cupping is known as hijama. It became widely known in 2016, when swimmers at the Rio Olympics, including Michael Phelps, competed with round purple marks on their shoulders.

Types of cupping

• Dry cupping: suction only. The cups stay still on the skin for a few minutes.

• Wet cupping (hijama): after dry cupping, the therapist makes tiny scratches in the skin and puts the cup back on to draw out a small amount of blood. It needs sterile, single-use blades and a trained practitioner.

• Fire cupping: a flame briefly heats the air inside a glass cup, which creates suction as it cools on the skin.

• Pump cupping: a small hand pump draws air out of the cup, so there is no flame and the suction is easy to adjust.

• Gliding cupping: the cup is moved over oiled skin like a massage stroke, and it leaves lighter marks.

Cupping therapy benefits

Most research on cupping looks at pain. Reviews, summarised by the US National Center for Complementary and Integrative Health, suggest cupping may ease neck and lower back pain for a short time. The studies are mostly small and of low quality, so it is hard to say how much of the effect comes from the cupping itself.

What people say they notice:

• tight shoulders and back feel looser;

• a warm, heavy, relaxed feeling in the area afterwards;

• relief after training, surfing or long hours at a desk.

Cupping does not remove toxins, and it is not a treatment for illness.

What do cupping marks mean?

The round marks come from suction pulling blood out of tiny blood vessels under the skin, much like a bruise. They range from pink to dark purple and usually fade within a few days to two weeks.

In traditional Chinese medicine, practitioners read the colour as a sign of "stagnation" in the area. Medically, the colour mostly depends on how strong the suction was, how long the cup stayed on, and your skin. Darker marks do not mean more toxins. Marks are often darker where muscles are tight and the first time you have cupping, and lighter in later sessions.

What happens during a cupping session

1. The therapist asks about your health, medicines and skin, then warms the back with a short massage and a little oil.

2. Cups go on the back and shoulders, usually four to ten at a time, and stay for 5 to 10 minutes.

3. The cups come off with a gentle release of the seal, and the area is massaged again.

Cupping feels like a firm pull or tightness, not a sharp pain. Tell the therapist if a cup feels too strong, and they can release some of the suction.

After cupping

• Keep the area covered and warm for the rest of the day.

• Keep strong sun off the marks for a day or two, as the skin can be sensitive.

• Drink water and take it easy. Some people feel tired or a little light-headed afterwards.

• After wet cupping, keep the small cuts clean and dry until they heal.

Who should avoid cupping

Skip cupping, or check with your doctor first, if you:

• are pregnant;

• have a bleeding disorder or anaemia, or take blood-thinning medicine;

• have sunburn, a rash, broken skin, or an infection where the cups would go;

• have diabetes, a heart condition or a pacemaker;

• have a fever or feel unwell.

The usual side effects are the marks themselves, some soreness and, rarely, small blisters. Fire cupping can burn the skin, and wet cupping can lead to infection if the equipment isn't sterile.

In short

Cupping uses suction cups on the back and shoulders. It may ease muscle pain for a while, the evidence is limited, and the marks are harmless bruise-like spots that fade within two weeks. If you are in Bali, our cupping therapy in Seminyak uses solid cups and a small hand pump, with no flame, at our spa or at your villa or hotel.

Frequently asked questions

How long do cupping marks last?

Usually a few days to two weeks, depending on the suction, how long the cups stayed on and your skin.

Does cupping hurt?

It shouldn't. It feels like a strong pull on the skin. Tell the therapist if a cup feels too tight, and they can ease the suction.

What do dark cupping marks mean?

That more blood was drawn into the skin, often because of stronger or longer suction, or tight muscles. They are not a sign of toxins and fade like a bruise.

How often can you have cupping?

Wait until the marks have faded before cupping the same area again, which usually means one or two weeks.

What is the difference between dry and wet cupping?

Dry cupping uses suction only. Wet cupping adds tiny scratches in the skin so the cup draws out a little blood.

Can I swim or sunbathe after cupping?

Swimming is fine once any wet cupping cuts have closed. Keep strong sun off the marks for a day or two.