"What does cupping actually do? Does a darker mark mean my body is in worse shape?" A question that comes up often is this one, and it is what people searching for "cupping" usually want answered too.

The short answer first. Cupping is a TCM external therapy that uses a cup to create negative pressure on the skin and draw the skin up into it.

The Hong Kong Department of Health's Chinese Medicine Regulatory Office describes it as using a cup as the tool, removing the air inside by burning or other means to form a vacuum, so that the cup attaches to a specific part of the body or an acupoint on the skin [CMRO].

Three numbers people ask about, as public sources state them: the cups generally stay on for no more than 10 minutes [MOHW-TW]; the marks usually fade within days to two weeks [KWH][CC-2023]; and best not to shower for 30 minutes after cupping [MOHW-TW].

Six things below: what cupping is, what happens in one session, how cup retention, sliding cupping and wet cupping differ, what the marks are, which situations to mention first or see a doctor about, and how to look after the area afterwards.

I. What cupping is: negative pressure, four common methods, and what TCM theory says

It sits within the broad "acupuncture therapies" group. The Hong Kong Chinese Medicine Regulatory Office says acupuncture therapy includes needling, moxibustion, cupping and others [CMRO]. Cupping itself does not use needles — except for method ④ below.

The World Health Organization's 2022 standard terminology for TCM defines cupping as a therapeutic method to create negative pressure by consuming the air inside the cup with fire or other methods and then placing the cup on the skin over the selected area [WHO-2022].

The four methods the same Hong Kong page lists [CMRO] — this is how each one works:

• ① Fire cupping: some of the air inside the cup is driven out with a flame, and the cup grips the skin. The traditional method Cleveland Clinic describes is setting an alcohol-soaked cotton ball alight inside the cup [CC-2023]; the same page's account is that the heat sends oxygen out of the cup, creating a vacuum, and the vacuum force pulls the skin up into the cup [CC-2023]. The WHO standard's wording: an ignited material is introduced inside the cup to consume the air, enabling the cup to suck itself onto the skin [WHO-2022].
• ② Flash cupping: the cup is attached and immediately removed, then attached again, repeatedly, until the skin flushes [MOHW-TW].
• ③ Sliding cupping: lubricant is applied first, then the attached cup is pushed and pulled back and forth along a set path [MOHW-TW].
• ④ Wet cupping (bleeding cupping): a needle lightly punctures the skin before the cup goes on [CC-2023]. This one draws blood; it breaks the skin.

Suction cups are also common now — a pump device draws the air out [MOHW-TW], which Cleveland Clinic calls the more modern approach [CC-2023]. No flame is involved. Glass, bamboo, ceramic and suction cups are all in common use [NATCM-2017].

How cup retention, sliding cupping and wet cupping actually differ, and what each requires — section III sets them side by side.

What TCM theory says. In TCM theory, cupping works through the stimulus of negative pressure, bringing blood to the local skin and causing local stasis [CMRO]; the theoretical action of the acupuncture-therapy group as a whole is to harmonise the organs, clear the meridians, and regulate qi and blood [CMRO].

Cleveland Clinic puts it directly: the suction breaks open tiny blood vessels under the skin, and that is what leaves the mark [CC-2023]. The two accounts answer different questions — one is about the theoretical action, the other about what physically happens in the skin.

For the difference between needling and cupping, see What Is Acupuncture (/what-is-acupuncture/).

II. What actually happens in one session: minutes, cups, and what it feels like

This section describes what a TCM practitioner generally does. HansMed Modern TCM's in-person service is coming soon.

• ① Before: the area to be cupped is uncovered. Common sites are the shoulders, back, lower back, buttocks and the upper parts of the limbs — fleshy, muscular areas [MOHW-TW]; the position should be comfortable and sustainable for a while [MOHW-TW]. Puli Christian Hospital's patient leaflet adds: not too hungry or too full, loose clothing, and remove any medicated plasters first [PCH-2022].
• ② How many cups: Cleveland Clinic says providers use between three and five cups on average, possibly up to seven; more than seven in one session is uncommon [CC-2023].
• ③ How long the cups stay on: the Taiwan Ministry of Health and Welfare's operating manual for the non-medical cupping trade (suction cups) says the cups should generally stay on for no more than 10 minutes, shorter for thin or delicate skin, older people and children [MOHW-TW]; Puli Christian Hospital says about 5–10 minutes [PCH-2022]. Cleveland Clinic says only "several minutes" [CC-2023]. Your practitioner may adjust this — follow what they tell you.
• ④ What it feels like: often described as "tight", "achy" or "slightly swollen". Cleveland Clinic's wording: cupping should not cause pain, though you may feel some skin tightness during the procedure [CC-2023].
• ⑤ If you feel unwell during it: for local pain, the usual handling is to release some suction or remove the cup at once [MOHW-TW]. If you feel dizzy, chest-tight, faint, sweaty or short of breath, tell the practitioner immediately [PCH-2022] — this is what is called "cup fainting" (晕罐), which the Hong Kong regulator lists as a potential risk of improper operation [CMRO].

If it is wet cupping: China's national TCM administration's infection-control guideline requires the skin to be disinfected first and the needles to be one person, one use — disposable needles discarded after use, reusable ones sterilised for each person [NATCM-2017]. You can ask beforehand whether this is how it is done.

If you are afraid of needles or have fainted from injections before, say so beforehand — Cleveland Clinic notes that in rare instances people develop vasovagal syncope, most commonly after wet cupping in people who pass out with needle sticks [CC-2023].

Hygiene of the cups: the same guideline requires cups to be cleaned and disinfected after each person [NATCM-2017]. "Are the cups disinfected?" is a reasonable question to ask. Why these requirements go beyond ordinary cup retention — section III.

III. Cup retention, sliding cupping and wet cupping: what actually differs, and what each requires

Of the methods in section I, these three are the ones readers tend to run together. The difference is not "which is better" — different things happen in the skin, and what is required of the operator differs with them.

① Cup retention — what people usually mean by "cupping". The WHO standard's definition of cup retention is one line: leave the cup in place after suction [WHO-2022].

The Taiwan folk-practice manual spells out the end point: the cup is left on for a period, until the local skin flushes or the stasis under the skin turns purple-black, and then removed [MOHW-TW]. The skin is not broken; what is left afterwards is the mark described in section IV.

② Sliding cupping. The WHO standard's definition: lubricate the cup mouth and the selected area first, then slide the cup up and down while retaining its suction [WHO-2022]. The manual's requirement is even pressure, so the cup does not lose its seal and drop off, sliding until the local skin is slightly flushed [MOHW-TW].

Cleveland Clinic calls it running cupping: lotion or oil goes on the skin before the cups do [CC-2023]. The skin is likewise not broken; one thing is added — the lubricant. China's national TCM administration's infection-control guideline adds exactly one requirement for sliding cupping: the lubricant used must be kept clean [NATCM-2017].

③ Wet cupping (刺络拔罐). The WHO standard's definition: prick the area to be treated with a three-edged needle or lancet, then suck out blood with a cup [WHO-2022]. Of these three, it is the only one that breaks the skin and leaves blood in the cup. The same infection-control guideline therefore adds a whole further layer of requirements:

• The skin is disinfected before the needle [NATCM-2017].
• Needles are one person, one use: a disposable needle goes straight into a dedicated sharps container as injurious medical waste after use, and reuse is strictly prohibited; a reusable needle must be sterilised for each person [NATCM-2017].
• Cups already have to be cleaned and disinfected after each person [NATCM-2017]; a cup that has held blood — the guideline calls it a 血罐, a "blood cup" — when disinfected by hand in a chlorine solution, needs four times the concentration required for an ordinary cup: 2000 mg/L available chlorine against 500 mg/L (the guideline also allows other methods, such as moist-heat disinfection) [NATCM-2017].
• After the cups come off, any broken skin is covered with a sterile dressing [NATCM-2017].

Why the logic runs this way. The guideline's reference list includes the national standard on occupational protection against bloodborne pathogens [NATCM-2017]. Why the needle and the blood cup carry more requirements than plain retention — this is the article's reading, not the guideline's sentence — comes down to one word: blood.

These are standards for medical institutions, not a checklist for you to run at home. Their one use at a consultation: if the practitioner mentions wet cupping, ask "Are the needles single-use? Are the cups disinfected?"

IV. The marks: what they are and why they fade — blood under the skin, colour, how long, whether they scar

What the mark is. Cleveland Clinic's account has two steps: the suction first draws fluid into the treated area, and that force expands and breaks open the tiny blood vessels (capillaries) under the skin [CC-2023].

Kiang Wu Hospital's Chinese medicine department puts it more directly: the bruising is caused by the negative pressure rupturing the capillaries under the skin, which bleed [KWH]. So the mark is blood under the skin — that sentence is this article's integration of the two pages.

The colour ranges from light pink through deep red to dark purple. The Hong Kong regulator's wording: if the skin shows purplish bruising after cupping, this is generally normal and will fade on its own [CMRO].

How it differs from a bruise from a knock. Cleveland Clinic: the marks are red and round [CC-2023]; although they look like bruises, they are not true bruises that injure muscle fibres [CC-2023].

How long they last. Kiang Wu Hospital's Chinese medicine department (Macau): in general the bruising gradually fades within a few days to a week [KWH]. Cleveland Clinic: they should fade in a week or two [CC-2023]. NHS Tayside's patient leaflet: they can last for several days or weeks [NHS-TAY]. The combined span of the three is a few days to about two weeks.

Why they fade. All three pages say the marks fade on their own [CMRO][KWH][CC-2023]. This article's reading: it is blood under the skin and the skin itself is not broken, so what fades is blood, not a wound — that is not a quotation.

How the body clears blood from under the skin, none of the pages cited here explains, and this article does not fill that in for them.

What the depth of colour means. Retention time is tied to the state of the skin: the Taiwan folk-practice manual requires shorter retention for delicate skin [MOHW-TW], and Puli Christian Hospital says too long may raise blisters [PCH-2022]. Those two pages speak to time and blisters, not to colour.

The same manual writes the end point of cup retention as: leave the cup until the local skin flushes or the stasis under the skin turns purple-black, then remove it [MOHW-TW].

In other words, in that manual the colour is the operator's signal that the cup has been on long enough — that is this article's reading of the sentence. Cleveland Clinic's page does not say what determines the colour.

The depth of a mark is not a gauge of the state of your body — that sentence is this article's position, not a quotation. "Darker means more toxins": none of the pages this article cites presents that as a verifiable fact.

Do they scar? The marks themselves fade [CMRO] — they are, as above, blood under the skin. Scarring does appear on Cleveland Clinic's list of risks, alongside skin infection and burns [CC-2023] — so what needs looking after is a blister, a burn or broken skin, not the mark itself.

V. Situations to tell your practitioner about first, or to see a doctor about first

Cupping has its scope. The list below is by situation, not by constitution — just say which ones apply when you consult.

• On blood thinners or anticoagulants (warfarin, aspirin and similar): NHS Tayside's patient leaflet asks you to tell them beforehand [NHS-TAY]; the Hong Kong regulator lists a bleeding tendency as unsuitable for cupping [CMRO]. Say it at the start of the consultation, and never stop prescribed medication on your own.
• Pregnant, or possibly pregnant: cupping on the abdomen and lower back is not suitable in pregnancy, and improper operation there may cause miscarriage [CMRO]. Cleveland Clinic's position is more conservative: you should not have cupping while pregnant [CC-2023]. In confinement or breastfeeding — mention that too.
• Skin disease or broken skin: skin disease, skin allergy, ulcerated or broken skin — not cupped [PCH-2022]; eczema and psoriasis are on Cleveland Clinic's list of reasons to avoid cupping [CC-2023].
• Children: children under six should be assessed by the practitioner first [PCH-2022]; shorter retention and fewer cups for children [MOHW-TW].
• Older adults: over seventy should be assessed by the practitioner first [PCH-2022]; fewer cups and shorter time for the elderly and frail [MOHW-TW].
• Fever or an acute illness: acute serious illness is listed as a contraindication [MOHW-TW]. See a doctor first, not the cups.
• Cardiovascular disease, epilepsy, anaemia, clotting problems, or a pacemaker: all of these are on Cleveland Clinic's list of reasons you should not have cupping [CC-2023]. Follow your doctor's diagnosis and treatment, and tell the practitioner.
• Your first time: fewer cups and a shorter time for first-timers [MOHW-TW]. Saying "it's my first time" is enough for the practitioner to plan around.

If you are taking any medication, be sure to tell the practitioner — and never stop prescribed medication on your own. TCM and Western medicine are complementary, not either-or.

If burns, blisters, broken skin, severe pain, or signs of infection develop at the cupping site, please contact your practitioner. If you experience fever, dizziness, or difficulty breathing, call 999 now, or go to the nearest hospital emergency department.

If you are experiencing seizures, loss of consciousness, or high fever, call 999 now, or go to the nearest hospital emergency department, rather than considering cupping.

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

VI. Aftercare: what TCM theory says, and the usual practice

In TCM theory, after acupuncture or cupping the body's pores are in an open state and it is easy for wind and cold to get in [KWH]. So the practices the theory attaches are keeping warm and staying out of draughts. Kiang Wu Hospital's Chinese medicine department lists these points [KWH]:

• ① Avoid direct wind and air-conditioning draughts, keep time in cold environments short, and adjust clothing to the weather [KWH].
• ② Keep the skin clean and dry to avoid infection [KWH]; if the skin is broken after the cups come off, cover it with a sterile dressing [NATCM-2017].
• ③ Rest: avoid overexertion and strenuous exercise [KWH].
• ④ Eat light: avoid spicy, oily and cold or raw foods, and drink adequate water [KWH]. The Taiwan folk-practice manual: no cold or raw food straight after cupping [MOHW-TW]; Puli Christian Hospital: drink a cup of warm water, and never iced water [PCH-2022].
• ⑤ Do not scratch [KWH].

Showering. The Taiwan folk-practice manual's wording: no bathing within 30 minutes [MOHW-TW]. The manual gives no reason.

Among the pages this article cites, the nearest explanation is Kiang Wu Hospital's line: after cupping the pores are in an open state and it is easy for wind and cold to get in [KWH] — but that sentence is about draughts and cold environments, not bathing.

So "no cold shower" is a general practice extended from the theory's concern (catching cold): warm water that day, no cold showers, no cold-water soaking; dry off and keep warm afterwards.

This is practice, not a promise of a result; if your practitioner gives you a different timing, follow theirs.

Before cupping, the advice runs the other way: shower beforehand and keep the skin clean [NATCM-2017].

How often. The Taiwan folk-practice manual: cupping the same area again is best spaced at least 3 days apart, and depends on the skin colour and the person's condition [MOHW-TW]. Whether there is a second session and how far apart — that is the decision of the practitioner who has seen you. Follow their written instructions.

Fitting it into Malaysian life

• The air-conditioned office: going straight back to sit under the vent is what Kiang Wu Hospital's "avoid direct air-conditioning draughts" looks like day to day in Malaysia [KWH]. Put on a jacket, or turn the vent away.
• Riding home on a motorbike: wind straight onto a freshly cupped back. Bring a jacket, or take a Grab that day.
• Kopi peng, teh ais: no cold or raw food straight after cupping [MOHW-TW]; make it warm that day and go back to iced the next.
• Pool, beach, cold shower: skip them that day — this is the Malaysian version of "no cold-water soaking". No shower within 30 minutes is the Taiwan folk-practice manual's number [MOHW-TW]; the rest is usual practice.
• The pharmacy (Guardian, Watsons): sterile gauze is what Puli Christian Hospital recommends for covering a blister [PCH-2022]; a large blister is covered with a sterile dressing [MOHW-TW]. The pharmacy stocks both.
• Cupping during confinement: tell the practitioner at the start that you are postnatal or breastfeeding (section V).
• Klinik Kesihatan or a clinic: for the non-emergency situations in section V — a large blister, bruising that does not fade, signs of infection — the nearest government clinic is the door to knock on; fever, dizziness or difficulty breathing is still 999.
• Home cupping sets from online shops or direct sellers: this article is about cupping performed by a TCM practitioner. The retention times and cautions above are not written for self-use.

Common questions

How long do the cups stay on? The Taiwan Ministry of Health and Welfare's operating manual for the non-medical cupping trade (suction cups): generally no more than 10 minutes, shorter for delicate skin, older people and children [MOHW-TW]. Puli Christian Hospital: about 5–10 minutes; too long may raise blisters [PCH-2022]. Cleveland Clinic: several minutes [CC-2023]. Your practitioner may shorten it depending on your situation — follow what they tell you.

How long do the marks take to fade? The mark is left by capillaries under the skin that the negative pressure ruptured and that bled [KWH] (section IV). Kiang Wu Hospital's Chinese medicine department: gradually within a few days to a week [KWH]. Cleveland Clinic: a week or two [CC-2023]. NHS Tayside: several days or weeks [NHS-TAY]. If the marks are very large or last a long time, see a doctor [KWH].

Can I shower straight after cupping? The Taiwan folk-practice manual's number is: no bathing within 30 minutes [MOHW-TW]. The manual gives no reason for the 30 minutes (section VI). The usual practice is warm water that day, no cold showers, no cold-water soaking; dry off and keep warm. If your practitioner gives you a different timing, follow theirs.

Can I sit in air-conditioning after cupping? Kiang Wu Hospital's advice is to avoid direct wind and air-conditioning draughts, keep time in cold environments short, and keep warm [KWH]. In Malaysian terms: do not sit directly under the vent, put on a jacket, or turn the vent away.

Will the marks scar? The marks themselves fade on their own [CMRO]; Cleveland Clinic says they are not true bruises that injure muscle fibres [CC-2023]. Scarring is on Cleveland Clinic's list of risks, alongside skin infection and burns [CC-2023] — so do not burst blisters, cover burns and broken skin and contact your practitioner; the mark itself needs no treatment.

Does cupping hurt? Cleveland Clinic: it should not cause pain, though you may feel some skin tightness during the procedure; afterwards you may feel bruised and slightly sore, but you should not have severe discomfort [CC-2023]. Kiang Wu Hospital: mild pain generally eases within a few hours to a day [KWH]. If there is local pain during the session, the usual handling is to release some suction or remove the cup at once [MOHW-TW] — say so on the spot. For what a first acupuncture session feels like, see Does Acupuncture Hurt the First Time (/does-acupuncture-hurt-first-time/).

In closing

✅ Remember these:

1. Cupping is a TCM external therapy in which negative pressure draws the skin up [CMRO]; of the four methods, the one that breaks the skin is wet cupping [CMRO][CC-2023].
2. The cups stay on for generally no more than 10 minutes [MOHW-TW], three to five cups on average [CC-2023], and it should not hurt [CC-2023].
3. The dividing line between cup retention, sliding cupping and wet cupping is whether the skin is broken; of the three, the one that leaves blood in the cup is wet cupping [WHO-2022], which is why the rules for needles and cups are stricter [NATCM-2017].
4. The marks are the trace of capillaries under the skin broken open and bleeding [KWH][CC-2023], and fade within days to two weeks [KWH][CC-2023]; their depth is not a gauge of how well or unwell you are.
5. Blood thinners, pregnancy, broken skin, children, older adults, fever, and the other situations listed in section V — say so at the start.
6. Afterwards: keep warm and out of draughts [KWH], skin clean and dry [KWH], no shower for 30 minutes [MOHW-TW], no iced water [PCH-2022].

❌ Do not do these:

1. Do not burst a blister yourself [PCH-2022].
2. Do not stop medication your doctor prescribed because you have started cupping.
3. Do not treat cupping as a weight-loss method — weight management is a matter of diet, exercise and overall habits.

👉 If you are unsure whether cupping is suitable for your situation, you are welcome to book an online consultation with HansMed, where a practitioner registered under the T&CM Act 2016 can assess it with you. Cupping is an in-person procedure; the in-person service is coming soon.

Reviewed by Mr. Lim Gao Hong, a TCM practitioner registered with Malaysia's Traditional and Complementary Medicine Council under the T&CM Act 2016, practising in general TCM, pain management and internal medicine.

Sit with a licensed TCM practitioner from wherever you are.

HansMed Modern TCM

「拔罐到底是在做什么？罐印越深是不是代表身体越差？」不少读者常问这句话，搜「拔罐」的人常想知道同样的事。

先给答案。 拔罐是用罐具在皮肤上造出负压、把皮肤吸起来的一种中医外治法。

香港衞生署中医药规管办公室的说明是：以罐为工具，利用燃烧或其他方法排除罐内空气，形成负压，使罐吸附于身体特定部位或皮肤穴位上 [CMRO]。

三个常被问的数字，公开资料是这样写的：一次留罐一般不超过 10 分钟 [MOHW-TW]；罐印一般在数天到两周内消退 [KWH][CC-2023]；拔罐后 30 分钟内不宜洗澡 [MOHW-TW]。

下面 6 个重点：拔罐是什么、一次会发生什么、留罐／走罐／刺络拔罐差在哪里、罐印是什么、哪些情况要先说或先就医、拔完怎么照顾。

一、拔罐是什么：负压、四种常见做法，以及中医理论怎么说

它属于「针灸疗法」这一大类。 香港中医药规管办公室说针灸疗法包括针法、灸法和拔罐等 [CMRO]。拔罐本身不用针——除了下面第 ④ 种。

世界卫生组织 2022 年的中医术语标准给「拔罐法」的定义是：以火或其他方法耗去罐内空气造成负压，再把罐放到选定部位的皮肤上的一种治疗方法 [WHO-2022]。

同一份香港说明列出的四种做法 [CMRO]，各自的操作是这样的：

• ① 拔火罐：用火把罐内的空气排掉一部分，罐子就吸住皮肤。克利夫兰诊所描述的传统做法，是把蘸了酒精的棉球点燃放进罐内 [CC-2023]；同一页的说法是：加热把罐内的氧气赶出去、形成真空，真空的力量把皮肤吸进罐里 [CC-2023]。世卫标准的写法是：把点燃的物料放进罐内耗去空气，罐就自己吸到皮肤上 [WHO-2022]。
• ② 闪罐：罐吸住随即取下，再吸、再取，反复到局部皮肤潮红 [MOHW-TW]。
• ③ 走罐：先在皮肤涂润滑剂，罐吸住后沿一定路线来回推拉 [MOHW-TW]。
• ④ 刺络拔罐：先用针在皮肤上轻刺，再上罐 [CC-2023]。这一种会见血，是有创操作。

现在也常见抽气罐——用抽气装置把罐内空气抽出 [MOHW-TW]，克利夫兰诊所称之为较现代的做法 [CC-2023]。这一种不用火。玻璃罐、竹罐、陶罐、抽气罐都是常用器具 [NATCM-2017]。

留罐、走罐、刺络拔罐三种实际差在哪里、各要求什么，第三节比一比。

中医理论怎么说。 中医理论认为，拔罐透过负压刺激，造成局部皮肤充血、瘀血 [CMRO]；针灸疗法这一大类在理论上的作用，是协调脏腑、疏通经络、调和气血 [CMRO]。

克利夫兰诊所的描述比较直接：吸力会把皮下的微血管拉破，留下的就是罐印 [CC-2023]。两种说法回答的是不同的问题——一个说理论上的作用，一个说皮肤上实际发生的事。

针法与拔罐的差别，见〈什么是针灸〉（/what-is-acupuncture/）。

二、一次拔罐实际会发生什么：几分钟、几个罐、什么感觉

本节描述的是中医师一般的做法。汉方现代中医的线下亲诊服务即将推出。

• ① 之前：露出要拔的部位。常用部位是肩、背、腰、臀、四肢近端等肌肉丰厚处 [MOHW-TW]；姿势以舒适、能维持一段时间为原则 [MOHW-TW]。埔里基督教医院的卫教单张提醒：不宜太饿或太饱，穿宽松衣物，先把贴着的膏药移除 [PCH-2022]。
• ② 罐数：克利夫兰诊所的说明是，平均用 3 到 5 个罐，也可能到 7 个；一次超过 7 个并不常见 [CC-2023]。
• ③ 留罐时间：台湾卫福部中医药司为民俗调理业（非医疗的拔罐服务，用抽气罐）编的操作手册写「一般留罐时间不宜超过 10 分钟」，皮肤薄弱、乐龄人士及儿童则缩短 [MOHW-TW]；埔里基督教医院写约 5～10 分钟 [PCH-2022]。克利夫兰诊所只写「几分钟」[CC-2023]。您的医师可能依情况调整，以医师的说明为准。
• ④ 感觉：常被描述为「紧紧的」、「酸酸的」或「有点胀」。克利夫兰诊所的说法是：拔罐不应该痛，但过程中可能感到皮肤紧绷 [CC-2023]。
• ⑤ 过程中不舒服怎么办：局部疼痛，一般做法是减压放气或立即起罐 [MOHW-TW]。若出现头晕、胸闷、眼花、冒汗、呼吸不顺，请立刻告诉医师 [PCH-2022]——这是所谓的「晕罐」，香港中医药规管办公室把它列为操作不当时的潜在风险之一 [CMRO]。

如果是刺络拔罐：中国国家中医药管理局的感染防控指南要求皮肤先消毒、针具一人一用——一次性针具用后废弃，可重复使用的须一人一用一灭菌 [NATCM-2017]。您可以事前问医师是不是这样做。

怕针、曾经打针晕倒的人，请事先说——克利夫兰诊所提到，极少数人会出现血管迷走性晕厥，以打针会晕的人做湿拔罐后最常见 [CC-2023]。

器具卫生：同一份指南要求罐具一人一用一清洗一消毒 [NATCM-2017]。您可以直接问：「罐是消毒过的吗？」这是合理的问题。这些要求为什么比一般留罐多，见第三节。

三、留罐、走罐、刺络拔罐：实际差在哪里，各要求什么

第一节的做法里，读者常混在一起的是这三种。差别不是「哪种比较好」，而是皮肤上实际发生的事不同，操作上要求的东西也跟着不同。

① 留罐——一般说的「拔罐」。 世卫标准给「留罐法」的定义只有一句：吸住后把罐留在原位 [WHO-2022]。

台湾的民俗调理操作手册把终点写得具体：留置一段时间，使局部皮肤潮红，或皮下瘀血呈紫黑色后再取下 [MOHW-TW]。皮肤不破，之后留下的是第四节说的罐印。

② 走罐。 世卫标准的定义：先在罐口和选定部位涂润滑剂，再在保持吸力的情况下上下滑动罐 [WHO-2022]。手册的要求是用力均匀、以防罐杯漏气脱落，滑到局部皮肤略呈潮红即可 [MOHW-TW]。

克利夫兰诊所把它叫 running cupping：上罐前先在皮肤上涂乳液或油 [CC-2023]。皮肤同样不破，多了一样东西——润滑剂。中国国家中医药管理局的感染防控指南对走罐只多一条：所使用的润滑剂应保持清洁 [NATCM-2017]。

③ 刺络拔罐。 世卫标准的定义：用三棱针或采血针先刺治疗部位，再用罐把血吸出 [WHO-2022]。这三种里，只有它会刺破皮肤、罐里会有血。同一份感染防控指南对它的要求，因此多出一整层：

• 针刺前皮肤要消毒 [NATCM-2017]。
• 针具一人一用：一次性针具用后按损伤性医疗废物直接放入专用利器盒，严禁重复使用；可重复使用的须一人一用一灭菌 [NATCM-2017]。
• 罐具本来就要一人一用一清洗一消毒 [NATCM-2017]；装过血的罐，指南另叫「血罐」，手工消毒时含氯消毒液的浓度要求是普通罐的四倍——有效氯 2000 mg/L 对 500 mg/L（指南也允许湿热消毒等其他方法）[NATCM-2017]。
• 起罐后如有皮肤破损，用无菌敷料覆盖 [NATCM-2017]。

为什么是这个逻辑。 指南的参考文献里列了《血源性病原体职业接触防护导则》[NATCM-2017]。针具和血罐的要求为什么比留罐多——这是本文的读法，不是指南原句——差别就在一个字：血。

这些是医疗机构内部的标准，不是给您在家核对的清单。看诊时的用法只有一种：医师提到刺络拔罐，就问一句「针是一次性的吗？罐是消毒过的吗？」

四、罐印是什么，为什么会消：皮下的血、颜色、多久消、会不会留疤

罐印是什么。 克利夫兰诊所的说明分两步：吸力先把液体引到被吸的部位，这股力量把皮下的微血管撑开、拉破 [CC-2023]。

镜湖医院中医科说得更直接：瘀斑是负压吸引导致皮下毛细血管破裂出血所致 [KWH]。所以罐印是皮下的血——这一句是本文把两页放在一起的整理。

颜色从淡粉到深红甚至暗紫都有。香港中医药规管办公室的说法：拔罐后若局部皮肤呈青紫瘀血，一般均属正常现象，可自行消退 [CMRO]。

它和撞伤的瘀青差在哪里。 克利夫兰诊所：罐印是红色、圆形的印记 [CC-2023]；看起来像瘀青，但不是伤到肌肉纤维的真正瘀伤 [CC-2023]。

多久消。 澳门镜湖医院中医科：一般情况下，瘀斑会在数天至一周内逐渐消退 [KWH]。克利夫兰诊所：应在一到两周内消退 [CC-2023]。NHS Tayside 的病人单张：可持续数天或数周 [NHS-TAY]。三个说法合起来的区间，是数天到两周左右。

为什么会消。 三页都说它会自行消退 [CMRO][KWH][CC-2023]。本文的读法是：它是皮下的血，皮肤本身没有破，所以消退的是血，不是伤口——这不是引文。

身体怎么把皮下的血清掉，本文引用的页面没有写，本文也不替它们补。

颜色深浅代表什么。 留罐时间与皮肤状况有关：台湾的民俗调理操作手册要求皮肤薄弱者缩短留罐时间 [MOHW-TW]，埔里基督教医院说留太久可能起水泡 [PCH-2022]。这两页说的是时间和水泡，不是颜色。

同一份手册把「留罐」的终点写成：留到局部皮肤潮红，或皮下瘀血呈紫黑色后再取下 [MOHW-TW]。

换句话说，在这份手册里，颜色是操作者判断留罐够了没有的信号——这是本文对那句话的读法。克利夫兰诊所的页面没有写颜色由什么决定。

罐印深浅不能当成身体状况的判读工具——这一句是本文的立场，不是引文。「越深毒素越多」，本文引用的资料里没有一页把它当成可验证的事实来写。

会不会留疤。 罐印本身会消退 [CMRO]，上面说了它是皮下的血。留疤出现在克利夫兰诊所的风险清单上，与皮肤感染、烫伤并列 [CC-2023]——所以要照顾好的是水泡、烫伤和破皮，不是罐印本身。

五、这些情况请先告诉医师，或先就医

拔罐有其适用范围。下面按情况分，不按体质分——看诊时照着说，就够了。

• 正在服用薄血药或抗凝血药物（warfarin、aspirin 等）：NHS Tayside 的病人单张要求事先告知 [NHS-TAY]；香港中医药规管办公室把「有出血倾向者」列为不宜拔罐 [CMRO]。请在问诊一开始就说，切勿自行停药。
• 怀孕或可能怀孕：孕妇的腹部及腰部不宜拔罐，操作不当可能引起小产 [CMRO]。克利夫兰诊所的立场更保守：怀孕期间不应拔罐 [CC-2023]。坐月子、哺乳中也请一并说明。
• 皮肤有病或破损：皮肤病、皮肤过敏、溃伤、破裂处不拔 [PCH-2022]；湿疹、牛皮癣在克利夫兰诊所的不建议名单上 [CC-2023]。
• 儿童：六岁以下的儿童应由医师评估 [PCH-2022]；儿童留罐时间缩短、罐数宜少 [MOHW-TW]。
• 乐龄人士：七十岁以上应由医师评估 [PCH-2022]；年迈体弱者罐数宜少、时间宜短 [MOHW-TW]。
• 发烧或急性病中：急性严重疾病列为禁忌 [MOHW-TW]。先看医生，不是先拔罐。
• 有心血管疾病、癫痫、贫血、凝血问题，或装有心脏起搏器：这几项都在克利夫兰诊所「不应拔罐」的名单上 [CC-2023]。请以西医的诊断与治疗为主，并把这些情况告诉医师。
• 第一次拔罐：初次接受者罐数宜少、时间宜短 [MOHW-TW]。说一声「第一次」，医师就知道怎么安排。

若您正在服用任何药物，请务必告诉医师，也切勿自行停药。中医与西医是互相补位的关系，不是二选一。

若拔罐部位出现烫伤、水泡、破皮、剧烈疼痛或感染迹象，请联络您的医师。若出现发烧、晕眩或呼吸困难，请立刻拨打 999，或前往最近的医院急诊部。

若您有抽搐、意识不清或高烧的情况，请立刻拨打 999，或前往最近的医院急诊部，而不是考虑拔罐。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

六、拔罐后怎么照顾：中医理论说的，和一般的做法

中医理论认为，针灸拔罐后身体的毛孔处于张开状态，此时容易受到风寒侵袭 [KWH]。所以理论附带的做法，是保暖和避风。澳门镜湖医院中医科列的注意事项是这几条 [KWH]：

• ① 避免直接吹风、吹空调，尽量减少在寒冷环境停留，按天气增减衣物 [KWH]。
• ② 保持皮肤清洁干燥，避免感染 [KWH]；起罐后如有皮肤破损，用无菌敷料覆盖 [NATCM-2017]。
• ③ 注意休息：避免过度劳累和剧烈运动 [KWH]。
• ④ 饮食清淡，避免辛辣、油腻、生冷，适量饮水 [KWH]。台湾的民俗调理操作手册：拔罐后不宜马上吃生冷食物 [MOHW-TW]；埔里基督教医院：喝一杯温开水，切忌喝冰水 [PCH-2022]。
• ⑤ 不要搔抓 [KWH]。

洗澡。 台湾的民俗调理操作手册写的是：30 分钟内不宜沐浴 [MOHW-TW]。手册没有写理由。

本文引用的资料里，最接近的解释是镜湖医院那句：拔罐后毛孔处于张开状态，容易受到风寒侵袭 [KWH]——但它说的是吹风和寒冷环境，不是洗澡。

所以「不冲冷水」是从理论的顾虑（受寒）延伸出来的一般做法：当天用温水、不冲冷水、不泡冷水，洗完擦干、注意保暖。

这是做法，不是结果的保证；医师若给了不同的时间，以医师的为准。

拔罐前，反过来是建议先洗澡、保持皮肤清洁 [NATCM-2017]。

多久一次。 台湾的民俗调理操作手册：相同部位拔罐以间隔 3 日以上为宜，且需依皮肤颜色和身体状况而定 [MOHW-TW]。要不要做第二次、隔多久，由看过您的医师决定——以医师的书面指示为准。

大马生活里怎么安排

• 冷气房：拔完直接回办公室、坐在出风口正下方，就是镜湖医院那条「避免直接吹空调」在大马的日常形态 [KWH]。披件外套，或把出风口调开。
• 骑摩托回家：风直接吹在刚拔过的背上。带件外套，或那天改搭车。
• Kopi peng、teh ais：拔罐后不宜马上吃生冷 [MOHW-TW]；当天换温的，隔天再喝冰的。
• 泳池、海边、冷水澡：当天跳过——这是「不泡冷水」在大马的版本。30 分钟内不沐浴是台湾的民俗调理操作手册的数字 [MOHW-TW]，其余是一般做法。
• 药剂行（Guardian、Watsons）：灭菌纱布是埔里基督教医院建议用来盖水泡的东西 [PCH-2022]；水泡过大则用无菌敷料覆盖 [MOHW-TW]。两样药剂行都买得到。
• 坐月子期间想拔罐：把产后、哺乳的情况一开始就告诉医师（第五节）。
• Klinik Kesihatan 或诊所：第五节里不属于急症的情况——水泡过大、瘀血不退、感染迹象——最近的政府诊所就是入口；发烧、晕眩、呼吸困难那一项仍是 999。
• 网购或直销的家用拔罐器：本文说的是由中医师操作的拔罐。上面的留罐时间与禁忌，不是给自行操作用的。

常见问题

一次要留罐多久？ 台湾卫福部中医药司为民俗调理业（非医疗的拔罐服务，用抽气罐）编的操作手册：一般留罐时间不宜超过 10 分钟，皮肤薄弱、乐龄人士及儿童则缩短 [MOHW-TW]。埔里基督教医院：约 5～10 分钟，太久可能起水泡 [PCH-2022]。克利夫兰诊所：几分钟 [CC-2023]。您的医师可能依情况缩短，以医师的说明为准。

罐印多久会消？ 罐印是负压吸引导致皮下毛细血管破裂出血留下的 [KWH]（第四节）。镜湖医院中医科：数天至一周内逐渐消退 [KWH]。克利夫兰诊所：一到两周 [CC-2023]。NHS Tayside：数天或数周 [NHS-TAY]。范围过大或长时间不消退，去看医生 [KWH]。

拔罐后可以马上洗澡吗？ 台湾的民俗调理操作手册的数字是：30 分钟内不宜沐浴 [MOHW-TW]。30 分钟的理由，手册没写（第六节）。一般做法是当天温水、不冲冷水、不泡冷水，洗完擦干、注意保暖。医师若给了不同的时间，以医师的为准。

拔罐后可以吹冷气吗？ 镜湖医院中医科的注意事项是：避免直接吹风、吹空调，尽量减少在寒冷环境停留，注意保暖 [KWH]。在大马的日常做法：别坐在出风口正下方，披件外套，或把出风口调开。

罐印会不会留疤？ 罐印本身会自行消退 [CMRO]；克利夫兰诊所说它们不是伤到肌肉纤维的真正瘀伤 [CC-2023]。留疤在克利夫兰诊所的风险清单上，和皮肤感染、烫伤并列 [CC-2023]——所以水泡不戳破、烫伤和破皮盖好并联络医师，罐印本身不需要处理。

拔罐会不会痛？ 克利夫兰诊所：不应该痛，但过程中可能感到皮肤紧绷；之后可能觉得像瘀青、轻微酸痛，但不应有严重不适 [CC-2023]。镜湖医院：轻微疼痛一般在数小时至一天内减轻 [KWH]。过程中若局部疼痛，一般做法是减压放气或立即起罐 [MOHW-TW]——请当场说。第一次针灸的感受，见〈第一次针灸会痛吗〉（/does-acupuncture-hurt-first-time/）。

结语

✅ 记住这几点：

1. 拔罐是负压把皮肤吸起的中医外治法 [CMRO]；四种做法里，会刺破皮肤的是刺络拔罐 [CMRO][CC-2023]。
2. 一次留罐一般不超过 10 分钟 [MOHW-TW]，平均用 3 到 5 个罐 [CC-2023]，不应该痛 [CC-2023]。
3. 留罐、走罐、刺络拔罐的分水岭是皮肤破不破；三种里，罐里会有血的是刺络拔罐 [WHO-2022]，所以针和罐的要求更严 [NATCM-2017]。
4. 罐印是皮下微血管被拉破出血的痕迹 [KWH][CC-2023]，数天到两周内消退 [KWH][CC-2023]；深浅不是身体好坏的判读工具。
5. 薄血药、怀孕、皮肤破损、儿童、乐龄人士、发烧，以及第五节列出的其他情况——一开始就说。
6. 拔完：保暖避风 [KWH]、皮肤清洁干燥 [KWH]、30 分钟内不洗澡 [MOHW-TW]，不喝冰水 [PCH-2022]。

❌ 不要这样做：

1. 不要自己戳破水泡 [PCH-2022]。
2. 不要因为开始拔罐就自行停掉医生开的药。
3. 不要把拔罐当成减重的方法——体重管理是饮食、运动与整体生活习惯的事。

👉 如果您不确定「以我的情况，到底适不适合拔罐」，欢迎透过汉方中医的线上问诊，由依 2016 年 T&CM 法令注册的医师为您评估。拔罐是亲诊的操作，线下亲诊服务即将推出。

本文由 林高鸿 医师 撰稿审阅。林高鸿 医师依 2016 年 T&CM 法令于马来西亚传统与辅助医药理事会注册执业，专长为中医全科、疼痛管理与内科。

无论身在何处，与持证中医师对坐。

汉方现代中医