Cupping therapy works by placing cups on the skin and creating suction to pull the underlying tissue upward, pooling blood in the area to trigger a localized healing response. The technique is straightforward, but doing it safely requires understanding the different methods, proper preparation, and what to expect afterward. Here’s how the process works from start to finish.
Types of Cupping
There are two main categories: dry cupping and wet cupping. The core difference is whether blood is drawn.
Dry cupping uses suction alone. A cup is placed on the skin and the air inside is removed, either with a hand pump, a silicone squeeze, or by briefly heating the air inside a glass cup with a flame (called fire cupping). The vacuum pulls skin and soft tissue upward into the cup. This is the most common form and the one most people try first.
Wet cupping adds a second step. After a cup is left in place for about three minutes to create mild suction, the practitioner removes it and uses a small scalpel to make light, tiny cuts on the skin’s surface. The cup is then reapplied so suction draws out a small amount of blood. Wet cupping is more invasive and carries a higher risk of infection, so sterile technique matters significantly more.
Sliding cupping is a variation of dry cupping where massage oil is applied to the skin first. The cup is attached and then glided across a larger area, combining suction with a massage-like motion. This works well for broad muscle groups like the back and shoulders.
Equipment You’ll Need
Cupping kits typically come with cups made from one of three materials: glass, silicone, or hard plastic. Each creates suction differently.
- Silicone cups are the most beginner-friendly. You squeeze them to push air out, place them on the skin, and release. The suction strength depends on how hard you squeeze. They’re easy to clean and don’t require any extra tools.
- Plastic cups with hand pumps give you more control. A small rubber pump attaches to a valve on the cup, letting you dial in the suction precisely. This is the most common setup in physical therapy clinics.
- Glass cups are used in fire cupping. A cotton ball soaked in alcohol is briefly lit inside the cup to heat the air, then removed. The cup is quickly placed on the skin, and as the air cools, it contracts and creates suction. This method requires training and should not be attempted without hands-on instruction.
You’ll also want massage oil or lotion (for sliding cupping or to help with cup adhesion), clean towels, and rubbing alcohol or mild soap for cleaning the skin beforehand.
The Step-by-Step Process
Start by cleaning the area of skin where you’ll place the cups. Wash it with mild soap and water, and make sure it’s dry. If you’re doing sliding cupping, apply a thin layer of massage oil.
Place the cup on a fleshy area. The back, shoulders, thighs, and upper arms are the most common spots. Avoid bony areas, the spine itself, and anywhere with broken skin, rashes, or varicose veins. Create suction using whichever method your cup requires: squeeze for silicone, pump for plastic, or flame for glass.
You should feel a pulling sensation and see the skin rise visibly into the cup. The feeling should be firm but not painful. If it hurts, release some suction immediately. For beginners, start with light suction and shorter sessions. Leave the cups in place for 5 to 10 minutes. Experienced practitioners sometimes go up to 15 or 20 minutes, but more time does not necessarily mean better results, and longer sessions increase the intensity of skin marks.
To remove a cup, press down on the skin next to the rim to break the seal. Never try to pull a cup straight off, as this can bruise or damage the skin. After removal, gently clean the area again.
What the Marks Mean
Cupping almost always leaves circular marks that range from light pink to deep purple. These are not bruises in the traditional sense. Bruises result from blunt trauma that damages blood vessels, while cupping marks come from blood being drawn to the surface by suction. They typically fade within 3 to 10 days.
Light pink marks or no marks at all suggest good circulation in the area with minimal tension or congestion. Bright red marks usually appear over areas with acute issues like muscle strain, inflammation, or a recent injury. They indicate that blood is flowing actively to the area.
Dark purple or near-black marks point to chronic stagnation, areas where tension or poor circulation has persisted for a longer time. These look dramatic but are common on spots like the upper back and shoulders in people who sit at desks all day. As they heal, darker marks often shift to brown or yellowish tones before fading completely.
Aftercare for the First 24 Hours
What you do after a session matters as much as the session itself. Drink plenty of water to support circulation and help your body process the metabolic byproducts brought to the surface. Avoid alcohol and excessive caffeine, both of which are dehydrating.
Wait at least 4 to 6 hours before showering, and when you do, use warm (not hot) water. Hot showers, saunas, and ice packs should all be avoided for at least 24 hours. Cupping increases blood flow and warms the tissue, and extreme temperatures can interfere with that process or irritate the skin. Don’t apply ice to cupped areas, since cold constricts blood vessels and can slow the healing response the treatment is designed to stimulate.
Wear loose, breathable clothing over the treated areas. Tight fabric creates pressure and discomfort on freshly cupped skin. Keep the marks clean with mild soap, and resist the urge to scratch, rub, or pick at them. Stay out of direct sunlight on the cupped areas for at least a day, as UV exposure can cause irritation and uneven fading.
Safety and Hygiene
For dry cupping at home with silicone or plastic cups, the hygiene requirements are manageable. Wash cups with soap and water after every use. If there’s been any contact with broken skin or blood (even incidentally), soap and water alone is not enough. Instruments exposed to blood require immersion in a 7.5% hydrogen peroxide solution for at least 30 minutes to achieve proper disinfection, or 6 hours for full sterilization. Standard 3% pharmacy-grade hydrogen peroxide is not strong enough. Alcohol and chlorine bleach are also insufficient.
Plastic cups can pit and degrade with repeated disinfection, making them harder to sterilize effectively over time. If you’re using them for anything involving broken skin, single-use disposable cups are the safer choice.
Certain situations call for skipping cupping entirely. Avoid cupping over sunburned, inflamed, or broken skin. People with bleeding disorders, those taking blood-thinning medications, and anyone with deep vein thrombosis should not use cupping. Pregnant women should avoid cupping on the abdomen and lower back. If you have a skin condition like eczema or psoriasis, cupping on affected areas can worsen flare-ups.
Getting Started Safely
If you’re new to cupping, the lowest-risk way to start is with silicone cups on large muscle groups like the upper back or thighs. Use light suction and keep your first sessions to 5 minutes or less. Pay attention to how your skin responds. Some redness and warmth is normal. Sharp pain, blistering, or skin that stays raised and swollen for hours is not.
Wet cupping, fire cupping, and cupping on sensitive areas like the neck or face should be left to trained practitioners. The margin for error is smaller, and the consequences of mistakes (burns from fire cupping, infection from wet cupping) are more serious. A licensed acupuncturist, physical therapist, or traditional medicine practitioner with cupping training can assess your specific situation and adjust the technique accordingly.