Wet cupping is a therapy that combines suction with controlled bleeding. A practitioner places cups on the skin to create a vacuum, makes small superficial cuts or punctures in the skin, then reapplies suction to draw out small quantities of blood and fluid. It has roots in traditional Chinese, Middle Eastern, and Greek medicine and remains widely practiced today, particularly in parts of Asia and the Middle East.
How Wet Cupping Differs From Dry Cupping
Dry cupping uses suction alone. A practitioner heats the inside of a glass cup or uses a manual pump to remove air, then places it on the skin. The vacuum pulls the skin upward, increasing blood flow to the area. No cuts are made and no blood is drawn.
Wet cupping adds an extra step: after an initial round of suction, the practitioner removes the cup and uses a scalpel or needle to make shallow scratches or punctures on the skin’s surface. The cup is then placed back over those small wounds, and the suction draws out a small amount of blood and extracellular fluid. Because it involves blood, wet cupping carries a higher risk of infection and exposure to bloodborne pathogens. This is a key reason dry cupping is more common in Western clinical settings.
What Happens During a Session
A typical wet cupping session follows three stages. First, the practitioner applies cups to targeted areas of the body using heat or a suction pump. This initial suction lasts several minutes and brings blood flow to the surface. Next, the cups are removed and the practitioner makes very shallow incisions or light scratches in the skin, just deep enough to break the surface layer. Finally, the cups are reapplied over the incision sites, and the negative pressure pulls a small volume of blood into the cup.
The amount of blood collected is modest, typically a few milliliters per cup. Sessions often involve multiple cups placed along specific points on the back, shoulders, or neck. One clinical trial for low back pain, for example, used six sessions over two weeks, placing cups at acupuncture points along the spine. The whole process usually takes 20 to 40 minutes depending on how many cups are used.
How It Affects the Body
Several biological mechanisms have been proposed to explain why wet cupping might relieve pain or improve health. The most well-supported involves local blood flow. The suction causes blood vessels in the treated area to widen by triggering the release of signaling molecules like nitric oxide from the cells lining blood vessel walls. This widening increases circulation, lowers resistance in the blood vessels, and may reduce localized inflammation.
The small incisions also appear to provoke a controlled immune response. By creating minor, localized tissue damage, the procedure triggers the body’s repair systems. Immune cells migrate to the area, and the body releases its own natural painkillers (endogenous opioids). Some research shows a shift in the local immune cell population: fewer of the cells involved in chronic inflammation and more of the cells responsible for acute healing and defense against infection.
There is also a theory around blood “detoxification.” One study found that the blood drawn during wet cupping contained significantly higher concentrations of heavy metals like aluminum, mercury, and lead compared to blood drawn from a standard vein in the same patients. Levels of uric acid, cholesterol, and triglycerides were also elevated in the cupping blood. Whether this represents meaningful removal of harmful substances or simply reflects the composition of blood drawn from superficial tissue remains an open question.
What the Evidence Says About Pain Relief
The strongest evidence for wet cupping involves musculoskeletal pain, particularly chronic low back pain. In a randomized controlled trial of 80 people with persistent nonspecific low back pain lasting at least three months, those who received six wet cupping sessions over two weeks had substantially lower pain scores than those who received no treatment. On a standard pain scale, the cupping group averaged about 29 out of 100, compared to 58 in the control group. Roughly 78% of people in the wet cupping group experienced a clinically meaningful reduction in pain, compared to just one person in the control group.
That improvement persisted for at least two weeks after the last session. Disability scores also dropped significantly, meaning people could move and function better in daily life. These are promising numbers, though it’s worth noting the control group received no treatment at all, not a sham procedure. That makes it harder to separate the physical effects of cupping from the psychological benefit of receiving hands-on care.
For broader systemic markers of inflammation, the picture is less clear. A study examining whether wet cupping could lower C-reactive protein (a marker of bodywide inflammation) in people with metabolic syndrome found no significant change. So while wet cupping may have meaningful local effects on pain and circulation, its ability to shift deeper metabolic or inflammatory processes is unproven.
Safety and Risks
The most significant risk with wet cupping is infection. Any time the skin is broken, bacteria can enter. Practitioners should use sterile, single-use blades or needles and dispose of all blood-contaminated materials as biohazardous waste. Cups should be thoroughly sterilized between patients or be single-use. If you’re considering wet cupping, verify that the practitioner follows strict hygiene protocols.
Other potential side effects include bruising, mild pain at the incision sites, skin irritation, and scarring. The circular marks left by the cups are cosmetic and temporary, but the small cuts can leave faint scars, especially with repeated sessions in the same area.
Certain people should avoid wet cupping entirely. Those taking blood-thinning medications face a higher risk of excessive bleeding. People with bleeding disorders, active skin infections, or open wounds in the treatment area are also poor candidates. Pregnant women are generally advised against it, particularly on the lower back and abdomen.
Healing and Aftercare
After a session, the incision sites are cleaned and bandaged. The small cuts are superficial and typically heal within a few days to a week, similar to a minor scrape. Circular bruising from the suction can last one to two weeks. During healing, it helps to keep the area clean and dry, avoid submerging it in pools or hot tubs, and protect it from sun exposure to minimize scarring. Most people can return to normal activities immediately, though some experience mild soreness or fatigue for a day or two afterward.