Dry cupping involves placing cups on the skin and creating a partial vacuum, which draws the skin into the cup. Wet cupping adds a small incision so blood is drawn. The practice is widely used for pain and is one of the more popular complementary therapies, particularly for back and shoulder pain.
It also produces marks that last for days, and those marks are frequently presented as proof that something has been “drawn out.” This article looks at what the therapy involves, what research says, and — importantly — what can go wrong.
What cupping involves
In dry cupping, a cup is placed on the skin and air is withdrawn, creating suction. Cups are commonly left in place for several minutes. In wet cupping, a small incision is made and blood is drawn into the cup. In fire cupping, a flame is briefly used to create the vacuum, which carries an obvious burn risk.
Facial cupping, a gentler variant used in cosmetic contexts, uses smaller cups and lighter suction with sliding techniques.
What the research says
The honest position is that the evidence base for cupping is limited and low quality. It has not been established as an effective treatment by any major health body.
This matters more for cupping than for many complementary therapies, because of a specific risk: the most serious harms associated with complementary therapy often come from delaying proven treatment, and cupping is commonly marketed directly for conditions like stroke, high blood pressure and arthritis — conditions where delay is dangerous.
The US National Center for Complementary and Integrative Health does not publish a fact sheet endorsing cupping for any condition. Its guidance on traditional Chinese medicine, which cupping belongs to, notes that some practices within traditional medicine carry documented risks and advises the general principle: do not use a complementary therapy to postpone seeing a health care provider about a health problem.
Cupping and acupuncture
Because cupping is often discussed alongside acupuncture, it is worth separating the evidence. Acupuncture has a substantial research literature: NCCIH reports that acupuncture may help ease back or neck pain, knee pain associated with osteoarthritis, postoperative pain and migraine, among others. However, NCCIH also found that acupuncture’s benefit was greater compared with no treatment than compared with sham acupuncture, meaning a meaningful share of the measured benefit comes from nonspecific effects rather than the specific treatment.
That finding does not transfer to cupping. Evidence about acupuncture should not be read across to cupping, which is much less studied.
Risks and safety
Burns
Fire cupping carries a genuine risk of burns. The cups and flame are applied directly to skin, and burns are a recognised complication of the technique.
Bruising and scarring
Extensive bruising is expected and is sometimes presented as a benefit. Scarring is a recognised possible outcome, particularly with repeated or prolonged application.
Infection
Wet cupping breaks the skin, so infection is a risk. This is the same category of concern NCCIH raises about acupuncture performed with non-sterile equipment, where complications have included infections and, in severe cases, punctured organs and injury to the central nervous system.
Blood disorders and blood-thinning medication
Cupping is not appropriate for people with bleeding disorders or those taking blood-thinning medication. The NHS lists warfarin among the medicines that interact badly with herbal and complementary products, and names anticoagulants generally as a concern with complementary therapies.
Who should avoid it
Advice is to avoid cupping if you have a bleeding disorder, are on blood thinners, have a skin condition or infection in the area, or are pregnant without first consulting a health care provider.
How to judge a cupping claim
When cupping is promoted, useful questions include:
- Was it tested in randomised controlled trials with a sham control?
- How large was the study, and who funded it?
- Is the claim about pain and comfort, or is it claiming to treat a disease?
- Is it being offered as a replacement for medical treatment?
The pattern to watch for is a therapy promoted as a cure for serious disease, with no trial evidence and no discussion of risk.
Frequently asked questions
Does cupping work?
The evidence is limited and of low quality. Cupping is not established as an effective treatment by any major health body, and it has not been shown to treat disease.
Is facial cupping safe?
Facial cupping uses lighter suction and smaller cups, and carries less risk than fire cupping on the body. It can still cause bruising and skin irritation, and it should not be done over broken skin or in the eye area. See a qualified professional and check for contraindications.
What do the marks mean?
They are bruising from the suction, not evidence that toxins have been removed. Practitioners sometimes interpret the colour of the marks as meaningful; this is not supported by evidence.
Can cupping treat high blood pressure or stroke?
There is no reliable evidence for this, and these are conditions where delaying proven treatment carries serious risk. Discuss any health condition with a doctor rather than treating it with cupping.
Can I take blood thinners and have cupping?
No. Cupping is not appropriate if you take blood-thinning medication or have a bleeding disorder. Consult your doctor.
How long do cupping marks last?
Bruising from dry cupping typically fades over several days to around two weeks. Persistent pain, swelling, blistering or marks that do not fade should be assessed by a clinician, as these can indicate a complication.
Sources
- NHS, “Herbal medicines and complementary therapies,” Health A to Z (page last reviewed 1 May 2026), on blood-thinning medicines and complementary therapy safety: nhs.uk
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health, “Acupuncture: Effectiveness and Safety” (last updated October 2022), on nonspecific effects and safety of related practices: nccih.nih.gov
- National Center for Complementary and Integrative Health, “Traditional Chinese Medicine: What You Need To Know” (last updated April 2019), on safety of traditional practices: nccih.nih.gov
This article is general information, not medical advice. It does not recommend cupping, any practitioner, or any product. If you have a health condition, are taking medication, or are pregnant, speak with a qualified health care provider before using complementary therapies, and do not delay conventional care.
