Cupping is generally low-risk when performed by a trained practitioner, but it is not risk-free. The most common side effects are mild and temporary: circular skin marks, bruising, and localized soreness that fade within a week or two. Serious complications are rare but documented, and certain people face higher risks than others.
Common Side Effects
The signature circular marks cupping leaves on the skin are not bruises in the traditional sense, but they look like them. These discolorations result from blood being drawn to the surface by suction, and they typically fade within 7 to 14 days. In some cases, the marks can persist longer or become permanent discolorations, especially with repeated sessions on the same area.
Beyond the marks, you can expect mild swelling, tenderness, and skin tightness at the cupping sites. These effects are temporary and resolve on their own. Less commonly, cupping can cause blistering if suction is too strong or left on too long.
Burns From Fire Cupping
Fire cupping, where a flame is briefly placed inside a glass cup to create a vacuum, carries a specific burn risk that other forms of cupping don’t. According to research on burn injuries from cupping, the most common cause is using too much alcohol to coat the inside of the cup. Other causes include accidentally knocking over the alcohol container during the session or mishandling the flame itself. These are practitioner errors, not inherent to the technique, which is why training matters so much with fire cupping specifically.
If you’re nervous about burns, silicone or pump-operated cups achieve suction without any flame at all and eliminate this risk entirely.
Infection Risk With Wet Cupping
Wet cupping (sometimes called hijama) involves making small incisions in the skin before or after applying the cups, allowing a small amount of blood to be drawn out. This breaks the skin barrier and introduces real infection risk if equipment isn’t properly sterilized. Bloodborne pathogens like hepatitis B, hepatitis C, and HIV can theoretically be transmitted through contaminated instruments. If you opt for wet cupping, single-use blades, sterile cups, and proper wound care afterward are non-negotiable. Ask your practitioner directly about their sterilization protocols before the session.
Rare but Serious Complications
A comprehensive review of neurological complications from cupping, published in 2025, identified cases of vascular and infectious complications. Subdural hemorrhage (bleeding between the brain and skull) was the most frequently reported serious event, occurring in 4 out of 14 documented cases. Nearly all patients recovered with medical or surgical treatment, though three did not fully recover. These cases are extremely uncommon relative to how widely cupping is practiced worldwide, but they demonstrate that severe outcomes are possible.
Skin Conditions Can Worsen
If you have psoriasis, eczema, or dermatitis, cupping can trigger flare-ups at the treatment sites. In psoriasis specifically, cupping has been documented to cause what’s known as the Koebner phenomenon, where new psoriatic plaques develop exactly where the cups were placed. The suction and skin trauma act as a trigger for the immune response that drives these conditions. The same applies to active sunburn, shingles, or fungal infections on the skin. Cupping should not be placed over any area where the skin is already compromised.
Who Should Avoid Cupping
Certain groups face elevated risks. If you take blood thinners or antiplatelet medications, the suction can cause excessive bruising or bleeding complications, particularly with wet cupping. The underlying concern is similar to what clinicians see with any procedure that affects blood vessels near the skin surface: when your blood doesn’t clot normally, even minor capillary damage can lead to outsized bruising or hematomas.
Practitioners also avoid cupping in these situations:
- Open wounds, recent surgeries, or fresh burns on the treatment area
- Varicose veins, where sliding cupping in particular risks damaging already weakened blood vessels
- Fractures or unstable joints beneath the cupping site
- Pregnancy, particularly over the abdomen, lower back, or pelvic region
Cups should never be placed directly over major arteries, lymph nodes, nerves, or body orifices.
The Regulation Problem
One of the biggest practical risks with cupping isn’t medical, it’s inconsistency. There are currently no universal safety or quality standards for cupping therapy. Licensing requirements vary widely by state and country. In some places, acupuncturists, massage therapists, and physical therapists can all perform cupping, each under different regulatory frameworks. In others, virtually anyone can offer it. A 2021 paper calling for standardized safety models noted that compliance with standard operational procedures is essential but largely absent across the field.
This means your safety depends heavily on the individual practitioner. Look for someone trained through an accredited acupuncture or physical therapy program rather than a weekend certification course. Ask about their experience, sterilization practices, and whether they screen for contraindications before treatment. A competent practitioner will ask about your medications, skin conditions, and medical history before placing a single cup.
Putting the Risk in Perspective
For most healthy adults, dry cupping performed by a trained practitioner is a low-risk procedure. The most likely outcome is temporary skin marks and mild soreness. Serious complications exist in the medical literature but are rare enough to qualify as case reports rather than common patterns. The risks climb meaningfully when practitioners are poorly trained, when fire cupping technique is sloppy, when wet cupping is done without proper sterile equipment, or when cupping is performed on someone with a condition that makes them vulnerable. If none of those factors apply to you, the biggest “danger” of cupping is probably the circular marks you’ll need to explain at the pool for a couple of weeks.