Wet cupping is a form of traditional therapy that combines suction with small, shallow skin incisions to draw out a small amount of blood. It has roots in numerous cultures, from ancient Chinese and Greek medicine to the Islamic practice known as Al-Hijamah, and it remains widely practiced today for pain relief and general wellness. Unlike dry cupping, which only uses suction, wet cupping intentionally breaks the skin’s surface to remove blood and fluid from the treated area.
How the Procedure Works
Wet cupping generally follows one of two approaches. In the traditional two-step method, a practitioner first makes superficial scratches or tiny incisions on the skin using a sterile scalpel or blade. Cups are then placed over those incisions, and suction pulls a small quantity of blood and interstitial fluid (the fluid that normally surrounds your cells) into the cup.
The Al-Hijamah method adds an extra step, making it a three-stage process. First, cups are applied to the skin to create suction before any cuts are made. The practitioner then removes the cups, makes the superficial incisions, and reapplies the cups for a second round of suction. This initial suction is thought to bring more blood to the surface, so the subsequent incisions draw out a greater volume of fluid. Cups are typically left on the skin for 5 to 10 minutes per application.
The incisions themselves are described as superficial scarification, meaning they only penetrate the outermost layers of skin. They’re not deep cuts. Practitioners use sterile, single-use blades to minimize infection risk.
Wet Cupping vs. Dry Cupping
Dry cupping pulls the skin up into a cup using negative pressure, but the skin stays intact. This creates localized pressure changes that increase blood flow to the area. Red blood cells can seep from capillaries into surrounding tissue without any incision, a process sometimes called dry diapedesis.
Wet cupping adds the bloodletting component. Because the skin is broken, blood and interstitial fluid actually leave the body. Analysis of the blood collected during wet cupping sessions shows it contains significantly higher concentrations of uric acid, urea, triglycerides, cholesterol, and certain heavy metals like lead and mercury compared to normal venous blood. Proponents argue this means the procedure selectively removes waste products and metabolic byproducts, though the exact mechanism behind this concentration difference is still debated. The blood loss also causes vasodilation and increases parasympathetic nervous system activity, which relaxes muscles and may partially explain the pain relief people report.
What the Research Shows on Pain Relief
Most of the clinical research on wet cupping focuses on musculoskeletal pain. In one randomized controlled trial on chronic neck pain, participants who received cupping saw their pain scores on a 0-to-10 scale drop from 9.7 to 3.6, while the control group stayed essentially unchanged at 9.5. Another study on nonspecific neck pain found pain levels decreased by nearly 2 points on the same scale, both at rest and during movement, after 10 to 15 minutes of cupping on the trapezius muscle.
Research on blood markers in athletes found that wet cupping reduced certain inflammatory ratios in the blood while increasing red blood cell counts, white blood cell counts, and hemoglobin levels in venous blood drawn after the procedure. The decrease in inflammatory markers suggests the body may mount a recovery response similar to what happens after controlled physical stress. These findings are promising but come from relatively small studies, and wet cupping is not a replacement for conventional treatment for serious medical conditions.
What Recovery Looks Like
Wet cupping leaves circular marks on the skin that look similar to bruises but are technically caused by capillary dilation and minor bleeding rather than blunt trauma. Most marks fade within 3 to 7 days. Darker marks, which tend to appear in areas with more chronic muscle tension or poorer circulation, can take up to 10 days to fully resolve. If marks persist beyond 10 to 14 days, that may reflect slower circulation, reduced lymphatic drainage, or use of blood-thinning medications.
The first 24 hours after a session require the most care. You should avoid hot showers, saunas, steam rooms, strenuous exercise, direct sun exposure, alcohol, caffeine, and cold plunges. For the first 48 hours, stay out of swimming pools, hot tubs, and natural bodies of water, since the small incisions are still healing and exposure to bacteria is a concern. Scrubbing, exfoliating, or using chemical skin products on the treated area should wait until the marks have faded. Lukewarm showers and gentle, fragrance-free moisturizers are fine. Deep tissue massage directly over the cupped areas should be avoided for at least 72 hours.
Safety Risks and Who Should Avoid It
The most significant risk of wet cupping is infection, because the procedure involves breaking the skin. This is why sterile, single-use blades and properly sanitized cups are essential. Scarring is possible, particularly if the incisions are deeper than intended or if aftercare instructions aren’t followed. Skin burns can occur with fire-heated cups if the practitioner is inexperienced.
Wet cupping is not appropriate for anyone taking blood-thinning medications, since even superficial incisions can lead to prolonged bleeding. It should also be avoided over sunburned skin, open wounds, skin ulcers, or areas of recent trauma. Pregnant women should not have cupping performed on the lower abdomen, lower back, or certain acupuncture points. Children under four should not receive cupping at all, and sessions for children ages four to fourteen should be significantly shorter, limited to 5 to 10 minutes depending on age.
If you’re considering wet cupping, look for a practitioner who uses disposable blades, sterilizes equipment between patients, and can clearly explain their hygiene protocols. In many countries, wet cupping is not regulated as strictly as other medical procedures, so the practitioner’s training and sanitation standards vary widely.