What does it mean if you feel lumps or bumps during scalp gua sha, and what should you do about it?

Under normal circumstances, a bumpy or uneven sensation during scalp gua sha may be caused by factors such as subcutaneous fat accumulation, thickened scalp stratum corneum, seborrheic dermatitis, folliculitis, or sebaceous cysts. Appropriate management strategies can be selected based on the specific cause. Detailed explanations are as follows:

1. Subcutaneous Fat Accumulation

Uneven distribution of subcutaneous fat on the scalp may lead to localized accumulation of tiny fat particles, resulting in a bumpy texture during gua sha. Reducing intake of high-fat and high-sugar foods and increasing regular scalp massage in daily life can help promote local fat metabolism and improve fat buildup.

2. Thickened Scalp Stratum Corneum

Inadequate cleansing over time can lead to excessive buildup of dead skin cells, forming rough, raised areas that feel uneven during gua sha. Using a gentle scalp scrub 1–2 times per week, followed by a nourishing shampoo, can help soften and remove excess keratin, keeping the scalp clean and refreshed.

3. Seborrheic Dermatitis

Excessive sebum production combined with overgrowth of Malassezia fungi can trigger inflammation, leading to red papules or flaky scales on the scalp, which create a bumpy sensation during gua sha. Under medical guidance, antifungal shampoos such as ketoconazole, selenium sulfide, or coal tar-based products can be used regularly to cleanse the scalp and reduce oil secretion.

4. Folliculitis

Bacterial infection of hair follicles causes inflammatory pustules—small red bumps that feel raised during gua sha. Topical treatments such as mupirocin ointment, fusidic acid cream, or clindamycin gel may be applied under medical supervision. Avoid scratching the scalp and maintain a dry, clean environment to prevent worsening symptoms.

5. Sebaceous Cyst

When sebaceous gland ducts become blocked, sebum cannot be discharged and accumulates to form a cyst. These cysts are typically firm, well-defined, and easily felt during gua sha. If asymptomatic, monitor without intervention and avoid squeezing. If the cyst grows larger or becomes infected, seek medical attention for surgical excision. Postoperative wound care is essential to prevent infection.

To maintain scalp health, it is important to keep the scalp clean using mild hair care products and avoid frequent chemical treatments such as perms and hair dyes. Maintain a light diet and minimize consumption of spicy or greasy foods. During gua sha, apply gentle pressure; discontinue immediately if pain or skin damage occurs, and provide proper local care. Seek medical advice when necessary.