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Does the absence of cupping marks indicate insufficient qi and blood?

Dec 10, 2025 Source: Cainiu Health
Dr. Sun Lianqing
Introduction
According to traditional Chinese medicine, when qi and blood are abundant and circulating smoothly, cupping often results in normal bruising on the skin. However, if there is a deficiency of qi and blood, the body's subcutaneous qi and blood may not adequately respond to the negative pressure stimulation during cupping, making it difficult to produce noticeable marks. Nevertheless, the absence of marks after cupping does not necessarily indicate qi and blood deficiency—insufficient suction strength or too short a duration can also lead to inadequate negative pressure stimulation, resulting naturally in no visible marks.

Generally, the absence of marks after cupping may be related to insufficient qi and blood, but it could also result from other factors such as technique or individual constitution. If concerned, it is advisable to consult a healthcare professional in advance. The detailed analysis is as follows:

According to traditional Chinese medicine (TCM), when qi and blood are abundant and circulating smoothly, cupping typically leaves normal bruise-like marks on the skin. However, if there is deficiency in qi and blood, the subcutaneous tissues may not adequately respond to the negative pressure stimulation during cupping, making it difficult for distinct marks to form. Individuals with this condition often also experience symptoms such as pale complexion, fatigue, and cold hands and feet.

However, the lack of marks after cupping does not necessarily indicate qi and blood deficiency. Insufficient suction strength or too short a duration can lead to inadequate stimulation, naturally resulting in no visible marks. Additionally, individuals with a balanced constitution and no internal stagnation of cold, dampness, or blood stasis may inherently exhibit a milder skin response to cupping, which might also lead to no marks appearing—this is considered a normal phenomenon.

The absence of marks after cupping does not require excessive concern. It's important to assess one’s overall symptoms. If signs of qi and blood deficiency are present, targeted调理 (regulation/treatment) can be applied. Always choose qualified practitioners for cupping and avoid blindly increasing suction intensity.

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