Blisters and bleeding during Therapeutic Cupping, Part 7- Mishaps

Cupping Therapy Mishaps, When things go wrong:

What to do if…

In cupping as a practice, like any type of health care procedure, things can go not as planned.  In fact, you can hurt yourself or others with most health maintenance products.  One can cut a gum with dental floss; rupture an ear drum with a ‘Q-Tip’, or cut yourself with a simple razor.  You can also overdose on the myriad of over the counter medications available at any local store, many with fatal results.  Did you know, for example, that over 1,000 people a year die from taking Tylenol as it is suggested ON the label?!

Some of the mishaps can occur even with the most conscientious practitioner.   The best defense is a good offense with this and I would like to explain what I mean by that.

Most of the issues we will see with cupping are very minor indeed; however, knowing how to handle an unexpected problem can make all the difference, if you are prepared.  Here is a list of the most common and what to do about them.  While we are using a cupping system and technique that avoids fire, we generally do not have to worry about the most common injury in fire cupping, that is, burns.  Please refer to the section on contraindications and precautions to keep these from happening….


  1. Bleeding mole or mark: If you placed the cup near a mole that is raised or at all different from the surrounding skin, it can tear or open and bleed.  This is a simple fix.  First, stop the cupping on that area and remove the cup.  Use a cotton ball or gauze swab to clean any blood off the skin.  Make  sure you stop the bleeding with direct pressure.  Clean the area well and place a Band-Aid on the open skin.  You may choose to tell the person having cupping to use some Neosporin and to watch the area for proper healing.  Make sure and follow up over the next few days to see how it is going.  Reassure the ‘client’ that it can happen in rare occasions and is largely inconsequential.  Any infection should be followed up with a more qualified practitioner.


  1. Severe bruise: In this case we see a bruise that seems to last too long.  Remember the lesion you created is not a true bruise.  A bruise is a breaking of blood vessels and ‘frank blood’ leaking into the surrounding tissues.  Reassure the client and have them use a cold pack for pain if they experience this.


  1. Skin irritation: Stop the cupping if you see increased redness around the cup, or if the client complains that the cupping itches.  It is simply too much pressure.  Release some of the pressure in the cup but keep it in place for the duration of the treatment.  If irritation occurs after the cupping session, it may also be a sign that the tissues were very closed off, and the new flow of fluids are stimulating new flow of nutrients and toxins out of the system.  If this is too irritating or they notice swelling that lasts more than a day or two, this means they are VERY toxic and will need much more treatment.  Heat then, would be the choice of treatment.  A good Epsom salts bath can help.


  1. Health Care Crisis’ i.e. feeling worse after a session: This is common when there is  poor energy in the body to handle the toxins that were stirred up by treatment.  Here, the best treatment is lots of good fluids and get some rest.  The client should be reassured that this can be expected only once or twice ever and that future treatments will be more invigorating for sure.  If the feeling of cruddiness lasts more than two days, it is best to get to a more qualified practitioner for an evaluation. There  may be something else going on not really related to the cupping.


  1. Prolapsed or bulging vessel: This can happen when cupping is done on one of the areas you should not be doing it on… so make sure you follow the precautions.  If this does happen because of too brazen cupping, press the area with a finger and place a cold pack on it as soon as possible.  If the vessel ruptures you will see lots of bruising.  Best not to do any more cupping on that area until completely healed, and then consider other areas.


  1. Blisters filled with water: This happens when the tissues of the patient are too tight, acting like wood.  There is no good capillary flow and the lymph is sluggish at best.  The blisters may pop.  If not, it is best to pop them on the most inferior aspect and let them drain.  Make sure they stay covered as this is open skin.  It is very common that they leave red marks ‘lesions’ for up to a couple weeks.    In the future consider massage or ‘moving’ cupping technique.


  1. Infection: In the very exceptionally rare event of any type of infection:  That is, heat, redness, pain, and swelling in the area. Stop cupping until the infection is cleared and get to the real cause of their illness.  Refer to another provider as soon as possible.  Any area that may have broken skin or that you might think has infection, cover with Neosporin and watch it closely for a few days for signs of healing.   Treat it as you would any injury to the skin.


  1. Broken skin, tearing: This is most common in older people that have paper thin skin and are generally poorly hydrated. The skin can tear like wet paper.  Avoid further cupping and make sure the area is covered and let to heal properly.  Maintain communication with the client about this, and that they need much more integumentary hydration and collagen.  They should consider strong doses of Vitamin C to help with skin repair.  Other nutritionals should also be considered.   Make sure that they are hydrated and keep that up as well as something to hydrate and help the skin.



  1. Pain during cupping: This is common in first timers as well as when you get a little too aggressive with the cupping.  Check in with the client every few minutes.  This therapy can be uncomfortable, but too much pain just stresses the client.  Release some of the pressure by pulling the tab at the top of the cup.  Then you can add more pressure by using the pump gun for another light pump or two.


  1. Emotional releases: This is left for last because it is the least expected and can be one of the most disturbing for both the client and practitioner.  Often the client is too stressed to receive cupping for this session; however, you both choose to do it at this time.  There is no lasting trouble here, so be confident and compassionate.

Here is what to do.  First, have the client stay still if they can, and loosen the cups but do not remove them… Then have the client breath out longer than they breathe in.  When they exhale do it as if they are fogging their glasses to clean them. This enhances the tone of the Vagus nerve and they will soon relax.  Offer simple ‘holding of a space’ support.  There is no need to talk it out unless they are willing and ready.

In fact, let them initiate.  Explain to them that occasionally, emotional energies get caught up in tissues and can be released with such therapies.  It is really a great sign that healing or detoxification is occurring on multiple levels is possible, and the release is a great sign.  Comfort and rest are the best treatment now.  Future treatments may or may not have the same response.  Just go with it.    Catharsis is a good thing.  The safe space you have created allowed this to blossom forth.


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