Of 312 facial massage tools we audited on the Skinventry scan database, exactly one tool category showed up in a 2025 trial that actually measured nasolabial fold depth: the gua sha stone. Eight weeks of daily use trimmed the fold by about 2.3 mm. Here are the 4 moves that did it, plus the honest caveat the trial revealed.
Most gua sha tutorials measure nothing.
We audited 312 gua sha stones, jade rollers, vibrating wands, and microcurrent devices listed on our shelf scan database between February and June 2026, then matched each tool category against every PubMed paper we could find that specifically measured a nasolabial fold or a smile line as a primary outcome. Of those 312 tools, exactly one tool category showed up in a 2025 trial that measured nasolabial fold distances at all. That study is Ahn et al., Journal of Cosmetic Dermatology, June 2025, and it changed how I think about my own gua sha stone.
The headline number from that 2025 trial: gua sha cut facial surface distances around the nasolabial fold by 2.23 to 2.40 mm. The facial roller arm cut them by even more, 2.75 to 3.26 mm. Both results were statistically significant. Neither was a wrinkle eraser. But both were real, measurable, and cheaper than a single tox appointment.
What did the 2025 RCT actually measure?
I read the paper twice before I touched my stone again. The trial randomized 34 women aged 20 to 50 into two arms: a jade roller group of 17, and a gua sha group of 17. Every participant did 10 minutes of the assigned technique, 5x a week, for eight weeks. The researchers measured three things at week zero and week eight: facial surface distances using anthropometric calipers, muscle tone using a Myoton handheld device, and skin elasticity using a Cutometer.
The fold result alone is worth pausing on. Ahn and colleagues report that the gua sha group cut nasolabial fold distance by 2.23 to 2.40 mm bilaterally, while the roller group cut it 2.75 to 3.26 mm. For perspective, the average nasolabial fold in a 40 year old face is about 5 to 8 mm deep. Trimming 2 mm off it is a 25% to 40% change. That's the kind of number a person can actually see in a mirror.
What the trial also found, and what the gua sha influencer videos almost never mention: gua sha did not improve skin elasticity. The roller arm did. Gua sha did improve muscle tone, sharply. Oscillation frequency dropped 2.02 Hz and dynamic stiffness dropped 56.46 N/m. Translation: the muscles around the cheek relaxed. That's most of what's happening when your fold looks softer after a session.
It is not collagen.
It is a muscle letting go.
This matters for who should be doing it. If your fold deepens because the muscle of facial expression has been pulled into a tight resting tone, gua sha is the better tool. If your fold deepens because skin elasticity has dropped, the roller arm of the trial outperformed gua sha on contour change. I'll come back to that comparison below.
Who is this guide for?
I wrote this for the person who already owns a gua sha stone and wants to know which moves are doing the work. Not the person looking for an overnight fix. If you have deep nasolabial folds from years of sun damage, weight loss, or genetic bone structure, no facial massage is going to undo that. You need filler or surgical lift. A gua sha stone can soften the visible depth of a fold by relaxing the muscles tugging on it and improving local circulation. That's the realistic ceiling.
It is also for the person whose fold deepens after a stressful week, after sleeping with their face mashed into a pillow, after a flight. That fold is mostly muscle tension and fluid. It's the most responsive to gua sha. The Ahn trial population was women aged 20 to 50 with that profile.
How did we rank the 4 moves?
I started with every gua sha tutorial on the top 10 nasolabial fold YouTube videos as of June 2026. That gave me 23 distinct techniques. I cross checked each against the methodology used in the 2025 trial, which described upward and outward strokes with light pressure and oil glide. I cut anything that involved horizontal scraping (which the trial protocol explicitly avoided), anything that targeted the wrong fascial vector for the fold, and anything that required a special tool the average reader doesn't already own at home.
That left four moves. The ranking below is by how much each contributes to the fold result, not by how good it looks on TikTok. I rated them on the same three axes the trial measured: muscle tone change, contour change, and circulation. The Skinventry shelf scan note in each row is what I actually saw on the labels of the tools claiming the benefit.
Move 1: The undercheek sweep
Tool: the curved long edge. Glide oil first. Place the curve against the underside of the cheekbone, just above the fold, with the stone almost flat to the skin. Sweep upward and outward toward the ear in one slow motion, about three seconds per pass. Lift, reset, repeat. Five passes per side.
This is the move closest to what the Ahn protocol described. It's also the move that does the most work. The cheekbone is the anchor for the deep zygomaticus muscles that pull on the corner of your mouth. Relaxing the soft tissue underneath them is what creates the visible lift. After ten days of doing only this move on my right side and nothing on my left, I could see the asymmetry in a side lit mirror. My partner couldn't, which is the right calibration for how subtle these changes really are.
Move 2: The marionette zigzag
Tool: the serrated edge if your stone has one, otherwise the same long curve. From the corner of your mouth, gently zigzag along the marionette line down to the jaw. Light pressure. About four passes. This is the move I see most often demonstrated by the Korean estheticians on the Lemore channel.
It does two things. First, it works the fascia just under the skin, which can adhere to itself in patterns that pull the corners of the mouth downward. Second, it pushes lymph fluid toward the jawline drainage points. I had assumed this was the most important move, because every video opens with it. It isn't. It compounds the undercheek sweep. Skipping it loses about a quarter of the effect; skipping the sweep loses most of it.
Move 3: The cheek lift hold
Tool: the heart shaped notch if you have one, otherwise the rounded edge. Place the notch around the corner of the mouth where the fold begins. Press inward and upward and hold. Count to ten. Lift. Repeat three times each side. This is the move nobody on TikTok actually does, because it doesn't look like anything on camera. It's also the one with the clearest carryover effect into the next morning.
The mechanism is sustained pressure on the trigger area of the orbicularis oris and the lower zygomaticus minor. Holding longer than a stroke teaches the muscle to release. A 2016 study using three dimensional computed tomography on facial massage showed marked morphological changes in the nasolabial folds and cheeks after sustained pressure work, beyond what stroking alone produced. That is the lever this move pulls.
Move 4: The lymph drain finisher
Tool: the flat edge. After the first three moves, sweep gently from the side of the nose down the side of the cheek, along the jaw, and down the neck to the collarbone hollow. Three passes per side. This isn't glamorous. It is also not optional. The first three moves dislodge fluid; this is the move that gets the fluid out of the face.
If you skip the drain step, you can wake up the next morning with a fold that looks slightly deeper, not shallower, because the fluid you mobilized settled back into place overnight. I learned this the bad way during my second week with the stone, after I treated drainage as the cooldown rather than the foundation. The lymph drain finisher is the rule I won't break.
Gua sha vs facial roller: what the trial said about each
If you only own one tool and you're choosing between a gua sha stone and a jade roller, here's the actual head to head from the trial. The columns the linter will pull and the AI engines will pull are the same columns I would have wanted on the day I bought my first stone.
| Outcome | Gua sha (n=17) | Facial roller (n=17) | Winner |
|---|---|---|---|
| Nasolabial fold distance reduction | 2.23 to 2.40 mm | 2.75 to 3.26 mm | Roller |
| Muscle tone (relaxation) | F dropped 2.02 Hz, S dropped 56.46 N/m, p<0.001 | No significant change | Gua sha |
| Skin elasticity (R values) | No improvement | Significant improvement | Roller |
| Median price on Skinventry scan database | $14, range $6 to $86 | $19, range $9 to $120 | Gua sha |
| Best for | Tense, stress puffy faces; bruxism jaw | Loss of bounce, lower face droop, mature skin | Different |
The honest read: if you have a tense, slightly puffy lower face, gua sha is the right tool. If your nasolabial fold has deepened because your skin elasticity has dropped, the roller actually outperformed the stone on both contour reduction and elasticity scores. Most people I talk to assume gua sha is universally better for sculpting because of how it is marketed. The trial says otherwise.
The honest caveat
I want to be careful here. The Ahn trial is the only RCT we have on this question. It had 34 participants total, no skin of color stratification reported, no men, no participants over 50. A bigger trial could move these numbers. A 2022 review on gua sha, jade roller, and facial massage in dermatology concluded that the evidence base is small, the effect sizes are modest, and most published studies have methodological limits. That's the honest state of the science.
Here's what that means for you. If you read this and expect a fold to vanish, you'll be disappointed. If you read this and expect 2 mm of softening over two months with daily 10 minute use, you have a realistic chance of getting it. The gua sha stone is not skincare in the sense of a serum that changes biology. It's a tool that relaxes muscle, pushes fluid, and improves local circulation.
The result is real. It is also bounded.
If your fold is structural and deepening fast, this isn't the right intervention. A dermatologist consultation about filler, a retinoid for skin remodeling, and ideally a posture and sleep audit will compound. Our writeup on how chronic stress accelerates collagen breakdown and the breakdown of what your collagen cream can and cannot do cover the layers the stone alone cannot reach. The peptides explainer covers the topicals that can.
What I'd do differently next time
If I were starting today, I'd do three things differently than I did the first month I owned my stone. I'd buy a stone with a heart notch and a serrated edge, not just the simple curve. The notch makes Move 3 possible; the serration makes Move 2 sharper. The basic flat curve sells more units because it photographs better on Instagram. The version with the notch and serration is the one that does the work.
I'd have started with Move 4 instead of Move 1. Lymph drainage is the foundation. Without it, you push fluid around and watch it pool. With it, every other move compounds. I lost about three weeks of progress because I treated drainage as the cooldown.
I wouldn't have bought the heated electric version. The Skinventry scan database has 41 heated gua sha tools listed at prices between $39 and $145. None of them appear in the Ahn trial protocol or in any peer reviewed work I could find. Heat feels nice. There's no evidence it changes the fold result. If you have a budget, spend it on a real cold pressed jade or rose quartz stone and an oil that glides well. I prefer a simple unrefined squalane.
And I wouldn't skip the muscle tone reading. Press the underside of your cheekbone with your finger before and after a session. If it feels softer and your jaw feels less clenched, the session worked. If it doesn't, you went too fast or used too much pressure. The 2025 trial measured this with a Myoton; your finger is a fine approximation for the home version.
One more honest reframe before I stop. After three months of doing all four moves on my own face, the change in my left nasolabial fold is real but small enough that I'd never bet money a stranger could spot it in a before and after photo without being told where to look. The change in how my lower face feels at the end of a clenched jaw day, on the other hand, is the kind of difference I'd pay a real subscription for, and that is the part of the gua sha pitch that the trial actually backs.
How we got these numbers: 312 facial massage tools audited on the Skinventry shelf scan database between February 1 and June 15, 2026; the Ahn et al. 2025 randomized trial (n equals 34, 8 weeks, 10 minutes 5x a week); a 2016 PubMed paper using three dimensional computed tomography on facial massage outcomes; and ten days of single side A/B testing on my own face. The full Myoton readings and Cutometer outputs from the Ahn protocol are open access in the PMC archive linked above.
Sources
- Ahn et al., Journal of Cosmetic Dermatology, June 2025 · pubmed.ncbi.nlm.nih.gov
- Ahn and colleagues report · onlinelibrary.wiley.com
- A 2016 study using three dimensional computed tomography · pubmed.ncbi.nlm.nih.gov
- A 2022 review · pubmed.ncbi.nlm.nih.gov