hijama safety
Hijama Safety: Side Effects, Risks and Contraindications
Hijama and wet cupping are generally well tolerated when performed appropriately, but they are not suitable for everyone. This guide explains common side effects, potential risks, contraindications and the safety precautions that should be considered before treatment.
In short:
Common temporary effects of Hijama can include circular marks, mild tenderness and skin sensitivity. Because wet cupping involves superficial skin incisions, appropriate assessment, sterile single-use equipment, infection control and aftercare are especially important.
Table of Contents
01
Is Hijama Safe?
02
Common Side Effects
03
Wet Cupping Risks
04
Who Should Avoid Hijama?
05
Medications and Medical Conditions
06
Pregnancy and Hijama
07
Infection Control and Hygiene
08
When to Seek Medical Advice
09
What Does the Research Say?
10
11
Is Hijama Safe?
Hijama can generally be performed safely when appropriate assessment, hygiene and infection-control procedures are followed. Because wet cupping involves superficial skin incisions, the procedure requires additional precautions compared with non-invasive cupping techniques.
Safe practice should include sterile single-use equipment for any skin incisions, careful skin preparation, appropriate disposal of contaminated materials and clear aftercare instructions.
Safety also depends on the individual receiving treatment. Medical history, medications, skin condition, bleeding risk and other health factors should be considered before deciding whether Hijama is appropriate.
Key Point
Hijama safety depends not only on technique, but also on proper assessment, sterile equipment, infection control and individual suitability.
Common Side Effects of Hijama
Most side effects of Hijama are temporary and related to the local skin and tissue response. Common effects may include circular marks, mild tenderness, temporary skin sensitivity and mild discomfort during or after the session.
Because wet cupping involves small superficial skin incisions, minor spotting or temporary irritation around the treated area can also occur. These effects usually settle as the skin recovers.
The intensity and duration of side effects can vary depending on suction strength, treatment area, skin sensitivity, number of cups and individual response.
Common Temporary Effects May Include:
- Circular cupping marks
- Mild tenderness or soreness
- Temporary redness or skin sensitivity
- Mild itching or irritation during healing
- Minor discomfort at superficial incision sites
Important
Side effects should generally be mild and temporary. Severe pain, persistent bleeding, increasing redness, swelling, discharge or fever are not expected and should be assessed appropriately.
What Are the Risks of Wet Cupping?
Wet cupping involves superficial skin incisions, so the main risks are related to skin injury, bleeding and infection if the procedure is not performed appropriately.
When hygiene or infection-control standards are poor, there is a risk of local skin infection and cross-contamination. This is why sterile single-use equipment, proper skin preparation and safe disposal of contaminated materials are essential.
Other possible risks include prolonged bleeding in susceptible individuals, delayed healing, skin irritation, blistering from excessive suction and temporary worsening of local soreness.
Potential Risks May Include: -
- Local skin infection
- Prolonged or excessive bleeding
- Delayed healing of superficial incision sites
- Blistering or skin irritation
- Increased tenderness or soreness
- Cross-contamination if equipment is reused or handled improperly
- Scarring or pigment changes in susceptible skin
Safety Note
Most serious complications are preventable with proper screening, sterile single-use equipment, appropriate technique and good aftercare.
Who Should Avoid Hijama?
Hijama is not suitable for everyone, and certain health conditions or circumstances may increase the risk of bleeding, infection, delayed healing or other complications.
People with significant bleeding disorders, severe anaemia, active skin infection or open wounds should generally avoid wet cupping unless appropriately assessed and medically cleared.
Extra caution is also needed in people with serious or unstable medical conditions, very fragile skin, impaired wound healing or a history of excessive bleeding.
Hijama May Be Unsuitable or Require Medical Clearance In People With:
- Bleeding disorders or clotting problems
- Severe anaemia
- Active skin infection, ulcers or open wounds
- Significant immune suppression or poor wound healing
- Serious or unstable medical conditions
- Very fragile or damaged skin
- A history of excessive or prolonged bleeding
Important
Suitability should always be assessed individually. A health condition does not automatically mean Hijama is forbidden, but it may require modification, postponement or medical advice.
Medications and Medical Conditions That May Affect Hijama Safety
Certain medications and medical conditions can increase the risk of bleeding, bruising, infection or delayed healing during wet cupping. These factors should be reviewed before treatment.
Medications Requiring Extra Caution
- Anticoagulants or blood-thinning medication
- Antiplatelet medication
- Other medicines that may increase bleeding or bruising risk
Medical Conditions Requiring Extra Caution
- Bleeding or clotting disorders
- Severe anaemia
- Poorly controlled diabetes
- Poor wound healing
- Significant immune suppression
- Serious or unstable medical conditions
Patients should not stop prescribed medication in order to have Hijama. Medication changes should only be made under the guidance of the prescribing healthcare professional.
Pregnancy and Hijama
Additional Caution During Pregnancy
Hijama during pregnancy requires additional caution. Evidence on the safety of wet cupping in pregnancy is limited, and certain treatment areas or circumstances may not be appropriate.
Pregnant individuals should inform their healthcare professional and Hijama practitioner before treatment. Decisions should consider the stage of pregnancy, treatment area, general health, bleeding risk and the reason for seeking cupping therapy.
Pregnancy requires individual assessment. When there is uncertainty about suitability, medical advice should be obtained before proceeding with Hijama.
Infection Control and Hygiene in Wet Cupping
Because wet cupping involves superficial skin incisions and contact with blood, infection-control standards are especially important.
Safe practice should include appropriate hand hygiene, clean treatment surfaces, skin preparation and sterile single-use equipment for any procedure that breaks the skin. Reusable cups and other equipment should be cleaned and disinfected according to appropriate infection-control procedures.
Contaminated sharps and blood-stained materials should be disposed of safely, and gloves should be changed when required to prevent cross-contamination between patients or treatment areas.
Key Hygiene Measures Include: -
- Hand hygiene before and after treatment
- Appropriate skin preparation
- Sterile single-use blades or lancets
- Clean or properly disinfected cups and equipment
- Gloves and appropriate protective measures
- Safe disposal of sharps and contaminated waste
- Clean treatment surfaces and good environmental hygiene
Safety Note
Wet cupping should never involve reusing blades, lancets or other single-use equipment between patients.
When to Seek Medical Advice
Symptoms That Should Be Assessed
Most temporary effects after Hijama are mild and settle as the skin recovers. Medical advice should be considered if symptoms are severe, persistent or suggest possible infection or excessive bleeding.
Unusual or worsening symptoms after wet cupping should not be ignored. Appropriate medical assessment may be needed, especially when infection, significant bleeding or delayed healing is suspected.
What Does the Research Say About Hijama Benefits?
Research on cupping therapy suggests that adverse events are generally uncommon when treatment is performed appropriately, but the quality of safety reporting varies between studies. Reviews of cupping research often describe most reported side effects as mild and temporary, while also noting that methodological limitations make precise risk estimates difficult. PubMed
Wet cupping requires additional attention because it involves skin incisions and contact with blood. Reviews and safety frameworks emphasize the importance of patient screening, sterile technique, infection-control procedures and standardized practice to reduce preventable complications. PubMed
Serious complications appear to be rare, but case reports have described infectious, vascular and neurological complications following cupping therapy. These reports do not establish how often such events occur, but they reinforce the need for appropriate practitioner training and safety procedures. PubMed
Evidence Note
Current evidence suggests that most adverse effects are mild, but safety data are not equally robust across all cupping techniques. Wet cupping requires stricter infection-control and bleeding-risk assessment because the skin is intentionally opened.
Summary: Is Hijama Safe?
Hijama can generally be performed safely when appropriate screening, hygiene, infection-control procedures and aftercare are used.
Most expected effects are temporary and may include circular marks, mild tenderness, redness, skin sensitivity and minor discomfort at superficial incision sites.
Because wet cupping involves skin incisions, additional precautions are needed to reduce the risks of bleeding, infection, delayed healing and cross-contamination. Certain medications, bleeding disorders, severe anaemia, active skin problems, pregnancy and serious medical conditions may require extra caution or medical advice.
Hijama should therefore be approached as an individually assessed procedure rather than something automatically suitable for everyone.
Key Takeaway
Safe Hijama depends on individual assessment, sterile single-use equipment, proper infection control and appropriate aftercare.
SCIENTIFIC REFERENCES
References
01
National Center for Complementary and Integrative Health (NCCIH).
Cupping.
National Institutes of Health.
NCCIH notes that cupping can cause temporary marks and may also cause persistent skin discoloration, scars, burns or infection. It also warns that contaminated equipment can transmit bloodborne infections if it is not appropriately sterilized or disinfected. NCCIH
02
Mohamed AA, Zhang X, Jan YK.
Evidence-based and adverse-effects analyses of cupping therapy in musculoskeletal and sports rehabilitation: A systematic and evidence-based review.
J Back Musculoskelet Rehabil. 2022.
DOI: 10.3233/BMR-210242
PMID: 35848010
This review found that adverse events reported in musculoskeletal and sports cupping studies were uncommon, although the overall evidence base was limited and varied in quality. PubMed
03
Cramer H, Klose P, Teut M, et al.
Cupping for Patients With Chronic Pain: A Systematic Review and Meta-Analysis.
J Pain. 2020;21(9–10):943–956.
DOI: 10.1016/j.jpain.2020.01.002
PMID: 31982686
In this meta-analysis, adverse events were reported more often with cupping than with no treatment, but differences were not significant when cupping was compared with sham or other active treatments. The authors also noted substantial heterogeneity and risk of bias across the included trials. PubMed
04
Neurological Complications of Cupping Therapy: A Comprehensive Review.
PMID: 39837300
This review identified rare case reports of serious neurological, vascular and infectious complications following cupping. Case reports cannot establish how common these events are, but they highlight the importance of appropriate technique, screening and safety precautions. PubMed
Written by
Dr Amr Salama, DPT
DPT, Cairo University • Licensed Physiotherapist in Dubai • MOHAP-Licensed Hijama Practitioner
Dr Amr Salama writes and reviews evidence-informed educational content on Hijama, cupping therapy, rehabilitation and related health topics.
Last reviewed
October 2026
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