Gua Sha and our Biases

When I was a boy, any time I would get a sore throat or a cold, my mom would pull out a soup spoon and scrape it against the back of my neck.

Growing up, this was what I associated with care. This is what I associated with healing, and this is what I learned was my mom saying to the universe “No, my child will not be sick and in pain.”

Later, I would learn that this was gua sha. A common practice in the Chinese community.

It is hard for me to separate gua sha from my mother’s love, her care, and the culture she gave to me.

I do not know if it worked, but I know my mom believed it did.

One day in the distant future, I will look at a stone used for gua sha and it will hit me.

It will hit me that all those things that my mother gave me are gone, and that all I hold in my hands is just a stone – and it cannot connect me to a culture and its traditions anymore.

But for now, it is something that I may not understand – but it is not something that I disparage without making an attempt to understand it.

At the end of the day, if there is no magic, if there is no effect, there’s still culture in that stone. And inside that culture hides an entire history and knowledge.

Many things we will never have the opportunity to understand, because it is hidden behind another language – 你很多人都看不懂.

Communication in the sciences is not as universal as we would think.

The walls of language still separate understanding. As English-speakers we are biased to believe that all knowledge and facts are written in English.

But they are not.

Recently, the International Union for Conservation of Nature missed the Taiwanese populations of the fairy pitta birds in its survey – because the numbers were not published in English.

There is research investigating these treatments and practices – it is just that I, and many of you, cannot read it.

The drug artemisinin was discovered in a mixture of herbs used in traditional Chinese medicine to treat malaria.

And there’s entire countries with a different perspective on care.

So, it is hard for me to judge – I just do not know enough, most of it I just can’t read.

Below is a screenshot of a paper that reviewed 437 papers on gua sha from 1994 to 2007. I cannot read any of them.

Understanding the world is a lot like watching a mystery show sometimes. Each episode we learn a bit more, and start building a bigger picture.

Only at the end of the show do we see the full picture, but sometimes the show gets cancelled on a cliff-hanger too.

But recognize that there are many shows, all on at the same time, saying different things.

And many, many, many of those shows we will never see – if they are not in our language.

So, I am not asking you to believe in gua sha, or any traditional medicines from different cultures, but I am asking you to maybe take a pause and recognize the biases that being inside an English-speaking culture creates.

At its core, gua sha might just be a stone and it might just be massage, and the secret might have been feeling loved and cared for.

But I do not know.

Accessibility is Aesthetic

Making your content more accessible is one of the easiest ways to increase your audience.

While Instagram has offered new tools to offer different ways to engage with content, there’s still a lot of easy steps we can choose to make our content even better!

For the past few days, I’ve been reaching out to my audience through my stories to learn about their needs. The Polls sticker is a great way to collect feedback.

You can view the process by tapping the ‘Accessibility’ stories highlight on my Instagram profile.

People have also shared with me many resources and tips that I’ll pass on to you:

  • Add descriptions of images in our captions. For example a photo of me right now I could describe as, “Stephen is sitting in front of his computer, his hair is long and unwashed. He seems stressed but happy that he is at home.

  • We can also describe or transcribe our posts by filling in the Alt Text found under ‘Advanced Settings’ when making or editing a post.

  • We can caption or transcript our videos. Using static, not animated text is easiest to read. Use a contrasting background for the text so it stands out from the video.

  • There are free fonts like this one, Atkinson Hyperlegible, that are designed for easy reading.

  • Small, swoopy, and animated text might be fun, but it can be hard to read.

  • #NotCapitalizingOurHashtags makes text to speech tools read out each letter individually.

  • For font colours, we want to make sure that we have good contrast between the text colour and the background colour. is a tool that will allow you to measure and adjust your text and background contrast.

  • When sharing Grid Posts to our Stories, it is not always clear that the square is tappable. A simple “Tap Below to Read” is all you need to add!

  • For those that can share links in their stories, the Swipe Up action will be hidden if the story has a light background. A simple ‘Swipe Up to Read’ in a contrasting colour can help.

  • Remember blogs? I know this type of image with text post is popular now on Instagram, but web text allows readers to adjust font size, change fonts, use browser reading modes, and it is easier for screen readers.

    I leave a link in the caption to a blog version of my posts. This one can be found at

  • For big blocks of text, left-aligned text is easier to read.

  • Try to break down chunks of text into smaller sections of three.

  • Big blocks of italicized text can be hard to read, they’re best used for emphasis. Consider bolding too!

For other tips on accessibility tap through to @Access_Guide_, right on Instagram!

On Making Amends: Creating a Space for Recovery, Healing, and Peace.

I want to share with you some lessons I’ve learned on how to create a space for healing and peace for people that have been harmed.

In my life, like any person, I have spoken and behaved in ways that have harmed people around me and the people I care about.

“Like any person” is crossed out, because I wanted to use that sentence to share a lesson I have learned. Harms we have enacted are not caused by society, culture, or something greater than us. They may be the soil that the harm we caused grew in, but deferring the blame to something greater than us is a way to unburden ourselves of the weight of creating harm.

To use a personal example, I had harmed a friend when speaking about a concern I had with myself. I did not recognize that I was upholding an abuse structure in our culture that had harmed my friend in the past. The abuse structure is bigger than I am, but I acted as a conduit from it to my friend. I am responsible for the harm I caused. Seeing someone uphold an abuse structure, intentionally or not – strikes fear into the people who were exiled or harmed by it.

I have learned that apologies can be a trap. We must recognize, as the people who have harmed, whether the desire to make amends is for us or for the people that we have harmed. Sometimes a person who has been harmed needs time and space. That is often the only thing within their power to control in response to harm. Offering an apology can sometimes destroy their power and control, and preclude that response.

An apology can act as a reminder of harm, before the person who was harmed is ready to confront and process the pain.

An apology can act as a ticking clock because it can force a person who is harmed to respond, and to respond within a polite time frame.

An apology is a burden because the person who was harmed must hold the weight of the apology and also perform forgiveness.

I have learned to recognize that because fear and confusion are common responses to being harmed, distancing is sometimes the only protective action that feels safe.

I have learned if forgiveness is offered, it is important to understand that forgiveness is not a resetting of relationships or closeness. Forgiveness is not a way to move backward, it is a way to move forward – and sometimes it means moving forward apart.

I have learned that forgiveness can be given by the person who was harmed, to themselves. And in that process, forgiveness can be given to you by a person unburdening themselves of the conduit that brought harm into their life.

Sometimes forgiveness means that the person will walk away from you, and that means sometimes we only need to provide them a path to do so clear of obstacles.

It takes care, time, and empathy to recognize that we are not always the source of healing.

How Marketing Numbers Without Context Can Boost Beauty Claims: Percentages and Fractions Need Context

The rising use of data and science in beauty marketing has led to an increase in percentages, fractions, and statistics. When it comes to percentages and fractions, it is extremely important to understand what they mean.

Often, important contextual information is left out. This can have the effect of boosting the claims brands make about their products.

Let’s look at something simple to begin with, how fractions can be converted into percentages – and vice versa.

2/4 is 50%

250/500 is also 50%

2 and 250 are numerators, while 4 and 500 are the denominators.

This numerator is how many parts of the whole, and the denominator represents the whole.

This comes into play when we look at claims like 90% of people agreed that For’real Serum increased skin dumplingness. What we’re missing is the context of the denominator.

90% could be 9 out of 10 people, or 900 out of 1000 people.

9 out of 10 people is a small sample and probably subject to some sort of bias. If 900 out of 1000 people agreed though, that would be more convincing.

This issue with lack of denominator context is also pervasive in claims using “bioavailability”, “penetration”, “absorption” and “conversion”. These are often claims of comparison – but they’re usually missing the context of how and what they’re being compared to.

How tall is Ranbir if we’re told “Ranbir is 20% taller”? We don’t have the information to know! But we can figure it out if we’re told “Ranbir is 20% taller than the average American firefighter in 2020”

In a similar vein, what does “20% more hydration” mean? We don’t have the information to know! But we have an anchor if we’re told “20% more hydration compared to before use”.

Let’s look at some beauty relevant examples…

40 times more skin penetration…

An important piece of information that’s missing is how was this determined? Is the way that this was determined applicable to the way that their customer will be using it on their skin? Often this data comes from models of skin (things are designed to mimic some aspect of skin, but are not skin), and in vitro (something that isn’t the living, whole organism) or cells. An ingredient might penetrate 40 times more into an individual dermal skin cell floating inside a plastic dish of nutrients over 2 days…but we are not giant dermal skin cells floating inside a plastic dish of nutrients.

What really matters is how the ingredient penetrates human skin that’s part of a living, functioning, whole human person. As well, it’s more relevant if the ingredient or product is used in a way that mimics how we would use it. If penetration increases after 40 minutes of being in a microwave oven…I would argue that information probably isn’t relevant.

90% skin “bioavailability”…

Claims like these often have the same issue as the previous claims we just looked at — like how a measurement was made. But often they also lack another type of context. What’s being measured?

What these claims insinuate is that 90% of what you’re applying to the skin will be “bioavailable” to the skin. But what’s often missing is the context that the 90% is usually a measure of what is “bioavailable” after skin penetration (or the skin model, cell, or in some cases a piece of gel or paper).

Let’s say you have 100 red balls of various sizes.

You shake them through a sieve.

8 red balls have passed through the sieve.

We have 8 red balls out of the 8 balls that fell through the sieve (8/8, 100%).

Is that 100% “bioavailability”?

We need to remember that we started with 100 red balls.

So out of those 100 red balls we started with, only 8 red balls passed through the sieve (8/100, 8%).

So is the “bioavailability” 8% or 100%?

Well, you’re using (and paying for) the 100 balls, so I would say the 8% is the number that’s more relevant.

Note: I have “bioavailability” in quotes because in terms of skincare it’s not well defined. In pharmacology, bioavailability is the amount of a taken drug that reaches the bloodstream.

“Bioavailability” is often used in the marketing of  nutritional supplements, but the pharmacology definition doesn’t really make sense because how a nutrient gets used or absorbed can also depend on a person’s current nutritional and physiological state.

The meaning of “bioavailability” in skincare becomes even harder to pin down. It can sometimes mean the amount of an ingredient that reaches the lower epidermis – but there’s no strict or widely accepted definition nor is there a standard way to measure it.

Often “bioavailability” in skincare is just a marketing term to make a product sound more unique and effective compared to its competitors.

INCI Isn’t Everything: Daft Punk Shows Us Why

Knowing the components of something doesn’t tell us their proportions, quality and properties, or how they’re put together.

Like how Daft Punk sampled Eddie Johns’ song “More Spell On You”; snipped, stretched, looped, and rearranged it into “One More Time” — ingredients can be remixed to create something new.

What is INCI? INCI or International Nomenclature of Cosmetic Ingredients is an English language ingredient dictionary and system of rules for naming the ingredients used in cosmetics.

If no INCI name or naming rule exists, other chemical, scientific, or common names can sometimes be used, depending on the region.

An ingredient list is just that, a list of ingredients. In some regions, the ingredients will be listed in decreasing concentration – some allow them to be listed in any order.

In the US the FDA regulations allow ingredients less than 1% in concentration to be listed in any order (after things higher than 1% in concentration).

Based on the ingredient list of this baked good:

Flour, Milk, Vegetable Oil, Egg, Sugar, Salt

Can you really tell what it is? It could be a cake, a crepe, a popover, a muffin, or pancakes. It could be a lot of things.

Having the concentration of the ingredients gives us a better idea. All this information is missing from an INCI list.

2 cups all-purpose flour

3 teaspoons baking powder

½ teaspoon salt

¾ cup white sugar

1 egg

1 cup milk

¼ cup vegetable oil

But the way that it’s put together is also very important (also information missing from an INCI list).

Step 1: Preheat oven to 400 degrees F (205 degrees C).

Step 2: Stir together the flour, baking powder, salt and sugar in a large bowl. In a separate bowl froth the egg with a fork, then add the milk and oil. Pour all at once into a well in the flour mixture. Mix gently until the batter is lumpy.

Step 3: Pour the batter into paper lined muffin pan cups.

Step 4: Bake for 25 minutes, or until golden.

Only now do we know that they’re muffins.

Just like the ingredient list of something we eat, a cosmetic or skincare ingredient list can provide us with valuable information.

It might highlight potential allergens or things we are looking to avoid. An ingredient list might give you a general sense of what it will be like. But it can’t tell you everything, and it’s not worth aching over.

You simply can’t divine concentrations, formulations, raw material information, and manufacturing processes if that information just isn’t there.

It’s Not Fungal Acne

Fungal acne is not a diagnosis.

“Fungal acne” often refers to the idea that a person who has not seen improvement in their acne from conventional treatments is actually suffering from acne caused by fungus. The fungus is often identified as the genus Malassezia, formerly called Pityrosporum.⁣

Fungal (or yeast, a type of fungus) infections of the skin can occur. Malassezia fungus can cause small red bumps or white-headed pimples on the skin. It might look a lot like acne, but it’s not acne. It’s a condition called malassezia or fungal folliculitis.

It’s described as acneiform, which means “looks like acne” but it isn’t acne.

Proponents of “fungal acne” will often recommend changing the products a person uses to being free of ingredients that supposedly feed fungus. This is akin to “detoxifying” and is a common trope in pseudoscience.⁣ Many of these “not fungal acne safe” ingredients also happen to overlap with acne triggers.

There’s little to no human evidence that removing the often highlighted ingredients will have benefits against fungal infections of the skin. The evidence given is often from cell culture studies, anecdotal, or taken out of context.⁣

A story shared by a Redditor highlights why self-diagnosing “fungal acne” can be dangerous. This Redditor self-diagnosed what they thought was “fungal acne” and went on a “skincare detox”. The infection continued to reoccur. Finally, after visiting a doctor, and a skin swab…it was confirmed to be a staph infection. This means during this time the Redditor was self-treating their “fungal acne”, they were letting a potentially dangerous staph infection go untreated.⁣

Fungal folliculitis can be identified by doctors through tests, their training, and experience. If the infection is confirmed to be fungal folliculitis, treatment often involves topical (or in severe cases systemic) antifungal medication.⁣

⁣It’s important to get a proper diagnosis, so the proper treatment can be given.⁣ It’s important not to self-diagnose. There are many conditions that can look like acne or how “fungal acne” is described, but can be harmful if left untreated.⁣

I’ve seen some experts use the term “fungal acne” colloquially online. We don’t need to simplify the terminology we use. We’re capable of using complex words like niacinamide or emulsification.

Call it by its name. Fungal folliculitis.

But only after a diagnosis is made.