Illustration of Köh Kchöl healing technique showing coin and radiating lines on skin.

Köh Kchöl: Decoding the Ancient Healing Practice Behind Linear Dermatosis

Rhea Morgan in Health & Wellness June 2025 • 4 min read.

"Uncover the mysteries of 'Köh Kchöl,' an ancient Cambodian healing technique, and its surprising effects on skin health, including induced linear dermatosis."

In the realm of dermatology, unusual presentations can often lead us down fascinating paths of cultural history and traditional practices. A recent case highlighted in the International Journal of Dermatology sheds light on one such practice: 'Köh Kchöl,' an ancient healing technique from Cambodia.

The study focuses on a 34-year-old Cambodian man with a medical history of human immunodeficiency virus (HIV) and hepatitis B coinfection, who presented with asymptomatic linear ecchymoses—essentially, patterned bruising—on his chest and arms. These unusual markings prompted an investigation into the patient's cultural healing practices.

The anamnesis revealed that the man had resorted to 'Köh Kchöl' as a means to treat a recent fever. This traditional method involves vigorous skin rubbing with a coin or other blunt instrument, revealing a surprising intersection between cultural healing and dermatological health.

What is Köh Kchöl and How Does it Affect the Skin?

Illustration of Köh Kchöl healing technique showing coin and radiating lines on skin.

'Köh Kchöl,' also known as 'Ga sal' in Cambodia, is a therapeutic technique rooted in traditional Chinese and Southeast Asian medicine. Similar practices exist in other Asian countries, such as 'Cao gio' in Vietnam and 'Kerok' in Indonesia. In Western medicine, the practice is sometimes referred to as coining, spooning, or scraping.

The technique involves repeatedly rubbing a blunt instrument, such as a coin or spoon, across the skin in a unidirectional manner. Typically, this is done along the vertebral column and ribs. The goal is to create linear petechial purpura, a pattern of small, red or purple spots caused by broken capillaries. Practitioners believe this process helps rid the body of negative energies and scrape away sickness.

The Procedure: Sturdy, unidirectional rubbing of skin with a blunt instrument.
The Intention: To create linear petechial purpura, believed to dispel negative energies.
The Result: Often leads to observable marks and, in some cases, dermatological conditions.

While 'Köh Kchöl' is intended as a healing practice, it can sometimes lead to unintended dermatological consequences. The case study mentioned earlier highlights the presentation of linear ecchymoses. These are essentially bruises that appear in a linear pattern, directly corresponding to the areas where the skin has been vigorously rubbed. Although the patient in the study presented with asymptomatic ecchymoses, it’s conceivable that other individuals might experience discomfort or even skin damage, depending on the intensity of the practice and the sensitivity of their skin.

The Intersection of Culture and Skin Health

The case of 'Köh Kchöl' and induced linear dermatosis serves as a reminder of the intricate ways in which cultural practices can intersect with health and dermatology. While traditional healing methods like 'Köh Kchöl' are deeply embedded in cultural beliefs and intentions of wellness, they are not without potential dermatological consequences. Understanding these practices can aid healthcare professionals in providing culturally sensitive and informed care. Further research is needed to fully understand the scope and impact of such practices on skin health, ensuring that both the cultural significance and the physical well-being of individuals are appropriately addressed.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1111/ijd.14124, Alternate LINK

Title: Induced Linear Dermatosis: Kӧh Kchӧl

Subject: Dermatology

Journal: International Journal of Dermatology

Publisher: Wiley

Authors: Khadija Sellami, Fabrice Bouscarat

Published: 2018-07-18

Everything You Need To Know

What is Köh Kchöl?

Köh Kchöl, also known as Ga sal in Cambodia, is a traditional healing technique originating from Cambodia, rooted in traditional Chinese and Southeast Asian medicine. This practice involves vigorous skin rubbing with a blunt instrument, such as a coin or spoon. It is similar to practices like Cao gio in Vietnam and Kerok in Indonesia. The intention is to rid the body of negative energies and scrape away sickness.

Why is Köh Kchöl important?

The practice of Köh Kchöl is significant because it highlights the intersection of cultural healing practices and dermatological health. In the case of a 34-year-old Cambodian man, Köh Kchöl was used to treat a fever and resulted in the presentation of linear ecchymoses. This demonstrates how traditional methods, though intended for wellness, can have dermatological consequences. Understanding these practices can aid healthcare professionals in providing culturally sensitive and informed care.

What are the possible dermatological consequences of Köh Kchöl?

The direct dermatological consequence of Köh Kchöl is the potential for induced linear dermatosis. The vigorous rubbing of the skin with a blunt instrument, as used in Köh Kchöl, creates linear petechial purpura, visible as small, red or purple spots. In more severe cases, this can lead to linear ecchymoses, or patterned bruising, which corresponds to the areas rubbed. Other potential consequences can include skin damage or discomfort, depending on the intensity of the practice and the sensitivity of the skin. It is important to understand that while Köh Kchöl is used for healing, it can have unintended dermatological outcomes.

What are the key aspects of the Köh Kchöl practice?

The key aspects of Köh Kchöl are the procedure, the intention, and the result. The procedure involves sturdy, unidirectional rubbing of the skin with a blunt instrument. The intention is to create linear petechial purpura, believed to dispel negative energies. The result often includes observable marks and, in some cases, dermatological conditions such as linear ecchymoses.

What are the implications of Köh Kchöl?

While Köh Kchöl is generally intended as a healing practice, the implications of its effects are multifaceted. For individuals, it means potential dermatological consequences such as bruising or skin damage, depending on how the practice is done. For healthcare professionals, it means understanding the cultural context of their patients and the potential for these practices to affect their skin health. Further research is needed to fully understand the impact of Köh Kchöl on skin health, ensuring that both the cultural significance and physical well-being of individuals are addressed appropriately. This practice underscores the need for healthcare providers to be aware of and sensitive to traditional healing methods.