Most people who have had a hot stone massage will never go back to regular relaxation massage. Knowing how to give a great hot stone massage will earn you lots of clients, but this type of massage could be detrimental to some people’s health. Clients sometimes have adverse reactions to the temperature increase, and skin reactions are possible as well. Read on to learn how to identify when hot stone massage is contraindicated.

Ask your clients to fill out an intake form before getting started. When they are done, look over it and identify any skin conditions, cardiovascular conditions or neuropathic conditions.

Look specifically for high blood pressure, loss of nerve sensation, inflammation, varicose veins and diabetes. Varicose veins and diabetes are strictly contraindicated, while loss of sensation and inflammation are local contraindications (avoid the area). Pregnancy is totally contraindicated as the rise in temperature puts too much stress on the mother’s body.

Review the client’s medications, if applicable. Controlled hypertension is OK, but if the client is not being treated for his high blood pressure, do not proceed. If the client is taking muscle relaxants or pain medication, proceed with caution as he may have trouble knowing when the stones are too hot.

Take a good look at your client. If she has any contagious skin conditions, such as shingles, you can avoid the area or wear gloves. Assess any skin issues like acne, burns, sunburns and open sores and do not massage over these areas.

Communicate with your client before you start the massage to determine any concerns she may have. Every body is different, so a client may ask you to avoid a certain area that may be very sensitive or painful for her.

Instruct the client to tell you if a stone is too hot or too heavy for him. During the massage, keep an eye on his skin as you massage the stones over him and note any changes that occur. Erythema is normal when hot stones are applied. Look for any facial expressions or nonverbal signals that may indicate the client is uncomfortable.


  • Clean your stones after every two or three clients. Use a brush and scrub them with antibacterial soap, then put tea tree oil and Epsom salts into the water of your stone warmer. These precautions will help keep the stones sanitary for every client.