Spiritual mediums possessed by ghosts prayed at a shrine before having their cheeks pierced with skewers for the annual Vegetarian Festival in Thailand.

Footage shows the psychics, known locally as 'mah songs' or 'horses of the gods', convulsing as they performed a ritual at the Jeng Ong Shrine in Phuket on October 19.

They were dressed in white ceremonial outfits, then had their faces stabbed with long skewers, needles and knives before parading on the streets.

The Taoist followers believe the intense pain will cleanse their spirits of sins from the previous year and prove their religious devotion - bringing good luck in the days ahead.

The yearly procession takes place every year at shrines across Phuket island, where there is a hardened Thai-Chinese community. Similar events happen around Thailand among those with Chinese ancestry, but few are as extreme as those on the holiday island.

The festival, also known as the Nine Emperor Gods Festival, usually takes place in the ninth lunar month of the Chinese calendar, typically around September or October. It has roots in ancient Chinese culture.

Participants also observe a strict vegetarian or vegan diet for nine days.

Devotees believe the sacrifice will cleanse their bodies and minds and invite good luck and fortune into their lives. Many participants believe it will also bestow health and spiritual strength.

This year's Vegetarian Festival will run until October 23.