Ultrasound Therapy

Minimally invasive cosmetic procedures, such as microdermabrasion, application of prescription topicals and non-ablative laser treatments are gaining in popularity. It seems more and more people are willing to achieve their cosmetic goal with less traumatic sequential treatments and virtually no down time. Common clinical goals seem to include collagen stimulation (for skin texture improvement and the reduction of fine lines), pigment reduction, and general skin rejuvenation from photo aging. Ultrasound and electrical stimulation can play a distinct role in the overall treatment of these problems. Both ultrasound and electrical stimulation are excellent methods of increasing blood flow and have an extensive history in the treatment of wounds. Although ultrasound and electrical stimulation accomplish many of the same things, their mechanics are considerably different. It is imperative to fully understand their unique characteristics in order to safely utilize them in cosmetic applications.

When ultrasound enters the body it reacts in various ways. It is absorbed more readily by muscle, tendons and bone than by fat. Harder surfaces like bone will absorb and reflect ultrasound energy. All of these will play a role in the eventual total tissue temperature rise. Researchers have found that by raising the tissue temperature by 10 degrees celsius, the local metabolic rate will increase 3 to 4 times. This in turn dramatically increases oxygen to the cells and the removal of waste products. Ultrasound intensity and time on tissue determines the amount of heat generated. Studies have shown that there also non-thermal benefits from ultrasound. These would be in the range of .5 watts per centimeter squared or less and/or on pulsed.

Known clinical uses for ultrasound therapy include:

Treatment of inflammation and edema reduction

Post trauma, either surgical or from a non-ablative laser, causes degrees of inflammation. The goal is to reduce this swelling quickly to eliminate any further cellular damage. Low intensity ultrasound alters cell permeability and aides in the reabsorption of interstitial fluid. Heat generating settings should never be used, for heat would only exacerbate an already swollen situation.

Tissue Healing

Ultrasound has been shown to enhance tissue repair through increases in macrophages, fibroblasts, endothelial cells and collagen. Some feel that these stimulated repair mechanisms are from the heat generated by ultrasound, while others feel that the non-thermal effects of cellular micromassaging are the cause. The bottom line is that ultrasound has been proven to advance the healing process. Wounds of course represent the extreme, but stimulating photo damaged or sub-optimal aging skin will result in healthier more vibrant skin.

Phonophoresis

Phonophoresis is the use of ultrasound to drive medications or topical products into the skin. The American Society for Aesthetic Plastic Surgery recently stated: "New skin care product formulations, used in conjunction with ultrasound, will allow for deeper penetration of topically applied rejuvenating agents into the skin, resulting in significantly improved aesthetic results." This is accomplished by the combined mechanical piston like effect of ultrasound and the altering of cell permeability. This process does not alter the chemical composition of the topical and is pleasant for the patient.

Increases extensibility of collagen tissue

Ultrasound used on higher intensities coupled with the stretching can improve the appearance and texture of scars. UltraSonic Facial: A new approach to skin rejuvenation and repair. This treatment combines microdermabrasion with ultrasound and electrical stimulation for skin texture improvement and the reduction of fine lines.

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