Ultraphonophoresis: mechanism of action, methodology, indications and contraindications

Ultraphonophoresis is a complex effect on the body of ultrasonic vibrations and active cosmetic products.

The sounding is carried out through contact media. Ultrasound increases the activity of drugs, promotes their intracellular penetration, prolongs their action, and reduces side effects.

The introduction of necessary substances into the body during ultraphonophoresis occurs through the excretory ducts of sweat and sebaceous glands. And what is no less important, transcellular and intercellular routes of penetration are also carried out. During the procedure, a cosmetic substance must be included in the composition of the contact medium, and it must retain its structure and pharmacotherapeutic activity when exposed to a mechanical wave. The substance included in the composition of the contact medium can be prepared in the form of an emulsion, ointment, cream or solution. The basis for the contact medium during ultraphonophoresis can be glycerin, lanolin, linden oil, DMSO, vegetable oil.

Unfortunately, not every substance can be administered using ultrasound. Of the traditional medications, only some preparations can be administered (cosmetologists may be interested in the administration of aloe extract, heparin, interferon, hydrocortisone, lidase, prednisolone).

The phoretic activity of particles depends on their structure and the degree of dispersion determined by the size of the molecules and the nature of the solvent. With the complication of the structure of the substance, its phoretic mobility of aqueous solutions of the substance. In this case, the amount of the substance introduced into the body does not exceed 1-3% of the amount applied to the skin surface and depends on the ultrasound frequency, increasing with a decrease in frequency and an increase in intensity to 0.8 W/cm ², and with a further increase in intensity, it begins to decrease. In the continuous generation mode, it is greater than in the pulsed mode; in the labile method, it is greater than in the stable one. The amount of the phoretic substance is directly proportional to the exposure time.

Medicinal preparations phonophoresized in an ultrasound field penetrate into the epidermis and upper layers of the dermis through the excretory ducts of the sebaceous and sweat glands. However, unlike electrophoresis, ultrasound does not accumulate medicinal substances in the skin in sufficient concentration, and they act for a relatively short time. Despite this, as a result of the combination of phonophoresis and various therapeutic effects of the ultrasound wave (mechanical, thermal, chemical), the therapeutic effects are potentiated and are quite pronounced. Significant progress in the use of phonophoresis in cosmetology occurred after the creation of cosmetic gels for ultrasound based on extracts from algae, ginseng, jojoba, etc. in the mid-90s of the 20th century. Phytoextracts are transported into the dermis and hypodermis thanks to a new generation technology - hydrolyzed fiber. The structure of hydrolyzed fibers makes it possible for these biologically active substances to penetrate into various layers of the skin and helps to solve many cosmetic problems. They are used for lifting, treatment of acne, pigmentation, cellulite.

Procedure parameters

The depth and strength of the impact of ultrasound on human tissues depend on the frequency and dose (intensity) of the ultrasound wave. The intensity of ultrasound in physiotherapeutic devices is dosed in W/cm2 ^. In cosmetology devices, the intensity is indicated in conventional units (color scale).

The dose (or intensity) of ultrasound is the energy transmitted in one second through an area of 1 cm2 ^located perpendicular to the direction of propagation of waves; it is measured in watts per square centimeter II (W/ ^cm2 )

When performing cosmetic procedures, the ultrasound intensity does not exceed 1.2 W/cm2 ^. If the ultrasound intensity changes over time, then it is pulsed ultrasound, and it is characterized by average or maximum changes.

Duty cycle is the ratio of the pulse repetition period to the pulse duration.

In domestic devices, the pulse repetition period is 20 ms or Ms. Accordingly, the duty cycle will be 10.5 and 2 ms.

The speed of ultrasound propagation in the human body depends on the density of the tissue, the nature and concentration of substances in a unit of volume. In muscles and internal organs, the speed of ultrasound fluctuates within 1450-1650 m/s, in bone tissue - 3500 m/s. Doses during treatment with an ultrasound device depend on the frequency of procedures, treatment time, application points, course of treatment, etc.

In cosmetology, ultrasound devices for facial treatments usually have 3 intensity levels, devices for body treatments - 8-10 levels. When choosing the intensity of the procedure, the cosmetologist should be guided by the client's sensations and the color scale of intensity. A slight warmth sensation is comfortable and sufficient for the procedure. With a further increase in the intensity level, a complication in the form of a burn can occur (especially when using a spatula emitter).

There are 2 modes of ultrasonic wave generation:

1. constant (consistent).
2. pulse..

Pulsed ultrasound wave is used to obtain non-thermal effects (treatment of inflammatory, pustular diseases, rosacea; procedures on sensitive skin, in acute pain syndrome).

Continuous ultrasound wave is used for cicatricial changes on the face and body (including post-acne), treatment of hematomas, "dark" circles under the eyes, stretch marks, hyperpigmentation, as well as during the period of remission of a number of skin diseases.

The intensity of generated ultrasonic vibrations in continuous mode is 0.05-2.0 W/cm2 ^. In pulsed mode – 0.1-3 W/ ^cm2.

Due to the intense attenuation of ultrasonic vibrations, the effect is carried out through an aqueous or oily contact medium (gel, cream, water).

When performing ultrasound therapy, a stable (fixed position of the emitter) and labile (movement of the emitter) technique can be used. The labile technique is used much more often. The emitter is moved slowly, without pressure, in circular motions. The recommended movement speed is 0.5-2 cm/s.

The duration of the procedure depends on the area of the skin being treated. The area of one impact field should not be more than 100-150 cm ². During the first procedure, only one field is sounded, and if it is well tolerated, several fields can be affected later. The duration of the impact on one field is 3-5 minutes, the total duration of the procedure is 10-20 minutes. Increasing the intensity or duration of the procedure does not increase the effectiveness of the treatment, which is due to the final value of the ultrasound wave energy absorbed by the skin for therapeutic purposes).

Duration of ultrasound treatment depending on the area of application

Scope of application	Time, min
Face	15
Eye area	5-10
Body	20-30
Stomach	12-15

Course - 10-14 procedures every other day (acne, acute stage - 3-5 procedures, body - up to 20 procedures). Maintenance course - 1 procedure every 10-14 days.

If the client experiences any discomfort during the procedure (weakness, dizziness, strong local heating under the emitter, etc.), the intensity should be reduced or the procedure should be interrupted.

A repeated course of treatment for the same area can be carried out no earlier than 2-3 months later. If the treatment consists of 3-4 courses, the interval should be extended after the 2nd course. The interval between courses of cosmetology care should be 0.5 years.

How to check the operation of the electrode? It is necessary to apply a drop of water to the emitter, and the drop will "boil" and begin to splash (cavitation effect - the formation of airless bubbles).

Disinfection of the emitter:

1. Turn on the device.
2. Select the “body” operating mode (or the maximum intensity value on the “line”).
3. Timer for 2 min.
4. Drop some water onto the emitter.
5. Turn off the device after 2 minutes.

Scheme of ultrasonic massage and phonophoresis procedures. To work on different areas of the body, a round emitter of a certain size (large, medium, small) or a paddle emitter is selected.

Face:

1. make-up removal;
2. cleansing with milk;
3. toning;
4. application of active concentrate;
5. concentrate work;
6. applying cream, working on cream.

Time - 15 minutes, choice of wave according to the program.

Eyes:

1. make-up removal;
2. cleansing with milk;
3. toning;
4. ultrasonic massage + phonophoresis according to the “face” program: application of active concentrate;
5. concentrate work;
6. applying cream, working on cream.

Time - 5-7 minutes, continuous wave.

Body:

1. body peeling; rinse with water;
2. application of concentrate to the problem; work with an ultrasonic emitter on the concentrate;
3. application of cream or gel; working with an ultrasonic emitter on cream or gel.

In procedures for volume reduction and weight loss, the intensity is set based on 10 gradations:

• + 10 kg of excess body weight - 5 USD;
• + 20 kg - 6-7 USD;
• + 30 kg - 8-10 USD.

Time - 20-30 minutes, continuous wave.

Advantages of the method:

1. No pain or discomfort during the procedure.
2. No electrical impact on the skin (ideal for those who cannot stand electric current).
3. Energizing tissues.
4. Ultrasonic wave on the entire surface of the emitter.
5. The use of a wide range of cosmetic products (Nature Bisse, Spain) provides a large selection of products for carrying out ultrasound procedures on the body and face).
6. The penetration of active substances with ultrasound is deeper than with electrophoresis; ultrasound - 6-7 cm max, electrophoresis - up to 1 cm (galvanic) and up to 3 cm (pulse currents).
7. 1-3% of the product taken for the procedure is introduced, of which the percentage of the substance in the product can be increased to 10% (with electrophoresis - up to 5%).
8. The depot's existence period is 2-3 days.
9. The means used are not limited to soluble substances.
10. Simple execution of the procedure.

Alternative methods

• On the face: microcurrent therapy, electrophoresis, mechanical vacuum therapy.
• On the body: endermology, needle lipolysis, vacuum massage.

Combination of method

• For the face: all types of superficial peels.
• On the body: myostimulation, deep heat, endermology.