Phonophoresis: mechanism of action, technique, indications and contraindications

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

The scoring is carried out through contact media. Ultrasound increases the activity of drugs, promotes their intracellular penetration, lengthening their action, reducing side reactions.

The introduction of the necessary substances into the body during ultraphonophoresis occurs through the excretory ducts of the sweat and sebaceous glands. And, no less important, there are also percutaneous and intercellular pathways. During the procedure, the cosmetic agent must be included in the contact medium, and it must maintain its structure and pharmacotherapeutic activity when the mechanical wave acts. The substance that forms part of the contact medium can be prepared in the form of an emulsion, ointment, cream or solution. The basis for the contact medium with ultraphonophoresis can be glycerol, lanolin, vase lipo oil, DMSO, vegetable oil.

Unfortunately, not every substance can be introduced by ultrasound. Of traditional medicines, only some drugs can be administered (for the cosmetologists, the introduction of an extract of aloe, heparin, interferon, hydrocortisone, lidase, prednisolone may be of interest).

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

The drugs medicated in the ultrasound field penetrate the epidermis and the upper layers of the dermis through the excretory ducts of the sebaceous and sweat glands. But, in contrast to electrophoresis, when using ultrasound, it is not possible to accumulate in the skin medicinal substances in sufficient concentration, and they act for a relatively short time. Despite this, as a result of the combination of the action of phonophoresis and various therapeutic effects of the ultrasonic wave (mechanical, thermal, chemical), the therapeutic effects are potentiated and prove to be quite pronounced. Significant progress in the use of phonophoresis in cosmetology occurred after the creation in the mid-1990s of the 20th century. Cosmetic gels for ultrasound on the basis of extracts from algae, ginseng, jojoba, etc. Phytoextracts are transported to 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 various layers of the skin and help to solve many cosmetic problems. With their help, lifting, treatment of acne, pigmentation, cellulite

Procedure parameters

The depth and strength of the effect of ultrasound on human tissue depend on the frequency and the dose (intensity) of the ultrasonic wave. Intensity of ultrasound in physiotherapeutic devices is dosed in W / cm ². In cosmetology devices intensity is indicated in conventional units (color scale).

The dose (or intensity) of the ultrasonic - is the energy of passing in one second through an area of 1 cm ², disposed perpendicular to the direction of wave propagation; measured in watts per square centimeter II (W / cm ² )

When performing cosmetological procedures, the ultrasound intensity does not exceed 1.2 W / cm ². If the intensity of ultrasound changes with time, then it is a pulsed ultrasound, and it is characterized by average or maximum changes.

The squareness 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 in the human body depends on the density of the tissue, on the nature and concentration of substances per unit volume. In muscles, internal organs, the ultrasound velocity varies between 1450-1650 m / s, in bone tissue - 3500 m / s. The doses for ultrasound treatment depend on the frequency of the procedures, the time of treatment, the points of application, the course of treatment, etc.

In cosmetology, ultrasound devices for working on the face, as a rule, have 3 levels of intensity, apparatus for working on the body - 8-10 levels. Choosing the intensity of the procedure, the cosmetologist should be guided by the client's senses and the color intensity scale. Comfortable and sufficient for the procedure of sensation of easy warmth. With a further increase in the level of intensity, one can get a complication in the form of a burn (especially when using a radiator-scapula).

There are 2 modes of ultrasonic wave generation:

1. constant (sequential).
2. impulse ..

A pulsed ultrasonic wave is used to obtain nonthermal effects (treatment of inflammatory, pustular diseases, couperose, procedures on sensitive skin, acute pain syndrome).

A continuous ultrasonic wave is used for cicatricial changes on the face and body (including post-acne), hematoma treatment, "dark" circles under the eyes, striae, hyperpigmentation, and also in the period of remission of a number of skin diseases

The intensity of ultrasonic oscillations generated in a continuous mode is 0.05-2.0 W / cm ². In the pulse - 0.1-3 W / cm ².

Due to intensive attenuation of ultrasonic vibrations, the action is carried out through an aqueous or oil contact medium (gel, cream, water).

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

The time of the procedure depends on the treated area of the skin. The area of one field of influence should not be more than 100-150 cm ². In carrying out the first procedure, only one field is sounded, and if it is well tolerated in the future, several fields can be influenced. The duration of exposure to one field is 3-5 minutes, the total duration of the procedure is 10-20 minutes. An increase in the intensity or time of the procedure does not improve the effectiveness of treatment, which is associated with the final value of the ultrasound wave energy absorbed by the skin for therapeutic purposes).

Duration of appointment of ultrasound treatment depending on the field of application

Application area	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). Supportive course - 1 procedure in 10-14 days.

If the client experiences discomfort during the procedure (weakness, dizziness, strong local heating under the radiator, etc.), you should reduce the intensity or interrupt the procedure.

The repeated course of treatment for the same zone can be carried out not earlier than in 2-3 months. If 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 work of the electrode? It is necessary to apply a drop of water to the radiator, while the drop "boils" and begins to splash (the effect of cavitation - the formation of airless bubbles).

Disinfection of the radiator:

1. Switch on the machine.
2. Select the mode of operation "body" (or the maximum intensity value on the "line").
3. Timer for 2 min
4. To drip water on the radiator.
5. After 2 minutes turn off the device

Scheme of procedures for ultrasonic massage and phonophoresis. To work on different areas of the body, a round radiator of a certain size (large, medium, small) or a radiator-blade is chosen.

Face:

1. make-up remover;
2. cleansing with milk;
3. tonification;
4. application of active concentrate;
5. work on concentrate;
6. application of cream, work on cream.

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

Eyes:

1. make-up remover;
2. cleansing with milk;
3. tonification;
4. ultrasound massage + phonophoresis according to the "face" program: application of active concentrate;
5. work on concentrate;
6. application of cream, work on cream.

The time is 5-7 minutes, the wave is continuous.

Body:

1. body peeling; rinse with water;
2. application of concentrate to the problem; work by an ultrasonic radiator on a concentrate;
3. applying a cream or gel; work with an ultrasonic radiator cream or gel.

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

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

The time is 20-30 minutes, the wave is continuous.

Advantages of the method:

1. Absence of pain and discomfort during the procedure.
2. Lack of electrical impact on the skin (ideal for those who can not stand the electric current).
3. Energy saturation of tissues.
4. Ultrasonic wave on the entire surface of the radiator.
5. The use of a wide range of cosmetics ("Nature Bisse", Spain) provides a large selection of means for performing ultrasound procedures for the body and face).
6. Penetration of active substances with ultrasound is deeper than in electrophoresis; ultrasound - 6-7 cm max, electrophoresis - up to 1 cm (electroplating) and up to 3 cm (pulsed currents).
7. 1-3% of the funds taken for the procedure are introduced, of which the percentage of the substance in the agent can be increased to 10% (with electrophoresis - up to 5%).
8. The lifetime of the depot is 2-3 days.
9. The agents used are not limited to soluble substances.
10. Simple execution of the procedure.

Alternative methods

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

Combination of the method

• On the face: all kinds of superficial peelings.
• On the body: myostimulation, deep heat, endermology.