Before a skin care professional can select the appropriate treatment regimens for their clients, they must have a basic understanding of electricity. Electrotherapy is the term for electricity used during skin care treatments. Many aesthetic treatments incorporate the use of electricity, as common as a basic facial using steam. The benefits desired and results achieved are dependent upon the appropriate use of electricity set to the proper dosage. Electrotherapy can be very beneficial to the skin when used wisely; however, use without adequate training and knowledge of the primary electrical concepts can be detrimental or deliver no effects at all. Together, let’s explore the current electrotherapy trends, its benefits, and electrical safety precautions necessary to run a thriving skin health center.
Direct and alternating are the two forms of electric current used in skin care, both charged by electrons. In a direct current, the electrons flow in only one direction, while the electron particles travel both ways in an alternating current.
ELECTROTHERAPY BENEFITS AND EFFECTS
Electrotherapy has three primary benefits: thermal, mechanical, and electrochemical.
Thermal (heating): One example of thermal electrotherapy is heat emitted from a steamer. It relaxes the skin and expands pores for extractions or deeper product penetration. Mild heat is relaxing, while intense thermal exposure can destroy tissue. To the contrary, brief exposure to cold is stimulating, while prolonged exposure damages tissue. Radio frequency is a form of thermal electrotherapy that creates friction or heat within the cells through radio waves, which generate heat or friction within the cells. Radio frequency devices deliver electrical energy deeply into the skin, changing electricity into heat. When set to specified levels, radio frequency tightens the skin and increases collagen and elastin production.
Mechanical (magnetic): These effects are similar to the push and pull of magnetic attraction, as with a rotating brush on a multi-function aesthetic machine used to exfoliate superficially and deep cleanse the epidermis.
Electrochemical: This form occurs as an electric current travels through a liquid conductor (product) onto the skin. Galvanic is the only direct current that produces an electrochemical effect by pushing positive or negative ions into the skin, making it more acidic or alkaline, depending on the desired results.
TRIED AND TRUE ELECTROTHERAPY DEVICES
The following devices have sustained growing popularity for many years.
Microdermabrasion has enjoyed popularity for years. It is often in the top five non-invasive aesthetic procedures reported by the American Society of Plastic Surgeons in their yearly report. I received microdermabrasion training in aesthetic school using aluminum oxide crystals; some professionals still prefer this method today. Most professionals have crossed over to the newer technology using the diamond-tip method and advancing even further to hydrodermabrasion and dermal infusion treatments. Whichever method you choose, the client benefits from increased circulation and superficial exfoliation.
We are often first introduced to high-frequency devices in aesthetic school. The sound of the current igniting the neon or argon gas lets you know that the Tesla current is at work, generating a bactericidal layer on the skin and eliminating excess oil. While many students and future skin care professionals use direct high-frequency for drying out oily skin, killing bacteria, or stimulating the scalp, the benefits of indirect high-frequency are often forgotten or overlooked. Using the indirect method, the professional can massage in serums for deeper penetration and nutritional value, in addition to stimulating the client’s skin.
This device uses a low-level, medium-amperage direct current to stimulate cells, soften skin’s outer surface, and drive serums into the skin. Two separate processes determine the benefits derived and results achieved based on the polarity used.
Iontophoresis is primarily used for dry, mature, or dehydrated skin. A treatment serum or gel is applied to the client’s skin. Next, a negative electrode is held by the client or can be placed under the shoulder. Lastly, the professional manipulates a positively charged electrode over the skin, which drives product penetration.
Desincrustation makes extraction much easier for the professional and less painful for the client. This process saponifies (softens and emulsifies) the keratin and sebum contained in hair follicles. An alkaline solution is pushed into the skin through negative polarity, followed by expression of the debris in the treatment area.
This modality is one of the newest, with its origination dating back to the 1980s, when it gained FDA approval as a muscle stimulator before transitioning into the cosmetic market. Microcurrent delivers low-level direct current to mimic the body’s natural electrical flow, which improves the appearance of the aging client. The device retrains muscles to their original state. Microcurrent sends waves through the skin, tissues, and down to the muscles. Microcurrent stimulates adenosine triphosphate production. Adenosine triphosphate stimulates collagen and elastin synthesis and is the biochemical way to store and use energy. The increase in adenosine triphosphate production energizes facial muscles, which are attached to the skin, resulting in an improved, lifted appearance.
Another newer and top-rated service offered by aestheticians is microneedling, otherwise known as collagen induction therapy. The pen-like device creates controlled micropunctures (channels) that stimulate the inflammatory cascade and wound healing process. The micro-injuries trigger the release of cytokines (small cellular substances that act as communicators) and growth factors that trigger the remodeling of collagen and elastin in the dermis.
The professional should be well educated on how to use this device. Microneedling can have very superficial penetration or reach deep into the dermis. Needle depths can range from 0.25 millimeters up to 3.5 millimeters. In most states, a professional is limited to a needle depth of one millimeter as defined by their scope of practice. The manufacturer of the specific unit can give guidelines as to precise needle depth penetration.
INNOVATIVE NEW ELECTROTHERAPY TRENDS USED IN SKIN CARE
One electrical stimulation therapy is plasma pen. Plasma Pen treatments are amongst the newest innovations in the aesthetic industry. This non-surgical, non-invasive technology treats sagging skin, wrinkles, and acne scars with amazing results. The procedure boasts no bleeding, bruising, or downtime; however, the client may experience social downtime, as the treated area will be very red, then crusty, followed by flakiness.
The three commonly recognized states of matter are solids, liquids, and gases. Plasma is the fourth state. Plasma forms when energy is added to a gas, causing some of its electrons to leave its atoms through the process called ionization.
The plasma pen produces plasma (an ionized gas) between the tip of the tool and the client’s skin through ionization. During the treatment, an electric arc forms (sometimes referred to as a plasma flash or miniature lightning). This arc focuses on a target on the surface of the skin, which causes a controlled burn and dissipates heat throughout the treatment area.
The outer layers of the epidermis are the only layers touched, causing the tissue to retract in a process called sublimation. Only the targeted tissue sublimates; therefore, there is no damage to the surrounding areas. Heat dissipation throughout the treatment area stimulates fibroblasts to secrete new collagen and elastin fibers which, in turn, promotes plumping and tightening of the skin. Normal activities can resume immediately with minimal discomfort.
Plasma pen treatments can address the following skin concerns:
- Accordion lines
- Acne scars
- Crow’s feet
- Forehead and frown lines
- Smoker’s lines
- Sagging neck
- Sagging jowls and jawline
- Marionette lines
- Nasal labial folds
- Stretchmarks (hyperpigmentation)
- Hooded upper eyelids
- Baggy lower lids
- Loose skin on arms
- Skin tags
- Lines on the décolletage
Many practices boast excellent results with this new technology; however, Health Canada has not authorized the sale or use of the pen in our neighbor to the north. The Canadian agency has received a few complaints from Canadian spas and state that they have not yet tested the device for safety. Diligent research will confirm if an FDA-approved plasma pen is the right choice for your business.
Thermal Stimulation Therapies
Cryotherapy and radio frequency are examples of thermal stimulation therapies. Cryotherapy is the practice of applying low-temperature treatments and dates back to ancient Egypt, the Roman Empire, and Greece. Cryotherapy is a non-invasive modality. Cryotherapy facials use alternating current to accelerate microcirculation, which encourages collagen production, supports better oxygenation of dermal cells, and helps detoxify tissues, which in turn tightens the skin and delivers a youthful glow. The skin is rapidly cooled by a beam of vaporized liquid nitrogen or carbon dioxide through a cryoprobe. Cryotherapy treatments reduce the surface temperature of the skin to four degrees Celsius. The procedure stimulates tightening of the microcirculation bloodstream, known as vasoconstriction, then, the dilation of blood vessels and capillaries, which help to flush out toxins and impurities. The entire treatment only takes 10 minutes with immediate results. This modality can be conducted as a single treatment; however, most providers feel that best results are achieved with a series.
Benefits of a cryotherapy facial include:
- Reduction in the appearance of wrinkles
- Stimulation of collagen and elastin production
- Reduction in pore size
- Improvement of hyperpigmentation
- Improvement of tone and texture
- Calming of inflammation
- Stimulation of follicular growth
- Lessening in the appearance of acne scarring
Contraindications for cryotherapy include:
- previous or current cancer patient
- a cold or allergy
Radio frequency, a skin tightening modality, is an aesthetic technique that uses radio frequency. Radio frequency is the oscillation rate of an alternating electric current. The energy from radio frequency currents in conductors radiates into space as electromagnetic waves (radio waves). In aesthetic treatments, these waves can heat tissue and stimulate collagen production. As skin tissue tightens, fine lines become less visible. The procedures are scheduled as a series, with results lasting approximately six to 18 months.
HOME USE DEVICES
Home use devices are often purchased by the consumer online, instead of more expensive in-office procedures or devices used to maintain professional treatment results.
Microneedling or dermal rollers create microscopic tears in the skin. These devices can cause injury to the epidermis. Unless purchased from a reputable manufacturer who supplies adequate training, the consumer should avoid these devices.
Handheld LED devices purchased from reputable manufacturers can be an excellent addition to the homecare regimen. Handheld light emitting diode devices can help fight acne bacteria, address aging skin, and provide therapeutic pain relief.
Handheld microcurrent devices lack the intensity of professional treatments but are a good option for in between office visits.
Home microdermabrasion devices are typically not as strong as a professional device. The consumer needs adequate training as to the correct frequency of use, the intensity of suction, and correct grit of the tip if multiple tips are supplied. Additionally, the consumer must be well versed on skin conditions that contraindicate its use altogether.
CONTRAINDICATIONS TO ELECTROTHERAPY
Contraindications to electrotherapy include the following:
- Inflamed skin
- Open lesions
- Heart conditions
- High blood pressure
- Metal plates, pins, and staples
- Dilated capillaries
- Couperose or rosacea
- Joint replacements
Use with caution with dental implants, braces, strong acne medications, and hypersensitive skin.
With indirect high frequency, additional contraindications include vascular skin, telangiectasia, heart disease, nervous clients, or high or low blood pressure.
Additional contraindications to galvanic include pacemakers, metal implants, diabetics, or heart conditions. And with microdermabrasion, additional contraindications are telangiectasias, acne lesions, recent use of retinoids, sunburn, or inflamed skin.
This list is not intended to be all inclusive; check with the manufacturer of the modality for a complete listing.
SAFETY PRECAUTIONS FOR ELECTROTHERAPY USE
Be sure to check that your outlets are not overloaded and that electrical cords are not frayed and are unplugged when not in use; additionally, check that floors remain dry. Never leave a client unattended when any electrical device (including a steamer) is in use. Make contact with the skin before turning on the unit when using galvanic or high-frequency to prevent shock.
Our exciting industry is always evolving. We are constantly introduced to innovative, advanced technologies that promise to deliver amazing results. Do your homework and research any new modalities that you are interested in adding to your treatment arsenal. Look for scientific studies to show safety and effectiveness. Finally, check with your state board to ensure that using this modality falls within your scope of practice.
Armed with education and information, elecctrotherapy can be a great addition to your spa.