The use of microcurrent in medicine and cosmetic improvement has been studied for more than 50 years. Stimulation with microcurrents is also called biostimulation or bioelectric therapy because it encourages cell physiology and growth. Essentially, microcurrent is a low level of electrical current that mirrors the natural current flow of the body. It serves as a noninvasive augmentation of the body’s natural electrophysiology through frequency, polarity balancing, and homeostasis. The effects of microcurrent (electroporation) in clinical medicine have demonstrated acceleration of healing bone tissue, wound healing, muscle rehabilitation, TMJ, tendon repairs, lymphedema, diabetes, and collagen remodeling.1,2 Nevertheless, microcurrent or microamperage electrical neuromuscular stimulator unlocked an exciting pathway to what may be possible for supporting the health and well-being of the skin. It also showed great potential for an aging population, as well as medical applications for supporting wound healing and pain management. The technology encourages a gentle energetic nudge to recharge cellular activity through mimicking the body’s own bioelectric current.
Microcurrent helps stimulate the body to manufacture and utilize proteins and nutrients required for optimal cell metabolism and it supports cell homeostasis. Marked improvement is found through increased circulation (lymph-blood), increased adenosine triphosphate synthesis, reduction of inflammation, increased fibroblastic activity, and more. Microcurrent is also beneficial for medical indications such as neuropathy, inflammation, healing (such as in pressure ulcers), stimulating bone repair, or management of pain.3,4,5,6
Electricity in human and animal tissue has been a topic of exploration for over 200 years. Understanding the principles of this science within the cells contributes to the appreciation of how all electrical devices stimulate and interact with tissue. Application and purpose of a device varies depending upon its intended use and who can use it. Microcurrent devices may be designed for supporting the healing of pressure ulcers and chronic wounds or for stimulating bone repair or management of pain. Others may be designed for cosmetic purposes, whereby they are beneficial for face lifting, muscle re-education, and overall tissue enhancement, as well as use for pre-and post-surgery care after cosmetic surgery.
Microcurrent is a noninvasive, nonthermal, and subsensory therapeutic treatment that delivers direct pulsed current in the millions of an amp called a microamp. It is subsensory, meaning it is normally not felt because the current is delivered in microamperage and is not able to incite nerve response. Instead it impacts biological activity. It also does not cause muscles to jump. Intensity levels for microcurrent can range from 25 to 1000 microamps depending upon the application. Manufacturers of these devices design them with variable programmable features and hand pieces. Microcurrent devices also require clearances and classification to ensure they are truly a microcurrent machine. Be mindful that some devices are misclassified and may not be a true microcurrent. Professional devices should be specifically engineered by a reputable company to ensure that an environment is created in the tissue that supports optimum response.
Wave Form Precision and Shape: How Waveforms are Delivered7,8
Waveforms are a graphic representation of the path, shape, direction, and pulse of the delivery of an electrical current. They permit microcurrent to penetrate cells at various frequencies and depths.9 We are not working with parameters such as high, medium, and low. Instead, it is about waveform measurement – the intensity of how much and how long the current is actually being delivered during a treatment. The shape of the waveform is what triggers different applications and results – circulation, muscle lifting, and increased circulation performed by numerous wave shapes.
Waveforms are generated and affect tissue at various intervals with laxity or intensity, allowing for fluctuations in the optimum delivery of the current. Sine waveform stimulates the epidermal and dermal blood lymphatic circulation and refines texture. Muscles may be lengthened to reduce fine lines and wrinkles and help to refine texture. Square waveform helps increases nutrient flow to the connective tissues of the epidermis, helps detoxify, reduces puffiness and fluid retention, and improves skin texture and lifts. Rectangle provides a tightening effect. Sawtooth has a palpating or pumping effect.
The science of electrophysiology is the study of the electrical properties of biological cells and tissues. It encompasses the voltage (current) activities and fluctuations that regulate the flow of ions throughout a cell membrane, the nervous system, and muscle organs such as the heart.10
Microcurrent is naturally generated in the body to produce the energy required for muscle movement and nerve impulses. It is the body’s own electrical system that provides the voltage for ionic exchanges across the cell membranes, allowing for cell functions including the intake of nutrients from the blood, removal of cellular waste, and movement of impulses along nerve pathways.11 The harmonious flow of these tiny electrical signals is also essential for healthy cell function and cell-to-cell communication. In the event of injury or disease there is signal disruption that obstructs the pathways of intercellular communication.
Cells are analogous to miniature batteries and electrical generators.12 They conduct electricity, create fluctuating electric fields, and are powered by a very low level of electrical voltage known as microcurrents. A unique bipolar membrane surrounds each cell and serves as a medium that separates intracellular and extracellular fluids. Imbedded in this membrane are 30 to 40 different ion channels that allow for communications in and out of the cell. The opening and closing of these channels are carefully regulated in order to influence cell function under normal and pathological conditions.13 Single molecules or complexes of molecules within the channels allow for the passage of positively and negatively charged atoms (ions) such as sodium, potassium, chloride, and calcium. The voltage difference in electrical potential across cell membranes is called membrane potential. Membrane potential arises from the interaction of ion channels and ion pumps that are embedded in the membrane, which maintain different ion concentrations on the intracellular and extracellular sides of a cell membrane.
Discovery of Ionic Channels
Earlier scientific studies confirmed the existence of ion channels in biological cells. There were numerous difficulties, however, in being able to define the specific types of channels. Ionic channels are very minute and arduous to measure. These difficulties were resolved through the development of an extracellular patch clamp method invented by German Nobel Prize winners, Erwin Neher and Bert Sakmann.14 By inserting an electrode pipette through the cell membrane, they were now able to closely study and measure the flow of ions including identifying the single channel currents in the cell membranes. This enabled them to confirm and study the regulation of ion channels that influences the life of the cell and its functions. Furthermore, Neher and Sakmann were able to record how a single channel molecule alters its shape to control the flow of current in and out of the cell, all within a few millionths of a second. Ionic channels play an important role in the generation of action potential in cells. Their revolutionary discoveries sanctioned further studies towards understanding the effect of defective ion channel regulation in the presence of disease, as well as toxic substances.
Mitochondria are essential to the growth and function of all cells and accomplish a multitude of metabolic tasks. The body has 250 different cells containing specific genes tailored to meet the requirements of each cell. There can be as many as 500 to 2,000 mitochondria scattered throughout the cytoplasm of a cell.15 The amount is specific to the location of the cell in the body. Mitochondria are the sites for aerobic respiration and energy production and contain their own DNA. They act as storage units for energy converted from food nutrients. Chemical energy is stored as sugars, amino and fatty acids, and is used for conversion into adenosine Triphosphate.16 Energy is manufactured in the form of adenosine triphosphate through the collaborative actions of proteins located in and on the inner mitochondrion membrane that is called the electron transport chain. Electrons are passed down this transport chain releasing energy at each step of the conversion process known as the Krebs Cycle. This complex electrochemical process is known as adenosine triphosphate synthesis.
New research reveals that the role of the mitochondria in health and disease is far reaching. Once defined as an energy factory, mitochondria also have specialized duties that adapt to each phase of life from embryo to old age. They are closely involved with most of the major metabolic pathways used by the cell to build, break down, and recycle its molecular building blocks. Moreover, it is also these progressive metabolic changes that become significant when assessing the actual biological age of cells and the state of their health. This information cascades into evaluating the probability of optimum response when performing aesthetic treatments.
The study of the cell indeed is complex but also cultivating for continual exploration in disease and optimum health. As members of the health care and beauty industry, grasping the core foundation of the physiology of cells and body systems creates new paradigms in the understanding of technologies and how they impact one’s ability to perform critical thinking when selecting treatment modalities, including cosmeceuticals.
GUIDELINES FOR USE OF MICROCURRENT
Each manufacturer will have a recommended protocol; however, the following are general guidelines.
Always provide a thorough skin analysis utilizing a health intake form and analysis device. Be mindful of any contraindications. Take a before and after picture at the first, sixth, and last sessions. Always take pictures in the same lighting and positioning: front face left-side view and right-side view with no smile, either standing or sitting.
Results are dependent upon age, health, lifestyle, and amount of accumulative skin damage. Be aware that it does take patience to repair and improve the skin which may involve several months. A homecare regimen is mandatory in order to provide optimum results. Years of sun exposure, smoking, alcohol, poor dietary habits, and overall lifestyle can compromise the skin barrier or its ability to repair. Systemic diseases and medications may also alter results or be contraindicative for treatment.
To prepare, thoroughly cleanse the skin – an enzyme may be used. Do not perform microdermabrasion or use an alpha hydroxy acid. Apply a well-formulated serum for the client’s skin type. Apply an interface product.
How many sessions?
Consider performing treatments in a series – call it a boot camp, especially when the skin has faced years of abuse, environmental exposure, or poor lifestyle (smoking, excessive alcohol, or poor nutrition). The concept that adenosine triphosphate can be stored is a valid reason for performing a series of sessions whereby there is a re-education process of muscle tissue. Perform a minimum of two to three times weekly (48 hours in between each treatment) for about 10 to 12 sessions.
The effectiveness of microcurrent is accumulative and, therefore, requires consistent sessions during the initial program. It is like exercising – one session a week is not going to provide much benefit. After the series, reassess the results. Normally, a once a month regular maintenance facial with the microcurrent is a good practice.
Do not layer too many treatments on the same day with a client. There is a great deal of energy that is delivered to the skin during the session of microcurrent. The skin requires time to receive and respond. Do not confuse it.
It is important to use the conducting product recommended by the manufacturer since they have designed and tested it to provide maximum conductivity. It is an essential interface to carry optimum signals between the electrode and the skin. Be aware that many products may not provide enough conductivity. This includes coupling gels, distilled water, and oil-based creams. If the machine has an indicator light for conductivity, it is a good guide for ensuring optimum conductivity.
Client commitment and compliance: if they are not committed, then do not waste their money. Maybe it is not the right time for them at the moment.
Suggested homecare regimen products should be biomimetic to the skin. What that means is that the cell requires saturated fatty acids, linoleic acid, phosphatidyl choline, ceramides, peptides, antioxidant, cholesterol, and other nourishing ingredients to help restore the skin. It is not necessary to use products containing exfoliators such as alpha hydroxy acids.
Clients should drink adequate levels of water daily and come hydrated to the session. Sometimes a glass of water just prior to treatment may be necessary. Furthermore, eating lots of fruits and vegetables helps provide minerals that carry current within the cells.
Surrounding Electrometric Devices During Treatment
Turn off any electrical warming blankets, since lying on one may interfere with treatment delivery. Warm the facial bed prior to treatment but unplug it during the session. Clients’ cell phones should be turned off and away from the treatment area.
CONTRAINDICATIONS AND CONDITIONS FOR MICROCURRENT
When in doubt, always check with a medical professional. Always work within the scope of practice.
Conditions that may require clearance from a medical professional include diabetes, light sensitive migraines, metal pins or plates at the site of treatment, stroke, and Bells palsy.
Conditions that may interfere with or reduce the results include application of an incorrect conducting product. Use what is recommended by the manufacturer who has tested and calibrated their device to the conducting formula. Poor conducting gels will not send a correct signal to and from the epidermis. Oil-based products do not conduct. Dehydration, age, poor lifestyle (smoking, alcohol), inadequate nutrition, tanning beds, overexposure to ultraviolet light, poor sleep habits, certain medications, and a thyroid condition can also interfere.
Summary of Microcurrent
· Promotes cell metabolism and tissue repair
· Supports circulation – blood and lymph
· Reduces inflammation
· Diminishes lymphedema in cancer patients
· Helps increase mitochondria activity through increasing adenosine triphosphate
· Increases natural production of collagen and elastin
· Supports scar repair by dispersing scar tissue and collagen remodeling
· Increases protein synthesis, gluconeogenesis (GNG), and membrane transport
· Reeducates and rejuvenates muscle tissue
· Supports healing of bone17
· Heals skin ulcerations18,19
· Helps with pain management in equine medicine20
· Aged and slackened skin
· Improvement of skin texture
· Mitigation of fine lines and wrinkles
· Reduction of acne scars
· Improvement of muscle and tissue when used pre- and post-surgery
· Reduction of trauma, irritation, and inflammation and aid in skin healing, as well as minimizing scar tissue, when applied post-surgically
· Muscle tightening or reduction of C-section scars in the abdominal area post-childbirth
Innovative applications for microcurrent technology encompass the beauty industry for face and body sculpting. There are significant benefits when applying these external energy sources. The application of microcurrent also supports skin correction by encouraging the repair process. Aging or compromised skin requires a program of restoration that is gradual and progressive for long-term optimum health. Microcurrent may mitigate the practice of aggressive peels or serve as an adjunct therapy to thermolysis (laser) as newer research reveals that these modalities may be adding more injury to compromised skin.
Clearly all modalities of correction certainly have their place. Prior to choosing a course of treatment, including product selection, the first step in skin correction is to determine the level of damage caused by sun damage, the aging process, and other skin conditions. A thorough skin analysis should be performed prior to any treatment.
The future for the use of microcurrent relies on education and understanding of the cells and body systems and the benefits that are available from this innovative technology. The intended use for microcurrent in aesthetics is to present a powerful and effective tool to aid in inspiring a healthy skin transition from youth to maturity.
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Alexandra J. Zani is an international educator, licensed instructor, speaker, author, and researcher in the professional skin care industry. Her career has included business ownership and management, consulting, product development, and author for textbooks and industry trade publications. Her academic background includes cell biology and medical technology. Zani has received numerous advanced certifications, both in the Unites States and abroad, in the dermal sciences, spa therapies, microcurrent, LED, and non-ablative laser. Zani is the owner and director of AEsthani Skincare Institute, LLC in Greenville, South Carolina and is also co-founder of Intellective Aesthetics, dedicated to post-graduate aesthetics studies.