This precise process provides for a particle-free, gentle, and effective removal of the outer layers of the stratum corneum, enhancing the skin's natural turnover and renewal process. Ultrasound operates without any harsh crystals or chemicals, using distilled water for the blade action. Results are immediately seen. The gentle frequency of low ultrasonic energy spins water molecules across the skin in fast, powerful, non-invasive vibrations of approximately 28,000 times per second, lifting micro-damaged corneocytes off the skin. This vibration action loosens the upper portions of the stratum corneum while it whirls away dead skin cells and dermal debris. The low frequency action is extremely safe and effective leaving the skin soft, smooth, and vibrant. In addition, a perfunctory benefit of this action kills bacteria in acne-prone clients via penetration of its membrane, kills viruses, reduces inflammation linked to skin aging, and opens tiny pathways around cells allowing water in and out that signals the cells at the stratum basal to perform like younger acting skin. The blade, in cavitation mode, can be used as a painless extraction method where comedones are observed 'dancing' on the tool itself!

Simply put, the 'wand' applicator tool resonates gentle sound waves into the skin, creating what is called a 'cavitation' effect. This is important to understand how the system operates. Cavitation is a non-invasive 'force' when low-level sound waves pass through a medium, skin in this instance, and create microscopic bubbles. These bubbles form instantaneously, then burst simultaneously that quickly repeat a rapid rebounding cycle releasing tiny amounts of energy on the skin's surface. This action can be likened to when a balloon pops with the sudden release of air under expansion pressure. The 'bubbles' trigger an effective peeling safe for all skins because it is non-invasive and color blind. No pre-treatment guidelines are needed for ultrasound making it a perfect procedure for acne, aging skin, rosacea, and pigmentation with immediate results.

How does the science substantiate the 'cavitation' theory?
Low frequency ultrasound produces change in water by the generation and subsequent destruction of cavitation bubbles through compression and rarefaction (decompression) cycles. At specific frequencies, the rarefaction cycle may exceed the attractive forces of the water and cavitation bubbles will form. These bubbles propagate by a process known as rectified diffusion. Vapor from the medium enters the bubble during its expansion phase and is not fully expelled during compression. The bubbles propagate over a period of a few cycles to an equilibrium size for the particular frequency applied. The energy for the chemical and mechanical effect is due to the hydrodynamics of these bubbles as they collapse in the compression cycles.
The cavitation bubble has a variety of actions within the liquid medium depending upon the type of system in which it is generated. These liquid mediums include homogeneous; heterogeneous, solid/liquid; and heterogeneous, liquid/liquid. In homogeneous liquid-phase reactions such as water, the bulk liquid immediately surrounding the collapsing bubble generates kinetic energy, which produces mechanical effects. The bubble itself will be subjected to extreme conditions of temperature and pressure on collapse leading to
chemical events.
In the first mechanism relating to the treatment as described in the method of use, the dynamic of bubble collapse differs. Collapse of a cavitation bubble on or near the surface is asymmetrical because the face provides resistance to the liquid flow from that side. The result is an inrush of liquid predominately from the side of the bubble remote from the face resulting in a powerful liquid jet being formed, targeted at the face. The effect is high-pressure micro-jetting and this is the reason low frequency ultrasound is effective for the cleansing of surfaces. It is also the force that releases comedones and milia and will destroy surface microbes.
Human skin behaves as an anisotropic, non-homogenous, non-linear visco-elastic material subjected to pre-stress. The rapid compression and decompression of the skin tissue due to the frequency, power densities, and technique provide the basis of a theory to the observed phenomenon of sebaceous material ejected from the follicle at depths estimated up to 4mm. Furthermore, water may enter the follicle on a subsequent pass as described in the method of use. The theorized result would be high pressure jetting inside the follicle sufficient to pierce the membrane of bacteria rendering it inactive.
The low dose ultrasound treatment results in mild and transient erythema that typically resolves between five to 10 minutes. This is a normal occurrence. For reasons not yet fully understood the treatment has consistently proved to be anti-inflammatory in more than 100,000 treatments, despite the transient erythema during ultrasound. One hypothesis for this anti-inflammatory action is that the pro-inflammatory free fatty acids produced by the action of P.acnes on sebum are removed by the cavitation. Reduction in these free fatty acids by other means such as esterification has significantly reduced comedones and inflammatory acne efflorescences. Free fatty acids are not primary parts of sebum, but rather are formed secondarily during hydrolytic decomposition of triglycerides. The catalyst enzyme is a lipase of bacterial origin formed primarily by the anaerobic, gram-positive P. acnes bacteria.
Ultrasound has been studied under the auspices of leading universities and has been substantiated to increase the efficacy of skin treatments up to 10,000 times! Healthy for the skin, ultrasound clients see instantaneous results after their
first treatment!
A prospective study was also undertaken involving six female subjects who underwent weekly post auricular treatments using the ultrasonic exfoliation function with intermittent 2mm punch biopsies performed for histological analysis. Histological results indicate that on average, 35.52 percent of the stratum corneum layer of the epidermis was removed with one treatment regimen consisting of three forward passes of the blade. Subjects experienced no complications from the post auricular treatments. Concluded from this study is that the ultrasonic system is an effective, economical, and user-friendly modality for clients desiring superficial rejuvenation of facial skin.
The exfoliation, or peeling of the skin, occurs through the formation of vapor bubbles within a flowing liquid at low-pressure regions that occur in places where liquid has been accelerated to high velocities. Vapor bubbles expand as they move along with the flow of the liquid and suddenly collapse when they reach regions of higher pressure. This phenomenon provides effective exfoliation of the outer layers of the epidermis when the blade is applied to skin, which has been sufficiently wetted with fluid. This is the key. The rapid mechanical oscillation of the hand piece interacting with the fluid on the skin produces controlled, even peeling, which effectively and safely detaches and removes skin cells from the outer layers of the stratum corneum without trauma.

Therapeutic ultrasound produces a combination of nonthermal effects (acoustic streaming and cavitation) that are difficult to isolate. You no longer need to use a steamer. Acoustic streaming is defined as the physical forces of the sound waves that provide a driving force capable of displacing ions and small molecules. At the cellular level, organelles and molecules of different molecular weight exist. While many of these structures are stationary, many are free floating and may be driven to move around more stationary structures. This mechanical pressure applied by the wave produces unidirectional movement of fluid along and around cell membranes.
Distilled water is applied to the face with a 4x4 inch cotton gauze. The wand (or blade) causes a rapid motion of the water resulting in surface cavitation as seen in a 'steam' arising from the blade as it is moved forward and backward over the face while the distilled water is dispensed. This part of the ultrasound treatment is completed in five to 10 minutes.

The Sonophoresis Principle of Ultrasound
Sonophoresis is the next modality and an important application process of ultrasonic skin rejuvenation. Not all machines claiming to be ultrasound feature this important phase of the treatment. The research on the subject has been extensively documented with lead researchers at MIT and the University of California at Santa Barbara. The researchers were, and still are, studying sonophoresis for transdermal drug delivery of substance such as insulin.
What is interesting is that the research group found several years ago that frequencies between 20KHz and 30KHz produced an effect that opened intracellular pathways into the skin and traditional Megahertz (MHz) ultrasound had no such effect. This is an important element of facial rejuvenation. Many 'fake' or underpowered ultrasound machines on the market do not have the Kilohertz (KHz) balance to be effective and at best only create a heat in the skin.
Why is correct KHz important? Sonophoresis uses ultrasonic frequencies to help transfer high molecular weight substances through the skin, such as antioxidants, peptides, botanicals, etc. Sonophoresis action creates pathways in skin that allow ingredients to pass into the environment. Low-frequency ultrasound, just above the range that is audible to the human ear, enables dissolved gases in liquid regions between skin cells to bubble up and start to move. This action creates pathways in skin to allow these formulas to pass into the body and the skin will stay permeable for four hours after ultrasound application.
One of the major problems when applying topical products to the skin is that they often have molecular weights too large to become bioavailable to skin cells. Sonophoresis uses ultrasonic frequencies to help transfer high molecular weight substances through the skin. Low-frequency ultrasound enables the dissolved gases in lipid regions between skin cells to effervesce and start to move. Almost all antioxidants will become more bioavailable to the skin cells through the pathways created by the sonophoresis frequency in accordance with the research that has been proved out to be a scientific fact.
Sonophoresis is integral in delivering topical antioxidants, peptides, AHAs, hyaluronic acid, ceramides, and other components into the skin for more effective transport. Given this, it is well documented that vitamins taken orally are not delivered to the skin in sufficient quantities due to poor absorption, improper functioning of metabolic systems, and the aging paradigm. For example, only 20 to 40 percent of vitamin E is absorbed into the body and a very small fraction of this percentage actually reaches the skin cells. Sonophoresis changes this medium by increasing the topical bioavailability of these ingredients to the cells, thus providing the skin a healthier outcome and maximizing the full benefits of these components.
It is well established by practicing aestheticians that cosmeceuticals play an important role in skin care if they are functional, penetrate the skin, safe, free of side effects, and used at proper levels. Antioxidants play a significant role in correcting skin disorders by reducing the oxidative load via detoxification, inflammatory inhibition, and DNA repair mechanisms. Research has shown that micronutrients play important functions in preventing cellular skin damage due to their active role in promoting energy metabolism. They also are active in DNA repair by acting as antioxidants by donating electrons and protons to reactive oxygen and reactive carbonyl species.
Damage to skin proteins is the major cause of skin deterioration. Glycation leads to the formation of complex chemical modifications termed advanced glycation end-products (protein-AGE). Protein-AGE causes skin damage in at least three ways: they cause DNA damage, they inhibit DNA repair, and they directly change the structure of skin matrix proteins resulting in loss of elasticity. Almost all antioxidants and other ingredients will have a superior bioavailability and be more effective to skin cells through the pathways created by the sonophoresis frequency, according to the research that has been proved out to be a scientific fact.
Key to ingredient delivery is the use of low-frequency ultrasound, which is sound waves oscillating at a rate above 20KHz. In the new method of diagnostics, low-frequency ultrasound is applied to skin for about two minutes. The sound waves cause cavitation – the blowing and bursting of micro bubbles that, in turn, open up tiny pores in the thin upper skin layer so that it becomes permeable. The skin stays permeable for four hours after ultrasound application.
Topical sonophoresis delivery allows direct targeting of the bioactive compound to the skin and increases the efficacy 4,000 – 10,000 times, depending on the molecular weight of the ingredient. Aestheticians increase the benefits of their skin care treatments resulting in superior outcomes for acne, treatments resulting in superior outcomes for acne, pigmentation, rosacea and aging skin.

Microcurrent Therapy: "Wave" of the Future
Microcurrent therapy is one of the most amazing and fascinating modalities used with ultrasound. The term micro-amp/current refers to an electric current measured as one millionth of an amp.
To understand its beginnings, micro-amp has been standard practice for many years in physical therapy to use milliamps for pain relief (TENS) and cellular healing. This view is rapidly changing as bioelectrical and biochemical researchers in the U.S. are realizing what scientists in Europe have known for quite some time; that the membranes of injured human cells retain excess electrical current. Damaged skin cells or any cells that comprise human tissue that have been injured, such as sun damaged skin, hold this excess current and thus need to be brought back into their natural range. The more damage, the greater the cell membranes "hold in" electricity.
The purpose of micro-amp therapy with an ultrasound treatment is to return the damaged facial skin cell's electrical potential to a normalized state. Cells are damaged via many different pathways and ultrasound delivers three levels of microcurrent designed to mimic the natural electrical potential of a human skin cell. This micro-amp therapy has been so successful that the Los Angles Lakers, The Canadian Olympic Team, four gold medal Olympian Carl Lewis, The New York Mets, and many other prominent sports teams have now abandoned milliamp electrical machines for the micro-amp machines. It is important to note that these athletes are not using micro-amp therapy to improve their looks but rather to accelerate the healing of various sports injuries. Nevertheless damaged tissue and the inflammatory responses of this damage are similar in nature and it is the degree of damage that is significantly different. This example is used as further proof to the importance why you should incorporate this phase into your skin care practice.

Micro-amp cell therapy has been shown to overcome the cell impedance barrier significantly to increase ATP production in the mitochondria, the cellular organelle that provides critical cellular energy building new proteins and increasing ion transport. By reestablishing homeostasis, micro-amp therapy permits the transport of nutrients back into the damaged cells, and the removal of waste products. Micro-amps in the 5uA to 50uA range increase epidermal growth factor receptors, which is one of the main factors in collagen synthesis. This therapy uses currents in the micro amp range that are 1,000 times less intense, and below sensation threshold. A typical micro-amp pulse is about 0.5 seconds.
Finally, micro-amps have a profound effect on the complex process of the immune system of the skin and rudimentary for the development of healthy tissues. An aesthetician's goal should always be to improve the Extra Cellular Matrix and connective tissue. Simply put, the dermis feeds the epidermis and they need the optimal function of each other to produce healthy skin. It is important to note that when the complex processes of the skin are supported by growth factors and DNA protective agents such as properly formulated sun blocks and antioxidants, it can better identify and destroy cells that have DNA damage. In short, when the immune system does not have to work "extra jobs", it has amazing resources to regenerate damaged
skin tissue.
Furthermore, when cells have healthy DNA and healthy membranes, they take in nutrients and expel waste products more effectively. This is what the cells in almost any organism strive for: a state of perfect homeostasis.
Because electricity will always take the path of least resistance, traditional electrical charges placed on the body will travel around the traumatized cells. A smaller current – one that can penetrate the cell and balance the cell electrically – can restore a more normal physiological state to the damaged cells. Small electrical charges may be helpful in initiating and perpetuating the numerous electrical chemical reactions in the healing process.
The seemingly amazing results that we can obtain with microcurrent therapy may just be a matter of throwing an electrical switch that allows the heating to commence. It is believed in the human electrical potential that the human body has the equivalent of electrical circuits that play a very important role in healing.
All the physiological rationale behind the clinical effects of microcurrent has not been fully ascertained. It would appear to be more clinically effective than other forms of electrical stimulation for the following reasons:

1. The microcurrent unit is biologically more compatible.
2. It is more effective in neutralizing the oscillating polarity of injured cells.
3. The current under 600 micro-amps has a positive effect on increasing local availability of ATP.
4. Microcurrent has a positive effect on increasing cell permeability.

Given all the excitement surrounding this wonderful technology, not all ultrasound appliances are created equal or perform based upon the energy principal discussed in this article nor are they registered by the FDA. The ultrasonic machine you purchase should be registered as a Class 1 device with the FDA and be able to prove it. When wisely selecting a unit, ensure the company you purchase the ultrasound from can provide the science behind the machine they sell and will also provide you references, training, treatments, marketing aids, hot line support, warranty, service, continuing education, manuals, and a loaner unit in the event you need one.
In conclusion, ultrasound is a cutting-edge system that utilizes low frequency sound waves to perform aesthetic services that raise the bar in professional skin care triggering a variety of functions that will provide new options for treating your clients including, but not limited to the following:

1. gentle exfoliation/peeling of stratum corneum with cavitation
2. deep sonophoresis penetration of topical anti-oxidants, peptides, hylauronic acid, ceramides, and other ingredients up to 10,000 times
3. removal of excess sebum to control acne, killing bacteria
4. removal of blackheads and milia (no more manual extractions!)
5. superior cleansing of the skin
6. normalize UV damaged skin cells with Microcurrent Technology
7. color blind; ultrasound can be used on all skins without negative effect
8. technology is based on scientific study, clinical trials, and years of use
9. low cost operation
10. high return on investment

Christine Heathman, Master Aesthetician, CME, LMT is the Founder and CEO of Glymed Plus. With over 20 years of practicing clinical aesthetics, her experience with the medical profession is well established. As a licensed professional she holds three licenses in aesthetics, one in California, a Master License in Utah, and one in Europe. As the Director of Education for the Gly-Med Institute of Skin Sciences in Spanish Fork, Utah, Heathman directs and provides the skin care professional with exceptional training. Her dedication to education is well established in the skin care industry and is known on a global basis for exceptional schooling in advanced skin care. For more information, please contact her via e-mail at This email address is being protected from spambots. You need JavaScript enabled to view it..