Ultrasound Therapy – Therapeutic Effects and Beauty Care

You most often encounter ultrasound during diagnostic examinations. In internal medicine, obstetrics, gastroenterology, angiology or cardiology clinics, ultrasound beams directed into your body are used to "draw" the contours and condition of your organs, vessels, etc. Normal and abnormal sizes, tissue structures and foreign formations can be seen. These images help determine the cause of your complaint and establish a diagnosis.

Ultrasound therapy is used for musculoskeletal complaints (joint and tendon inflammations, muscle pain, contractures, etc.) and for dermatological/cosmetic treatments.

For musculoskeletal complaints, 1 MHz ultrasound is generally used because these beams can penetrate 10–15 cm deep into the body. In contrast, 3 MHz ultrasound reaches a maximum depth of 2–3 cm, so its main use is for the skin and its treatments, and it can also be used for superficially located tendons and small joints (e.g., finger joints). For cavitation treatments, however, frequencies below 640 kHz are truly effective.

From the above it follows that a 3 MHz device is not suitable for treating, for example, the knee or hip joint, because these beams cannot penetrate deeply enough. They are, however, 100% effective at the surface. Meanwhile, 1 MHz ultrasound has a significantly smaller effect on the skin and superficial structures, while it can reach deeper areas. Both 1 and 3 MHz ultrasound have little cavitation effect; frequencies below 640 kHz do not have significant therapeutic effects but are suitable for fat reduction.

Therapeutic ultrasound devices for musculoskeletal complaints can be purchased here.

Beauty, dermatological and cavitation ultrasound devices can be found here.

How does ultrasound work?

Ultrasound treatment should be focused directly on the inflamed tissues. The applicator that emits the ultrasound beam at the appropriately set intensity must be placed directly on the skin. The use of ultrasound gel is mandatory to ensure proper coupling. The applicator should be moved slowly and circularly over the painful area. You must not "stay" on a single point; the head must remain in continuous motion.

The main effect is produced by heating the tissues

The ultrasound beams introduced into the body interact with the treated tissues. The delivered energy is absorbed, converted into heat, and warms the treated tissues. This increases circulation in the area. That improves the removal of metabolic products, including pain-causing substances (toxins). The effect of treatments develops slowly, since healing is actually based on indirectly stimulating the body's self-healing ability.

In other words, the healing is not directly "done" by the ultrasound beam, but by your body! Ultrasound is needed to initiate and accelerate the healing process.

As a result of the treatment, pain, inflammation and swelling decrease. Stiff muscles, ligaments, tendons and joints relax.

Ultrasound causes tissues to warm in the following order: bone, tendons, ligaments, nerves, muscle, skin, internal organs, and least of all fat tissue. Thus bones are the most sensitive to ultrasound treatment.

If you treat your face with 1 MHz ultrasound, most of the beams pass through your skin into deeper tissue layers, so you effectively warm the facial bones. Using 1 MHz on the face results in a significantly smaller effect than 3 MHz ultrasound. On the face, 3 MHz frequency is fully absorbed in the superficial layers and therefore exerts a stronger effect.

You should not apply ultrasound "unlimitedly" to the same area. Treat only for the necessary time at one session. Treat every other day or at most once a day. For an area the size of a palm, no more than 5–10 minutes per session is needed!

Do not treat for a longer time at once even if you have the time! Applying too high an intensity for too long to one area can cause harmful effects. The main effect of ultrasound comes from heating the tissues. If an area receives too much at once, it will not help but will halt healing. Think of it like sunbathing. If you regularly sunbathe for 15–20 minutes, you gradually tan; if you lie out for 3–4 hours at once, you don't tan — you burn.

Applied correctly and regularly in appropriate doses, ultrasound helps.

Mechanical effect = Micromassage

As mentioned earlier, ultrasound is a mechanical vibration that "massages" the cells. This stimulates microcirculation and cellular activity. The permeability of the skin and cell membranes generally improves, allowing active substances to penetrate more easily and deeply. For example, the active ingredients of an ointment or cosmetic applied to the skin penetrate deeper and thus their effect is enhanced. That is why it is used in aesthetic treatments. It is good for driving wrinkle-treatment or skin-firming cosmetics deeply. On the face use 3 MHz ultrasound; for cellulite on buttocks, hips and thighs both 1 and 3 MHz can be used.

Fat-reducing effect – cavitation

If you hold ultrasound in one place for a long time, the fat tissue cells heat up and tiny bubbles form that want to "escape." They rupture the fat cell membrane and the fat leaks out, carried away by your lymphatic system and circulation. This effect is utilized in aesthetic fat-reduction treatments.

Frequencies below 640 kHz have a significant fat-reducing effect; with devices using these frequencies (for example a LipoZero G150 and Lipozero G39 devices) you can achieve a 2–3 cm reduction in hip/thigh circumference with about 10 treatments.

Be careful! Many vendors "play tricks" and ascribe cavitation effects to all ultrasound devices. Therapeutic or facial 1 and 3 MHz ultrasound devices also have some fat-reducing effect, but in terms of fat reduction they fall far short of devices specifically designed for fat removal. It's like car racing: you can drive fast in a Formula 1 car, but not in a Trabant (although the Trabant still moves down the road).

Applications of ultrasound therapy

From the above it follows that ultrasound is worth applying in cases where warming, softening of tissues, stimulation of blood circulation and acceleration of healing-regeneration processes are needed. Primarily it is suitable for inflammatory processes, especially chronic (stubborn) conditions. It also aids the delivery of active substances deeper, so you can use it for both medical and beauty purposes.

Musculoskeletal diseases

Ultrasound therapy is most widely effective in the treatment of musculoskeletal diseases, inflammations and injuries, and in alleviating the associated pain.

• In disc herniation, "pinched nerves", lumbago and sciatica it quickly reduces nerve root swelling and edema, thereby reducing pain.
• Other conditions: spondylosis, intervertebral disc changes, fibromyalgia, bursitis, periarthritis.
• It reduces inflammation in tennis and golfer's elbow.
• It relaxes muscles that have become stiff and tense around the painful area. It disperses myalgic knots.
• It can be used to treat neuritis and trigeminal neuralgia.
• Effective in reducing symptoms of arthritis and arthrosis.
• Beneficial for Duplay disease, Dupuytren's contracture-related tendon stiffness, tenosynovitis, muscle stiffness (e.g., stiff neck, torticollis) and muscle cramps.
• Reduces hematomas 2–3 days after the hematoma forms (it may increase fresh bleeding).

Preparation before physiotherapy

Ultrasound warms and thus relaxes and makes muscles and tendons more flexible. Ultrasound treatment prior to physiotherapy specifically reduces exercise-induced pain and makes the exercise session more effective.

It is similarly beneficial before manual massage. Treating painful muscle knots before a massage reduces discomfort from the massage and allows the therapist to work more effectively.

Accelerating absorption of drugs and active ingredients

Ultrasound waves "loosen" cell membranes, allowing various active substances and drugs to reach deeper tissues and improving their absorption. This effect is called phonophoresis.

You can use this in Peyronie's disease (induratio penis plastica), where active substances can be delivered into the hard plaque that causes penile curvature. (By the way, injection directly into the penis is the only real solution for this.)

Ultrasound treatment can also enhance the effect of cosmetic agents. Note that only gentle, low-intensity beams should be used on the face!

Cosmetic applications of ultrasound therapy

Besides medical uses, ultrasound therapy is widely applied in aesthetics. Ultrasound helps deliver cosmetic active ingredients into deeper skin layers, in cellulitis and cellulite treatments, wrinkle treatments and skin-firming applications, and it is used to reduce stubborn fat deposits and pads.

Ultrasonic "liposuction", also known as cavitation

With a "real" cavitation ultrasound machine (frequencies below 640 kHz), 10 treatments can reduce abdominal circumference by as much as 2–4 cm. It is important that immediately after cavitation treatment you undergo machine-assisted compression therapy or perform light physical activity (swimming, jogging). Without this, the dissolved fat droplets "re-solidify" and no lasting effect remains.

Significant fat-reducing effects come from frequencies below 640 kHz; you can expect meaningful results from devices using these frequencies (for example a LipoZero G150 and Lipozero G39 devices).

Many vendors attribute cavitation effects to every ultrasound device, but this is not the case. Such claims can be misleading. Although therapeutic or facial 1 and 3 MHz ultrasound devices have some fat-reducing effect, they fall far short of devices specifically designed for fat reduction. Their cavitation effect is only a few percent of that of devices below 640 kHz.

It's like car racing: you can move along the road in a Trabant, but to really race you need a Ferrari.

Cellulite treatment

In cellulite, waste products accumulate in the dermis and form increasingly large nodules. As they grow, the skin surface slowly becomes uneven, resembling orange peel. Some data suggest that cellulite affects about 90% of adult women. It is mainly seen on the hips and thighs. Dieting generally has little effect.

Ultrasound therapy can be used to treat cellulite. It increases local circulation and, due to its mild cavitation effect, destroys cellulite nodules so that harmful substances are released and removed by the circulation. After cellulite treatment, perform 30–40 minutes of active exercise (jogging, swimming) or apply a wave massage device. Without this, the disrupted nodules' material reassembles instead of leaving the body.

Wrinkle treatment

Ultrasound therapy facilitates the penetration of active ingredients such as essential oils, fat-soluble vitamins (e.g., vitamins A and E), and water-soluble substances through the skin. They loosen tissues, making ultrasound a highly effective aesthetic treatment, for example for wrinkle reduction.

Dosage of ultrasound

You can read in detail about how to dose ultrasound treatment in this article of mine.

Here I will only mention that ultrasound stimulates healing only within a certain dose!

If the treatment time is too short, the beneficial effect is minimal.

If you double the treatment time, that may already be "too much for the tissues" and can actually stop existing healing processes.

If you overdose—for example, if you hold a high-intensity beam on one point for minutes—it can lead to tissue damage and make things worse.

Therefore, use ultrasound treatment only if you have been examined and you know your diagnosis. Treat with the intensity and duration recommended for that condition. More ultrasound is not necessarily better!

If you follow the recommendations, you can expect the favorable effects described above.