Cream, gel, oil or serum: what is the best conductive medium for radiofrequency & ultrasound cavitation treatments?
“Radiofrequency” is an all encompassing term for treatment with different types of high frequency electrical currents
Different machines utilise different frequencies, from an extra low of 300kHz to an extra high of 5GHz
The types of physical phenomena at play on those different machines are quite distinct and therefore different contact liquids are needed at different frequencies
Generally gels and serums can be used at low frequencies, oils at higher frequencies, glycerine at most frequencies and lotions and creams are not that practical…
Full analysis below
[Caution / Disclaimer]
The analysis below is for educational purposes only. As a matter of safety, do NOT change your radiofrequency treatment contact medium without consulting with your machine manufacturer or distributor first. Blind experimenting can cause burns or other injury/irritation. This article does NOT constitute professional advice.
Radiofrequency at lower frequencies
The lowest frequency machines (300kHz to 1MHz) are based on ionic currents creating heat in the tissues - and unfortunately on the skin surface too, depending on treatment medium.
In this case, gels or creams with high water content applied on the skin will pose little resistance to the electricity generated by the RF machine, so they will not heat up.
However, being composed primarily by water, gels and creams will evaporate with constant movement and heating, meaning constant gel or cream application will be needed.
RF treatment gels
Gels, being just water and thickener are the most unstable, as the dried up thickener will flake, creating a lot of mess.
RF treatment creams
With creams, however, things are more complicated. A cream is a mix of water and oil.
When water evaporates, due to heat and constant moving of the RF handpiece, we are left with oil, which is not absorbed nearly as fast as water by skin. This will indeed pose more resistance to RF currents and therefore it will heat up.
This means that unless we keep replenishing the cream we will have very high superficial heating. This defies the whole point of radiofrequency treatment, which is deep heating.
The solution is to use a low-fat / high-water content cream to ensure we are not left too soon during treatment with an oily cream that will create epidermal overheating. Still, we have to keep replenishing it, to avoid epidermal overheating.
RF treatment serums
Of course, using serums during low frequency RF treatment is unworkable as serums evaporate in no time. And contrary to popular belief do not absorb deep in the skin either. They just stay on the epidermis (total waste of money - but try to explain that to “beauty experts”...)
RF treatment glycerol and glycol products
There is also a fourth option as a contact medium for low frequency RF, comprising of glycerine, propylene glycol, hydroglycolic gels and hydroglycolic creams. Glycerine* and propylene glycol** do not pose as much resistance to electricity as oil in these frequencies and they do not get absorbed as fast by the skin as water does, so they stand somewhere in-between, providing a good compromise. Still they heat up the skin perhaps more than we want to, so combining them with water, in the form of a hydroglycolic gel, or with water and oil, in the form of hydroglycolic gel-cream, is an even better compromise.
* Many low power RF machines are typically operated with pure glycerine as a contact medium, which heats up epidermis too much, creating skin redness and high temperature, and fooling the unsuspecting therapists and clients that the machine is very strong. It is not. It’s just that the glycerine overheats the epidermis while deep inside the dermis and hypodermis feel very little.
** Propylene glycol is never used on its own, as it is too runny, making a mess everywhere. Propylene glycol also overheats the surface, just like glycerine.
RF treatment oils
Oil as a contact medium with a low frequency RF treatment would create electrical arcs between skin and machine, leading to burns. Definitely not recommended.
RF treatment with no contact medium
Finally, having no contact medium with low frequency RF treatment would create electrical arcs between skin and machine, leading to burns. Definitely not recommended.
Radiofrequency at higher frequencies
The higher frequency machines (10MHz to 5GHz) are based on water molecules rotation creating heat in the tissues - and unfortunately on the skin surface too, depending on treatment medium.
RF treatment gels and creams
In this case water-containing products (gels, creams, hydroalcoholic gels/creams, serums) cannot be used as a treatment medium as they will be excessively heated, burning the epidermis.
So there are two options left: glycerine / propylene glycol or oil.
RF treatment glycerol / glycol products
Again, in this case glycerine / propylene glycol will give the illusion of effective treatment as they will heat up on the surface of the skin making it look red, while deep in the skin (dermis/hypodermis) temperatures will remain lower. This simply means ineffective treatment.
RF treatment oil
Oil on the other hand is completely inert at high frequencies, so it will allow the deeper tissues to be treated properly (if the machine is strong enough) without overheating of the epidermis.
RF treatment without contact medium
Non-movable (hands-free) high frequency radiofrequency applicators may be used without any contact medium, depending on the technology they use, always ensuring the sweat (water) does not accumulate.
Radiofrequency at intermediate frequencies
RF frequencies of 1-10MHz fall somewhere in-between. In that case some water or some oil can be the right or wrong ingredient in the contact medium formulation, depending on how the machine operates.
In most cases glycerine or propylene glycol is used.
Ultrasound cavitation: gel, oil, cream or serum?
With ultrasound things are not so critical as with radiofrequency, but the choice of conductive medium is still important.
Generally, high frequency ultrasound 1-10MHz would ideally require a gel, but creams and serums can also be used.
In lower frequencies (30-300kHz) oil can also be used.
Electro-mesotherapy effect with the combination of ultrasound/radiofrequency and a concentrated contact medium
Both ultrasound and radiofrequency enhance the absorption of active ingredients, so if a quality, concentrated cream/gel/serum/oil is used, there is an extra benefit to be derived from the active ingredients in the contact medium.
The problem is that most such serums and creams are not that concentrated at all. Quite the opposite: most are in fact quite diluted, especially all those “magic” serums advertised.
The other problem is that some actives may actually damage the ultrasound/radiofrequency head. Vitamin C (highly acidic) and essential oils are prime examples of that.
And there is yet another problem: some actives can cause irritation to the skin and using RF/ultrasound can make them even more irritating. A good example is strong exfoliating agents, such as glycolic acid. Combining the two can be from tricky to dangerous - clearly not a good idea...
In summary
As we saw above, the choice of contact medium can turn a radiofrequency treatment more effective, more ineffective or even dangerous. This is because it can lead to low, medium or excessive heat on the surface (epidermis), depending on the combination of machine setup and contact medium.
Sometimes we need some heat on the epidermis (e.g. for acne treatment), while in other cases we don’t need any (e.g. for cellulite reduction, deep fat reduction).
So quite often it’s not just the machine and the operator technique, it’s also the contact medium that’s important.
Caution / Disclaimer
The analysis above is for educational purposes only, for the public to understand how contact media can affect the application of a radiofrequency treatment.
It is NOT a professional instruction manual on the use of radiofrequency treatment contact media. Different machines, according to the technology they utilise, may require contact media IN CONTRAST to the analysis above - this is only a general article.
As a matter of safety, do NOT change your radiofrequency treatment contact medium without consulting with your machine manufacturer or distributor first. Blind experimenting can cause burns or other irritation. This article does NOT constitute professional advice.
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