Author's Note: Part 1 of this article (September issue) discussed gua sha, face cupping and microneedling.

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As more and more acupuncture professionals incorporate cosmetic facial acupuncture into their practices, maximizing consumer visibility is vital. Ancillary services are an attractive, effective and lucrative adjunct to cosmetic facial acupuncture treatments.

Facial gua sha and face cupping devices are relatively inexpensive to purchase, can be efficiently applied, and are effective for immediate reduction in tissue inflammation, face sculpting and improving complexion. Microneedling, microcurrent and light-emitting diode (LED) devices, although more expensive to purchase, yield longer-lasting benefits.

Microcurrent

For decades, acupuncturists, physicians, physical therapists and chiropractors have relied on low-level electrostimulation for muscle re-education and tissue healing. As its name implies, microcurrent delivers a subsensory microamperage (uA) current that is 1,000 times less than the milli-amperage (mA) of many transcutaneous electrical nerve stimulation (TENS) units commonly used by acupuncturists to treat pain.

Unlike the mA of TENS units, the subsensory stimulation of uA, when applied to the body, mimics the body's innate low-intensity cellular electrical current to accelerate tissue repair. As an adjunct to cosmetic facial acupuncture treatment, microcurrent is utilized to improve cutaneous tissue integrity and promote underlying muscle re-education.

Microcurrent applied to the face enhances cellular Krebs cycle activity to increase mitochondria adenosine triphosphate (ATP) and expedite cellular activity. As a result, there is an increase in healthy synthesis of numerous proteins and chaperones, and the proliferation of collagen-producing fibroblasts. Microcurrent mitigates ROS oxidation of healthy cells, enhances tissue repair, improves wound healing, and improves muscle integrity.

According to a 1975 study published in the British Journal of Dermatology, dermal collagen content decreases by 1 percent every year. Microcurrent enhances skin adenosine triphosphate (ATP) production, stimulates collagen and elastin synthesis, replenishes the loss of natural collagen, and re-energizes face muscles to improve face muscle tone.

Benefits of Microcurrent:

• Improves cell wall permeability
• Significantly increases ATP
• Improves protein synthesis
• Enhances fibroblast / collagen activity
• Rehydrates skin
• Enhances lymph drainage
• Reduces tissue inflammation
• Improves tissue circulation
• Evens skin tone and texture
• Re-educates muscle activity
• Relaxes forehead muscles
• Tightens jowls
• Relaxes neck muscles
• Improves neck tissue
• Lifts and tone cheek and mid-face muscles
• Softens the appearance of fine lines and wrinkles

Light-Emitting Diode (LED) Therapy

Images courtesy of Celluma Light Therapy Irradiation with certain wavelengths of light (photobiomodulation) ranging from blue to red and near-infrared light has been demonstrated to produce a range of physiological effects in animal and human cells and tissues. Discovered in the late 1960s, use of these coherent, monochromatic beams for health promotion rapidly became known as low-level laser therapy (LLLT).

Among health care practitioners, LLLT was primarily used for wound healing and reduction of pain and inflammation. In recent years, non-coherent light sources such as light-emitting diodes (LEDs) and broad-band lamps have become popular. The advantages of LEDs include minimal laser safety considerations, an ability to target a large area of tissue at once, and ease of home use.

Images courtesy of Celluma Light Therapy LED waves are the visible light waves along the electromagnetic continuum. Measured in nanometers, they range from violet and blue (400-500 nm in length) to orange and red (600-700 nm). The therapeutic effect of each wavelength is dependent upon its length and therefore depth of penetration through the skin surface.

When placed over the body, LED photons are absorbed through the epidermal and dermal cellular membrane to stimulate mitochondrial activity and accelerate ATP synthesis. Enhanced ATP production encourages a cascade of metabolic events, resulting in improved biochemical and cellular function.

Benefits of Blue Light (470 nm):

• Acne (FDA approved) – kills deleterious effects of Propionibacterium (P. acne), psoriasis and actinic keratosis (AK)

Benefits of Red Light (640 nm):

• Tissue healing (superficial / deep)
• Collagen production
• Skin dyschromia
• Fine lines and wrinkles
• Post-laser treatment

According to Ablon (2018), LED may also be an effective and safe treatment for squamous cell carcinoma in situ, as well as basal cell carcinoma.

Integrating Ancillary Services into Your Practice

Understanding how and when to add ancillary services to your practice is important. As each service affects different tissue layers, a multitude of services in your toolbox will be beneficial. Tool choices are determined by practitioner financial investment, patient financial constraints and treatment time.

Typically, each service requires approximately 10-30 minutes of additional time. LED can be applied along with acupuncture treatment and requires minimal extra time.

The charts demonstrate the various services, layer of tissue penetration, average purchase cost, average revenue per service, and approximate amount of time required to perform each service. Order of services performed is dependent upon treatment intention with regard to tissue layer treatment.

Practical Takeaway

It is no secret that as more and more traditional Eastern Asian medicine (TEAM) graduates and seasoned practitioners incorporate cosmetic facial acupuncture into their practices, the need to maximize consumer attention is essential. Although the primary purpose of our profession is to help heal and maintain the health of our patients, we are still business owners with salaries, taxes and operating expenses to pay. Offering ancillary services not only boosts treatment results, but also promotes professional visibility, adds monetary value to a service menu and improves the profits of your practice.

Resources

• Ablon G. Phototherapy with light emitting diodes: treating a broad range of medical and aesthetic conditions in dermatology. J Clin Aesth Dermatol, 2018;11(2):21-27.
• Ahn AC, Grodzinsky AJ. Relevance of collagen piezoelectricity to "Wolff's Law": s critical review, Med Engin & Physics, 2009;31(7):733-741.
• Bordoni B, Simonelli M. The awareness of the fascial system. Cureus, 2018;10(10):e3397.
• Langevin HM. Connective tissue: a body-wide signaling network? Med Hypotheses, 2006;66(6):1074-7.

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Click here for more information about Shellie Goldstein, DAPM, AP, LAc.

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