How do you determine RF / ultrasound treatment strength?

• Total energy applied during treatment means nothing (for continuous movement RF or ultrasound)

• If kJoules mean nothing, how do we measure treatment intensity?

• Infrared thermometer to the rescue

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Total energy applied during treatment means nothing (for continuous movement RF or ultrasound)

Back in the early 2000s, when RF treatments were static (using the “stamp” or “pulse” method), counting the total amount of energy applied on the skin (as measured in Joules, kiloJoules to be precise), meant something: it signified how strong the treatment was on that particular area.

Today this stamp/pulse method is only being used for one ultrasound treatment, one RF treatment and for RF microneedling and HIFU.

If you have been following this blog you would know that we are not big fans of the stamp method (and consequently HIFU and RF microneedling), as at reasonable intensities it limits effectiveness/efficiency and at high intensities it causes burns.

Nowadays most RF and ultrasound cavitation treatments use the continuous movement method, as opposed to the stamp/pulse method. This allows us to provide high amounts of energy on the tissues per unit of time, for better efficiency and without skin burning - as long as a well trained and responsible therapist provides the treatment.

So for continuous movement RF and continuous movement cavitation, total energy used means nothing.

This is because of one applies e.g. 100kJ (kiloJoules) of RF or cavitation over 20 minutes it will not be at all the same treatment as one where 50kJ are applied over 40 minutes on the same body area.

In the former case the tissue could be treated at, say 39-41°C for 20 minutes (great for good results) while in the latter case it could be treated at, say, 36-38°C for 40 minutes.

Despite the longer session time, treatment in the second case will produce no results, simply because at 36-38°C no fat is released and no skin tightening occurs, i.e. a waste of 40 minutes.

In both cases the therapist would have achieved what the “protocol” suggested, i.e. 50kJ of treatment on the same area - but results couldn't be any more different.

Unfortunately, many good aesthetic equipment manufacturers still use total Joule power in their protocols for different treatment areas, which is absolutely pointless, and at some point they have to up their game when it comes to therapist training protocols.

In one case a client can have amazing results with 50kJ; in another they may get burned; and it another they will have a pointless RF/ultrasound massage.

For continuous movement ultrasound/RF, total energy power (measured in Joules, practically kJ) means nothing.

If kJoules mean nothing, how do we measure treatment intensity?

It’s simple. For the client (and consequently for us therapists) what matters is results. And results in radiofrequency (and quite often in ultrasound cavitation) depend on how long a good therapeutic temperature is maintained for a given amount of time.

So for our example above, what would make sense is to focus on keeping the particular area of the body at a particular temperature for an X amount of time - all to be determined according to the client’s needs.

If we applied the same temperature for half the time, treatment would probably be inadequate; while if we did so for double the time treatment may probably be excessive.

Infrared thermometer to the rescue

So for continuous movement RF and ultrasound, forget about total energy used, buy a good infrared thermometer and measure treatment temperature and treatment time instead.

(Don’t save the pennies though, as most IR thermometers are quite inaccurate and you may think you treat at 40°C when in reality you only reach 38°C - which, although fine for cooking, it is a big difference for our purposes.)

This will make more sense in terms of treatment efficacy and treatment safety too.

Please note: all the above temperatures, total treatment energy and treatment time are imaginary, for example’s sake. Also, deep acting treatment will provide higher deep skin temperatures than more superficially acting ones, even if both display the same skin surface temperature on the infrared thermometer.

Check our professional consultancy for a masterclass in radiofrequency, ultrasound cavitation, cellulite and skin tightening

Do you want to deeply understand radiofrequency, ultrasound cavitation, cellulite and skin tightening? Attend a half-day, 1-day, 2-day or 3-day professional consultancy / one-to-one training and confidently offer your clients the safest, strongest and most effective treatment possible. Service available via Zoom or at our central London practice.