Closeup of Woman getting an ultrasonic facial with an ultrasonic spatula

The Ultrasonic Facial | the Ultrasonic Spatula | How They Work

One of the biggest criticisms of standard / day spa facials is that the creams and serums used often aren't able to penetrate your skin well. Some (like Vitamin C and retinoids) break down with exposure to sunlight and oxygen. So the longer those creams sit on your skin, the less likely they are to work.

“The skin is an amazing barrier, and so it takes a long time for things to get through it,” says Dr. Adam Friedman, an associate professor of dermatology and director of translational research at George Washington University.

For clarification, when I say a standard / day spa facial, I mean a cleaning, followed by a skin analysis, exfoliation, pimple extraction if needed, a mask, and moisturizer. There might also be a massage, a steam treatment, or a light peel.

One way aestheticians are able to increase the penetration of creams and serums is by using exfoliation.

What's exfoliation? How does it work?

Exfoliation removes the top layer of your skin to reveal the smooth, beautiful skin below. The outer layer of your skin, called the epidermis, is made up of old, dead cells that are continually shedding. They're replaced by new cells below, which move up to replace the dead cells. As the new skin cells move up, they harden and die. This skin cycle is ongoing and takes about 30 days.

But if those old, dead cells stay on the surface - instead of shedding - they can give your skin a flat, dull appearance. The buildup can also cause blemishes, and scaling. Exfoliation makes your skin more beautiful in 2 ways. It reveals the new skin below and improves the penetration of skincare products.

Ultrasound is one way to exfoliate skin and aestheticians LOVE it! This quote comes from the

"For a treatment suitable for all skin types, even sensitive skin, I believe ultrasonic exfoliation is a fabulous treatment."

What's ultrasound?

Ultrasound is sound waves (greater than or equal to 20 kHz) that travel at such a high frequency that you cannot hear them (unless you're young with FANTASTIC hearing).

Is it safe?

Ultrasound has been used in medicine for a long time. Many people are familiar with it because it's used to check the growth and development of babies while women are pregnant. Ultrasound is also used in cataract surgery and to break down kidney stones. It may even help to regrow teeth!

When ultrasound is used in physical therapy, it's called phonophoresis. First medication is applied to your skin, then the ultrasound waves are used to help the medication penetrate the skin - allowing it to be absorbed by the tissues below. So yes, ultrasound is used in lots of different applications. And when used as directed, ultrasound is very safe.

horizontal closeup of a woman getting an ultrasonic facial with an ultrasonic spatula

How does the ultrasonic facial work? (Sometimes you'll hear it called sonophoresis.)

Skin acts as a barrier to keep the good stuff in your body in AND the bad stuff out. It's built kind of like a brick wall. When skin works like it's supposed to, it's hard for creams and serums to penetrate. Katherine Farady, a Dermatologist in Austin, Texas, describes it like this:

"The outer layer of skin usually contains 20-35% water. The 'skin barrier,' also known as the stratum corneum, is comprised of a dead flattened layer of cells called corneocytes, forming the 'bricks,' and the intervening layer of lipids, forming 'the mortar.' This bricks and mortar structure prevents water loss through the skin."

"Low frequency ultrasonic exfoliation uses sound vibrations to disrupt your skin's barrier function," says Samir Mitragotri, PhD, assistant professor of chemical engineering at the University of California, Santa Barbara. (

The sound waves create small spaces between the skin cells (holes in the mortar between the bricks) that allow the ingredients in the creams / serums to quickly be absorbed into your skin.

Your aesthetician will apply water to your skin to loosen surface skin cells. Then she'll glide a "spatula" across your skin. It emits inaudible sound waves (about 28,000 per second) to lift the old cells off the surface of your skin. At the same time, those soundwaves push the water into your skin - leaving it plump and hydrated.

Are there any clinical studies? Is there any proof the ultrasonic facial works?

Low frequency ultrasound is used in many different medical applications. It allows medications to penetrate your skin more deeply. BUT there aren't many studies of how well ultrasound works for skin rejuvenation. In fact, I was only able to find 1 study of ultrasound & the ultrasonic spatula in skin rejuvenation.

A study by Steven Dayan, Shridhar Ventrapragada, and Anil R. Shah, followed 48 women ranging in age from 26 - 63. Each completed 8 treatments and had post-treatment photographs.

  • 32 of the patients got salicylic acid + ultrasound.
  • 16 got ultrasound alone.
  • All patients tolerated the study well and found the ultrasound therapy soothing.
  • There were no adverse effects
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Results of the study:  

  • An objective difference was seen when a mild skin exfoliant was added. The categories with significant improvements included skin laxity, fine wrinkles, uneven pigmentation, and overall improvement. Only coarse wrinkles did not show significant improvement.
  • Improvements in facial skin were thought to be from exfoliation, NOT underlying structural skin changes. So the changes affected the epidermis (top layer of skin) most, with minimal effects on the dermis (2nd layer of skin).
  • Ultrasound was well tolerated with no downtime.
  • It was most effective when used with a mild peeling skincare product like salicylic acid.
  • Further study needs to be done to determine the best ultrasound exposure time, intensity level, and the best peeling skincare product to be used with the ultrasonic facial.
  • Ultrasound is widely used and safe when used by non-medical personnel under the guidance of a doctor.

And agrees that a light peel combined with ultrasound gives a better result:

"Personally, I like to do a light acid and enzyme peel beforehand to start the exfoliation process so when I use the ultrasonic tool it exfoliates deeper into the skin to give better results."

Is it safe for all colors of skin?

Ultrasonic facials are very gentle and safe for even sensitive skin. They work well for people with rosacea, acne, dull, or aging skin. They're safe for all skin colors because they don't cause redness, swelling, or irritation. So you could have this facial on your lunch break and return to work looking great!

Does ultrasonic exfoliation hurt?

Nope. It's non-abrasive, not invasive (Ha! It rhymes!) and pain free.

How about down time?

Your skin may be a little pink right after an ultrasonic facial, but most people feel comfortable returning to their regular activities right away. That said, some people do get mild flaking when the ultrasonic facial is used with other exfoliating treatments or when it's used with active ingredients that increase flaking.

Is there anyone who should not have an ultrasonic facial?

  1. Women who are pregnant or breastfeeding
  2. People with pacemakers
  3. People with facial skin cancer
  4. People with a bleeding disorder or people taking blood thinners / anticoagulant therapy
  5. People who have a fever
  6. People with an infection in the area to be treated.

How about home devices? Do those ultrasonic spatulas work?

The reviews I read are decidedly mixed. It may be that people don't use them correctly. One reviewer on Amazon wrote this review of the Trophy Skin Labelle Ultrasonic Gentle Stainless Steel Facial Skin Scrubber:

"I am a licensed esthetician and purchased this product for use on my own skin at home. I have a professional table-top Ultrasonic Device that I use for the professional services I provide in my studio. Although this model is not as powerful as the table-top version I use professionally, it is the closest I have come to the larger, far more expensive professional version I use on clients. The key to using your Ultrasonic spatula is adequate fluid on the skin to give you the proper "pressure washing" effect, and holding the device at the correct angle. You should notice a fine mist spraying along as you move the spatula. Your skin should feel baby soft when you're done with your treatment. For clogged pores, especially around the nose and chin area, be sure to move slowly to allow the sonic waves to move the contents of your pores up and out. This device has performed beautifully for many hours and the charge lasts a good, long time."

While there isn't much evidence to prove that ultrasonic facials & ultrasonic spatulas work, more studies may prove they do. It does sound like they exfoliate well, and aestheticians do seem to like them - a LOT.

I'd be interested to hear your experiences! Have you tried an ultrasonic facial? Did you like it? Let me know. Email amy {at} masterpieceskinrestoration {dot} com. Thanks for reading!

Head shot, Amy Takken, RN & Founder, Masterpiece Skin Restoration

Amy Takken, RN

Amy Takken is a registered nurse with 20+ years of experience helping people improve their health. Her in-depth skincare articles have been featured on Nazarian Plastic Surgery and The Palm Beach Center for Facial Plastic & Laser Surgery. She's also been quoted on Amy loves research and constantly watches for new products and treatments to help you improve your skin’s health – because healthy skin is beautiful! To reach Amy, visit our contact page.

Looking for more information about the different kinds of facials? Try these:

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The Information provided on our website is not medical advice and should not be viewed as such. By law, only a medical doctor can diagnose or give medical advice. As a registered nurse, my goal is to educate, so I provide information on skin care, skin care products, and skin care treatments. If you have any condition that concerns you, please see a medical doctor. While most skin conditions are benign, some - like melanoma - can be deadly. If there is any doubt, please, please consult your physician. Thank you!

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