Focused Ultrasound

Article by Maggie Staszcuk
This article appears in the March | April 2021 issue of ASCP Skin Deep magazine

Skin Deep Magazine - High Intensity Focused Ultrasound. Girl receiving HIFU treatmentAs we age, collagen and elastin fibers break down and lead to fine lines and sagging jowls. Since no one can avoid this biological process, antiaging treatments are a perennially popular service for a range of clientele. According to dermatologist Carolyn Jacob, MD, our skin’s collagen begins to diminish by 1 percent each year after the age of 30.1 Skin on the neck is especially fragile and thinner than skin on the face and body. As a result, this area tends to develop signs of aging faster. It’s no wonder there are countless skin tightening treatments for the neck, and one of the most popular is focused ultrasound.

How Focused Ultrasound Works

Focused ultrasound is a skin tightening treatment using the same technology as ultrasound for imaging purposes but with a different intensity. Similar to a magnifying glass focusing sunlight, ultrasound for skin works by rapidly heating the targeted tissue to between 65 and 70 degrees Celsius.2 Ultrasound focuses this heat to a depth of 1.5–5 millimeters within the reticular layer of the dermis, where fibroblasts (the cells responsible for collagen and elastin production) are located. The above papillary and epidermal layers are spared. As heat builds, the cells are damanged.4 This cell damage is an important part of the process, but not the end goal; the goal is to encourage the body’s wound healing response to stimulate cells to rebuild. Over time, collagen and elastin increase, leading to smoother, plumper looking skin.

What to Expect With Focused Ultrasound

A good candidate for focused ultrasound is the client with mild to moderate skin laxity. Loose skin under the chin and around the neck, or fine lines and wrinkles in this region, are a good indicator your client may be a candidate. Focused Ultrasound skin tightening treatments have little to no downtime, although some clients may experience redness or tingling that resolves within a few hours. Beyond this, clients are free to go about their normal routine following their skin tightening treatment.5 During treatment, comfort levels will vary from client to client. Some clients report discomfort due to the amount of heat generated by the focused ultrasound device, but this sensation only lasts while the ultrasound energy is being applied.6 Pain management in the form of numbing agents or distractions like music and vibrations around the collarbone may be used.


ASCP Skin Deep magazine, Esty of the Year issue 2021ASCP Skin Deep magazine

The award-winning ASCP Skin Deep magazine is the premier estheticians' source for the latest trends, techniques, products, and news from the biggest names in the industry. In this issue:
The Other Side of Fear: Want See how ASCP's 2021 Esty of the Year dominated anxiety to become an inspiration
Rescue and Rebuild: Get advice on how to identify the signs of Rosacea and a treatment to calm it


Liability Insurance

Professional liability insurance for focused ultrasound protects you in case a client sues. ASCP members have access to optional focused ultrasound insurance and other advanced modalities like microneedling, permanent makeup, and radio frequency services. More information about focused ultrasound insurance and advanced esthetics coverage that protects you and your esthetics practice, including the steps for applying, visit Pricing for focused ultrasound insurance ranges from $672 - $792 for the year, and you can bundle that coverage with other advanced modalities to save more.



1.Emily Taylor, “4 Doctor-Approved Ways to Tightening and Tone Loose Skin,” New Beauty, accessed February 2021,

2. Emily Taylor, “4 Doctor-Approved Ways to Tightening and Tone Loose Skin.”

3. Sabrina Guillen Fabi, “Noninvasive Skin Tightening: Focus on New Ultrasound Techniques,” Clinical, Cosmetic and Investigational Dermatology 8 (February 2015): 47–52,

4. Cynthia Cobb, “Can High Intensity Focused Ultrasound Treatment Replace Face Lifts?” Healthline, accessed February 2021,

5. Ultherapy, “Frequently Asked Questions About Ultherapy,” accessed February 2021, 

6. Ultherapy, “Frequently Asked Questions About Ultherapy.”

7., “Everything You Need to Know About Offering Ultrasonic Skin Therapy in Your Esthetics Practice,” accessed February 2021,

8. Ultherapy, “Frequently Asked Questions About Ultherapy.”


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