Extracorporeal shock wave therapy (ESWT) has been extensively studied for its multiple biological properties, and although it is widely applied in esthetical procedures, little is known about its effects on the epidermis and dermis. In this study, a histological and immunohistochemical study of the effects of ESWT was performed on rat skin. Forty-five female rats were treated with one or two sessions of ESWT and sacrificed on days 1, 7, 14, and 21 after treatment. The samples were histologically processed and then morphometric analyses were performed to assess the epidermis, dermis, and subcutaneous fat tissue thickness. Immunohistochemical reactions were also performed against the antibodies: basic fibroblastic growth factor (FGF2), its receptor (FGFR1), and α-smooth muscle actin. Slides were scanned and digitally assessed, to determine the microvessel density (MVD) and digital scoring of the immunohistochemical staining. The results showed that ESWT produced a significantly higher collagen content, MVD, and epidermis and dermis thickness than the control, non-treated group. Both in epidermis and dermis, FGF2 was overexpressed in the ESWT-treated groups, whereas FGFR1 was increased only in the group treated with two ESWT sessions at 21-days post-treatment. The ESWT-treated groups have also shown diminished thickness of subcutaneous fat tissue. In conclusion, ESWT induces neocollagenesis and neoangiogenesis, and upregulates the FGF2 expression, particularly in the groups treated with two sessions. Furthermore, it was demonstrated that overexpression of FGF2 on skins treated with ESWT seems to be a key role on its mechanism of action.
This is a preview of subscription content, log in to check access.
This study was funded by the Brazilian National Council of Scientific and Technological Development (CNPq) research fellowship (registered under numbers 145722/2013-9, 101367/2014-7, and 117277/2014-2 to C.D.S.) and by FAPESP (São Paulo Research Foundation) for the Ph.D. fellowship to C.D.S. (#2015/25905-1).
Compliance with ethical standards
This experimental protocol followed the guidelines of the Animal Experimentation Code of Ethics and Brazilian College of Animal Experimentation and was duly approved by the Ethics Committee of Potiguar University, Laureate International Universities (protocol number 002/2017).
Conflict of interest
The authors declare that they have no conflicts of interest.
Not applicable. This article does not contain any studies with human participants.
Nobile V, Michelotti A, Cestone E (2016) A home-based eyebrows lifting effect using a novel device that emits electrostatic pulses containing RF energy, resulting in high frequency, low level transdermal microcurrent pulsations: double blind, randomized clinical study of efficacy and safety. J Cosmet Laser Ther 18:234–238. https://doi.org/10.3109/14764172.2016.1156704CrossRefPubMedGoogle Scholar
Widgerow AD, Fabi SG, Palestine RF et al (2016) Extracellular matrix modulation: optimizing skin care and rejuvenation procedures. J Drugs Dermatol 15:s63–s71PubMedGoogle Scholar
Fitzpatrick RE, Rostan EF (2003) Reversal of photodamage with topical growth factors: a pilot study. J Cosmet Laser Ther 5:25–34CrossRefPubMedGoogle Scholar
Birgin E, Gebhardt C, Hetjens S et al (2018) Extracorporal shock wave therapy enhances receptor for advanced glycated end-product-dependent flap survival and angiogenesis. Ann Plast Surg. https://doi.org/10.1097/SAP.0000000000001279