High-Intensity Focused Ultrasound (HIFU) systems feature multiple handpieces with varying focal lengths to precisely target skin lesions located at different anatomical depths. Because conditions like seborrheic keratosis or sebaceous hyperplasia exist at specific layers of the skin, a "one-size-fits-all" focal depth would be ineffective. The range from 0.8 mm to 2.3 mm allows clinicians to project energy exactly where it is needed without damaging surrounding tissue.
The necessity for multiple focal lengths stems from the varying depth of dermatological targets. By swapping handpieces, practitioners can shift the zone of thermal coagulation to match the specific location of the lesion, ensuring efficacy while preserving the epidermis and underlying structures.
The Physics of Depth Control
Matching the Lesion's Location
Effective HIFU treatment requires the focal point of the ultrasound energy to align perfectly with the target tissue.
Different pathological conditions naturally occur at different depths within the skin's structure.
Using the wrong focal length results in energy being delivered either above or below the actual problem area.
Targeting Superficial Irregularities
Handpieces with shorter focal lengths, such as 0.8 mm, are engineered for surface-level interventions.
These are essential for treating superficial lesions that reside in the upper layers of the epidermis.
Common targets for this depth include conditions like seborrheic keratosis, which sit high on the skin's surface.
Addressing Deeper Pathology
Certain conditions are rooted deeper within the dermis or subcutaneous tissue.
For these cases, handpieces with focal lengths of 1.8 mm or greater are required to penetrate sufficiently.
This depth is typically necessary for treating conditions like sebaceous hyperplasia, where the target glands are located further beneath the surface.
Understanding the Trade-offs
Precision vs. Risk
The ability to customize depth increases treatment precision, but it also introduces the risk of operator error.
Selecting a focal length that is too deep for a superficial lesion may bypass the target entirely, rendering the treatment ineffective.
Conversely, using a shallow focal length for a deep lesion risks damaging the surface skin without resolving the underlying issue.
The Importance of Anatomical Knowledge
Successful outcomes rely heavily on the clinician's ability to accurately assess the depth of the lesion before selecting a handpiece.
This requires a thorough understanding of skin anatomy and the specific characteristics of the pathology being treated.
Equipment versatility is only as effective as the diagnostic accuracy of the user.
Making the Right Choice for Your Goal
To maximize safety and results, handpiece selection must be dictated by the specific pathology.
- If your primary focus is treating superficial epidermal lesions: Select a 0.8 mm handpiece to concentrate energy on surface irregularities like seborrheic keratosis.
- If your primary focus is addressing deeper dermal or glandular issues: Utilize handpieces with focal lengths of 1.8 mm or more to effectively target conditions like sebaceous hyperplasia.
Precise depth control is the defining factor that transforms raw ultrasound energy into a targeted clinical tool.
Summary Table:
| Focal Length | Target Skin Layer | Recommended Applications |
|---|---|---|
| 0.8 mm | Superficial Epidermis | Seborrheic keratosis, surface-level irregularities |
| 1.3 mm - 1.5 mm | Mid-Dermis | Fine lines, skin tightening, collagen stimulation |
| 1.8 mm - 2.3 mm | Deep Dermis / Subcutaneous | Sebaceous hyperplasia, deep structural remodeling |
| Precision Benefit | Targeted Coagulation | Maximizes efficacy while preserving surrounding tissue |
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References
- Jacek Calik, Natalia Sauer. Healing Process after High-Intensity Focused Ultrasound Treatment of Benign Skin Lesions: Dermoscopic Analysis and Treatment Guidelines. DOI: 10.3390/jcm13040931
This article is also based on technical information from Belislaser Knowledge Base .
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