Synchronous Parallel Ultrasound Induces Long-Term Extracellular Matrix Remodeling of Human Skin

BACKGROUND Energy-based interventions improve signs of skin aging by inducing controlled thermal injury and activating regenerative wound healing pathways. OBJECTIVE This study investigates the underlying mechanism of acute and long-term extracellular matrix (ECM) remodeling induced by Synchronous Parallel Ultrasound technology leading to skin regeneration. METHODS/MATERIALS An in vivo porcine model was used to investigate the acute thermal injury. In vivo human skin biopsies were obtained from subjects at baseline and at 1, 4, 7, and 10 months post-treatment. Histological evaluation was performed using Hematoxylin and Eosin, Masson's Trichome, Verhoeff–Van Gieson, Unna Taenzer, and Alcian Blue stains to assess changes in ECM protein expression. RESULTS Thermal injury was restricted to the dermal layer. Histological analysis revealed a gradual increase in connective tissue collagen and elastin with unique reorganization and parallel realignment of the dermal fibers. Increased expression of glycosaminoglycans (GAGs) was also observed, indicating sustained fibroblast activity and matrix regeneration across all time points. CONCLUSION These findings provide histological evidence of continuing and long-lasting dermal remodeling after Synchronous Parallel Ultrasound treatment, characterized by neocollagenesis, neoelastogenesis, and GAGs production. The study supports the efficacy of Synchronous Parallel Ultrasound in the long-term induction of skin regeneration.