Lasers in Medical Science

, Volume 34, Issue 2, pp 389–396 | Cite as

Effects of the extracorporeal shock wave therapy on the skin: an experimental study

  • Thayná Melo de Lima Morais
  • Patrícia Froes Meyer
  • Liliane Santos de Vasconcellos
  • Julio Costa e Silva
  • Ito Ferreira e Andrade
  • Vinicius Alves Freire de Farias
  • Igor Candido da Silva
  • Roberta Marinho Falcão Gondim Araújo
  • Rodrigo Marcel Valentim da Silva
  • Esteban Fortuny Pacheco
  • Ciro Dantas SoaresEmail author
Original Article


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.


Extracorporeal shock wave therapy Fibroblast growth factor 2 Collagen Inflammatory cells 



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.

Informed consent

Not applicable. This article does not contain any studies with human participants.

Supplementary material

10103_2018_2612_Fig4_ESM.png (4.6 mb)
Supplementary Figure 1

A: The device utilized for the experiments. B: Image demonstrating the use of the device in one subject. (PNG 4691 kb)

10103_2018_2612_MOESM1_ESM.tif (6.1 mb)
High resolution image (TIF 6208 kb)
Supplementary Video 1

(AVI 11631 kb)


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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  • Thayná Melo de Lima Morais
    • 1
  • Patrícia Froes Meyer
    • 2
  • Liliane Santos de Vasconcellos
    • 2
  • Julio Costa e Silva
    • 2
  • Ito Ferreira e Andrade
    • 2
  • Vinicius Alves Freire de Farias
    • 2
  • Igor Candido da Silva
    • 2
  • Roberta Marinho Falcão Gondim Araújo
    • 3
  • Rodrigo Marcel Valentim da Silva
    • 3
  • Esteban Fortuny Pacheco
    • 4
  • Ciro Dantas Soares
    • 1
    Email author
  1. 1.Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental SchoolUniversity of Campinas (UNICAMP)PiracicabaBrazil
  2. 2.Physiotherapy DepartmentPotiguar UniversityNatalBrazil
  3. 3.Medicine DepartmentPotiguar UniversityNatalBrazil
  4. 4.Physiotherapy DepartmentFederal University of Rio Grande do NorteNatalBrazil

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