Comprehensive Notes on Low-Intensity Direct Current (Microcurrent)

Low-Intensity Direct Current (Microcurrent)

  • Microcurrent is defined as any current with an amplitude less than 1 mA (10^{-3}A).

  • Waveforms are typically DC or monophasic pulsed current.

  • Other names include low-volt pulsed current, micro electrical neuromuscular stimulator, or micro electrical stimulation.

  • Micro amperage is insufficient to excite sensory or motor nerves.

  • APTA recommends the term low-intensity direct current (LIDC).

  • LIDC is typically DC or monophasic pulsed current in the micro amperage range.

  • Monophasic pulsed current pulse duration depends on frequency; a typical pulse duration is 500 msec (0.5 sec).

  • Frequency on LIDC stimulators varies from 1 to 1,000 Hz.

  • Because LIDC is DC or monophasic, one electrode is the anode and the other is the cathode.

  • Cell populations respond differently to anodal and cathodal stimulation.

  • LIDC originated from observations of micro amperage DC flowing out of injured tissue.

  • Outward flow indicates an electrical potential across the skin, called the transepithelial potential (TEP).

Transepithelial Potential (TEP)

  • TEP is created by the separation of ions across sheets of epithelial cells (i.e., skin).

  • TEP is distinct from the resting membrane potential of single cells.

  • Ions accumulating on opposite sides of epithelial tissue create TEP.

LIDC and TEP Summary

  • LIDC originated from micro amperage DC flowing out of injured tissues, indicating TEP.

  • TEP arises from ion separation across epithelial cell sheets.
    *TEP is electrical potential created when ions accumulate on opposite sides of epithelial tissue.
    Current Amplitude: Micro amperage range (insufficient to excite sensory or motor nerves)
    Therapeutic Benefit: No therapeutic benefit from activating sensory or motor nerves (physiologically implausible)
    Recommended Terminology: Low-Intensity Direct Current (LIDC)
    Waveform Type: Typically, DC (Direct Current) or Monophasic Pulsed Current
    Pulse Duration: For monophasic pulsed current, pulse duration typically 500 msec (0.5 sec), much longer than most other pulsed currents
    Frequency Range: 1 to 1,000 Hz
    Electrode Polarity: One electrode is the anode and the other is the cathode (due to the nature of DC or monophasic current)
    Electrode Effects:
    Anodal Stimulation: Positive effects on cell populations
    Cathodal Stimulation: Negative effects on cell populations
    Physiological Effect on Cells:
    Anodal: May attract negatively charged ions, affecting certain cell populations
    Cathodal: May attract positively charged ions, influencing other cell populations
    Clinical Use: Often used for iontophoresis, wound healing, and pain management without nerve activation
    Voltage and Current Considerations: Low voltage and microamp current typically used, no strong electrical field to stimulate motor or sensory nerves

  • The skin's external surface has a net negative charge, known as the skin battery.

  • Injury creates a pathway for positively charged ions to flow from deeper tissues to the skin surface.

  • The wound becomes the cathode due to loss of positivity.

  • Lateral currents of injury are created as positive ions flow toward the wound cathode.

  • Clinical use of LIDC aims to augment these endogenously produced currents of injury.

  • HVPC can result in current with micro amperage intensity at low pulse durations and frequency.

  • Increasing the frequency or pulse duration of HVPC can result in milliamperage intensity.

Electrode Types and Effects on Cell Populations

  • Anode (Positive)

    • Attracts negatively charged ions (anions).

    • Can induce cellular activation depending on cell type.

    • May stimulate tissue repair or wound healing.

    • Anti-inflammatory effects in some cases.

  • Cathode (Negative)

    • Attracts positively charged ions (cations).

    • Typically results in cell membrane hyperpolarization.

    • May influence nerve regeneration or pain modulation.

    • More likely to cause tissue damage if not carefully controlled.

Clinical Use of Microcurrent and Best Evidence

  • LIDC is used to stimulate epithelialization of tissues in a non-healing skin wound.

  • The cathode is placed over the wound site, with the anode placed adjacent to the wound.

Microcurrent as Alternating Current

  • Microcurrent uses both positive and negative polarities.

  • Current is measured in Micro Amps with an intensity of 175-1000.

  • The frequency of the microcurrent ranges from 0.1-680 Hz.

Galvanic Currents

  • Galvanic currents are used primarily for facial muscles

  • Galvanic currents use mild electric currents that consist of positive and negative ions to stimulate the local muscles.

  • The outcome of a galvanic current is maintaining the muscle physiology.

  • Continuous direct current (also called galvanic current) has been used for wound healing, iontophoresis, and in the treatment of denervated muscle.

Galvanic Treatment Types

  • Two major uses of direct current in skin therapy:

    • Iontophoresis.

    • DE incrustation.

Types of Direct Current Stimulation

  • Three different types of stimulation: anodal, cathodal, and sham.

  • Anodal stimulation is positive (V+) stimulation that increases the neuronal excitability of the area being stimulated.

  • Cathodal (V−) stimulation decreases the neuronal excitability of the area being stimulated.

Low Frequency Currents

  • Low frequency currents are therapeutically used currents whose frequency is in the range of 0 to 100 cycles per second.

  • The primary use of low frequency current is the stimulation of nerve and muscle.

Direct Current (DC) vs Alternating Current (AC)

  • Direct current (DC) occurs when the current flows in one constant direction. It usually comes from batteries, solar cells, or from AC/DC converters.

  • DC is the preferred type of power for electronic devices.

  • Alternating current (AC) occurs when the electric current periodically inverts its direction.

Microcurrent Frequency

  • Frequencies are set at two different levels; for example, one microcurrent channel might be set at 10 Hz, and the second at 40 Hz.

  • The technician will apply the current with a saturated towel or with skin patches.

  • It's very important for the patient to drink plenty of fluids before FSM treatment.

Microcurrent Contraindications

  • Microcurrent cannot be performed on clients with diabetes, epilepsy, a pacemaker, pregnant women, or anyone under the direct care of a physician.

Galvanic vs Microcurrent Treatments

  • Galvanic treatments utilize direct current to conduct active ingredients into deeper skin layers and perform deep cleansing, while microcurrent treatments use low-level alternating current to stimulate facial muscles, promoting collagen and elastin production

Galvanic Current Frequency & History

  • PULSE DURATION –more than 1ms which may be unto 300ms.

  • FREQUENCY-less than 50 Hz.

  • HISTORY- LUIGI GALVANI (1737-1798) discovered the Galvanic current in 1780s.

  • Rectangular, saw-tooth, triangular & trapezoidal.

Maximum Current Frequency

  • Nuclear gamma rays have frequencies above 10^{20} hertz, and you may model their emission as a result of AC currents flowing inside atomic nuclei.


Term 1: Microcurrent
Definition 1: Current with an amplitude less than 1 mA (10^{-3}A).
Term 2: Waveforms of Microcurrent
Definition 2: Typically DC or monophasic pulsed current.
Term 3: Other names for Microcurrent
Definition 3: Low-volt pulsed current, micro electrical neuromuscular stimulator, or micro electrical stimulation
Term 4: Micro amperage
Definition 4: Insufficient to excite sensory or motor nerves.
Term 5: Low-Intensity Direct Current (LIDC)
Definition 5: Typically DC or monophasic pulsed current in the micro amperage range.
Term 6: Monophasic pulsed current pulse duration
Definition 6: Depends on frequency; a typical pulse duration is 500 msec (0.5 sec).
Term 7: Frequency on LIDC stimulators
Definition 7: Varies from 1 to 1,000 Hz.
Term 8: Because LIDC is DC or monophasic
Definition 8: One electrode is the anode and the other is the cathode.
Term 9: LIDC originated from observations of
Definition 9: Micro amperage DC flowing out of injured tissue.
Term 10: Transepithelial potential (TEP)
Definition 10: Electrical potential across the skin.
Term 11: TEP is created by the
Definition 11: Separation of ions across sheets of epithelial cells (i.e., skin).
Term 12: TEP arises from
Definition 12: Ions accumulating on opposite sides of epithelial tissue.
Term 13: Anode (Positive)
Definition 13: Attracts negatively charged ions (anions).
Term 14: Cathode (Negative)
Definition 14: Typically results in cell membrane hyperpolarization.
Term 15: LIDC is used to
Definition 15: Stimulate epithelialization of tissues in a non-healing skin wound.
Term 16: Microcurrent
Definition 16: Uses both positive and negative polarities.
Term 17: Galvanic currents
Definition 17: Mild electric currents that consist of positive and negative ions to stimulate the local muscles.
Term 18: Outcome of a galvanic current
Definition 18: Maintaining the muscle physiology.
Term 19: Three different types of stimulation
Definition 19: Anodal, cathodal, and sham.
Term 20: Anodal stimulation
Definition 20: Positive (V+) stimulation that increases the neuronal excitability of the area being stimulated.
Term 21: Cathodal (V−) stimulation
Definition 21: V− stimulation decreases the neuronal excitability of the area being stimulated.
Term 22: Low frequency currents
Definition 22: Therapeutically used currents whose frequency is in the range of 0 to 100 cycles per second.
Term 23: Primary use of low frequency current
Definition 23: Stimulation of nerve and muscle.
Term 24: Direct current (DC)
Definition 24: Occurs when the current flows in one constant direction.
Term 25: undefined
Definition 25: Occurs when the electric current periodically

Electrode Types and Effects on Cell Populations

  • Anode (Positive)

    • Attracts negatively charged ions (anions).

    • Can induce cellular activation depending on cell type.

    • May stimulate tissue repair or wound healing.

    • Anti-inflammatory effects in some cases.

  • Cathode (Negative)

    • Attracts positively charged ions (cations).

    • Typically results in cell membrane hyperpolarization.

    • May influence nerve regeneration or pain modulation.

    • More likely to cause tissue damage if not carefully controlled.

Clinical Use of Microcurrent and Best Evidence

  • LIDC is used to stimulate epithelialization of tissues in a non-healing skin wound.

  • The cathode is placed over the wound site, with the anode placed adjacent to the wound.

Microcurrent as Alternating Current

  • Microcurrent uses both positive and negative polarities.

  • Current is measured in Micro Amps with an intensity of 175-1000.

  • The frequency of the microcurrent ranges from 0.1-680 Hz.

Galvanic Currents

  • Galvanic currents are used primarily for facial muscles.

  • Galvanic currents use mild electric currents that consist of positive and negative ions to stimulate the local muscles.

  • The outcome of a galvanic current is maintaining the muscle physiology.

  • Continuous direct current (also called galvanic current) has been used for wound healing, iontophoresis, and in the treatment of denervated muscle.

Galvanic Treatment Types

  • Two major uses of direct current in skin therapy:

    • Iontophoresis.

    • DE incrustation.

Types of Direct Current Stimulation

  • Three different types of stimulation: anodal, cathodal, and sham.

  • Anodal stimulation is positive (V+) stimulation that increases the neuronal excitability of the area being stimulated.

  • Cathodal (V−) stimulation decreases the neuronal excitability of the area being stimulated.

Low Frequency Currents

  • Low frequency currents are therapeutically used currents whose frequency is in the range of 0 to 100 cycles per second.

  • The primary use of low frequency current is the stimulation of nerve and muscle.

Direct Current (DC) vs Alternating Current (AC)

  • Direct current (DC) occurs when the current flows in one constant direction. It usually comes from batteries, solar cells, or from AC/DC converters.

  • DC is the preferred type of power for electronic devices.

  • Alternating current (AC) occurs when the electric current periodically inverts its direction.

Microcurrent Frequency

  • Frequencies are set at two different levels; for example, one microcurrent channel might be set at 10 Hz, and the second at 40 Hz.

  • The technician will apply the current with a saturated towel or with skin patches.

  • It's very important for the patient to drink plenty of fluids before FSM treatment.

## Microcurrent Contraindications