Low-Dose Biophysical Stimulation for Dermal Conditioning in Aesthetic Physiotherapy: A Narrative Review

Aesthetic medicine uses both injectable treatments and energy-based interventions, including established higher-energy procedures that intentionally induce controlled tissue injury. This narrative review focuses on a narrower, less established area within aesthetic physiotherapy: low-intensity, non-ablative biophysical stimulation for dermal conditioning and recovery. The modalities considered are microcurrent or low-intensity electrical stimulation, therapeutic ultrasound and sonophoresis, lower-intensity radiofrequency, extracorporeal shockwave or acoustic wave therapy, and low-level laser or light-emitting diode photobiomodulation. Evidence from skin aging, wound repair, mechanotransduction, bioelectricity, sonophoresis, nonablative radiofrequency, shockwave biology, and photobiomodulation supports modality-specific biological plausibility, but it does not establish a common regenerative dose range or demonstrate that combining these modalities with injectable skin boosters produces synergy. In this review, low-dose is used descriptively and must be interpreted according to the exposure variables of each modality. Proposed effects on product distribution, residence, interstitial exchange, recovery, and tissue remodeling are distinguished from established outcomes and should be considered hypothesis-generating. Clinical validation requires modality- and product-specific dosing, objective measurements, appropriate controls, and controlled trials.