High-Intensity Focused Ultrasound in Dermatology: A Review with Emphasis on Skin Cancer Management and Prevention

Area of Science:

• Dermatology and oncology
• Medical physics and bioengineering

Background:

• High-intensity focused ultrasound (HIFU) is a novel non-invasive therapeutic modality.
• Dermatological HIFU platforms operate at approximately 20 MHz for precise, submillimeter-scale ablation.
• HIFU is suitable for treating benign, premalignant, and malignant skin conditions.

Purpose of the Study:

• To review the mechanistic basis of dermatological HIFU.
• To present current evidence on HIFU efficacy for skin conditions.
• To explore HIFU's role in field cancerization and prophylaxis.

Main Methods:

• Review of mechanistic principles: thermal coagulation, acoustic cavitation, immunomodulatory effects.
• Analysis of current clinical evidence for actinic keratoses and basal cell carcinomas (BCCs).
• Comparison with conventional therapies (surgery, PDT, cryotherapy).

Main Results:

• Early studies report clearance rates of 70-97% for actinic keratoses and BCCs.
• Excellent cosmetic outcomes and reduced procedural pain compared to conventional therapies.
• HIFU allows for faster healing and treatment of multiple lesions in one session.

Conclusions:

• HIFU is a significant advancement in non-invasive skin cancer management.
• Offers oncologic efficacy combined with patient-centered care.
• Further research is needed on long-term oncologic outcomes and standardized protocols.