Tag Archives: Facial Acupuncture

Acupuncture Malpractice Insurance – Neuromuscular Facial Conditions Part 1

So today’s lecture topics are I’m going to define a neuromuscular facial condition. I’m going to talk a little bit about the theory behind a multifaceted approach, and then I will talk about submuscular needling and scalp acupuncture.

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi, my name’s Michelle Gillis. I am an acupuncture physician practicing in Florida, and today I am going to be speaking to you about treating neuromuscular facial conditions. This is part one of a part two presentation. First slide, please.

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So this is just a little bit about me. I am a former faculty member of the Maryland University of Integrative Health, and I am currently on the doctoral faculty at Yo Sound University, and I. I have been teaching facial acupuncture classes internationally since 2005. Here are some publications that I have completed in the Journal of Chinese Medicine.

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So a neuromuscular facial condition is any group of disorders which can cause weakness or pain on one or both sides of your face, you might lose the ability to make facial expressions have . Pain, difficulty eating, drinking, speaking clearly. You can have ear pain, you can lose your sense of taste, smell, it can affect your eyes, your vision.

And you can also have the inability to sense heat or cold or be very sensitive to the heat or cold. What I have discovered over many years in practice is that using a multifaceted approach to treating these conditions, because some of them can be very difficult to treat, and using a multifaceted approach, can yield a more effective treatment than just using one of these modalities or the other.

Some examples of neuromuscular facial conditions is are Bell’s palsy, Ramsay Hunt syndrome, posis of the eyelids, and this can be one eyelid or both eyelids, synkinesis, which is when you’re trying to move one. Part of your face, but another part moves involuntarily. The side effects of a stroke TMJ Trigeminal Neuralgia multiple sclerosis, and there are many others I.

Part one and two of this presentation represents about an hour of what is usually a two-day class that I teach on treating neuromuscular facial conditions.

So the interesting thing about our face is that our face is the only part of our body where the skin is connected directly to the muscles, which is what gives the. Our ability to move the skin on our face without having to move any bones or ligaments or tendons. So here we have an example. We have skin, and then we have muscle.

And as you can see it, the skin is connected directly to the muscle and then down to the bone.

For example, here is a cross section of a part of the cheek, and you can see the skin and then the fat, and then the fascia and invested inside of this fascial layer is the muscle, and then there is deeper fascia and there is the facial nerve.

When treating the face, there are several things that’s, that are important and you wanna make sure you are increasing the blood flow to the area. I. Increasing the qi to the area and also if there’s any fossil adhesions that exist, that you can break these up because all of this can affect how the face moves and the sensations that we feel.

By using a technique called submuscular needling. In some instances it’s intramuscular needling, but submuscular needling can increase the flow of blood and QI to the area can help to break up any fascial adhesions. And if you are thinking in terms of . Cosmetic benefits. It can also stimulate collagen production to the area.

There are several muscles on the face, head and neck that are really conducive to this submuscular needling approach. And they are the auricular muscles, the temporalis muscle, the platysma, the masseter, the anterior digastric. The frontal, the proces, the corrugator, and the levator muscle. We are only gonna speak about a couple of those today.

And the using submuscular needling is part of this. Multifaceted approach. So in addition to Submuscular needling, we’re also going to talk today about scalp acupuncture, and then next time facial motor points, facial cupping and guha and derma rolling.

So here is another cross section of the face. And as you can see, the facial nerve is invested in this it’s called the SMA layer. It is the superficial muscular AERA system, and the nerve can become entrapped. And when that happens the signal that gets to the muscle, which in turn goes out to the skin, which moves the skin on our face, moves, the muscles in our face can become compromised.

So the first muscle I wanna talk about for Submuscular needling is the frontals and. The frontals muscle goes on either side of the eyebrows. There’s one head on one side of the eyebrow and one on the other. And what you would do is you would take, typically I do half inch needles and I would needle underneath the muscle.

And this is what it looks like here.

So when needling the frontals muscle, the way that you isolate the muscle is you ask your patient to raise their eyebrows. Go ahead and raise your eyebrows, okay? And then relax and you can find the border of the frontals muscle and the way that you needle. Is you’re going to go from the origin to the insertion.

So the origin is up here and the insertion is here.

And typically what I do is I will put in. Usually three needles

on the lateral edge, and I will put in two needles. On the medial side, and when you’re needling, what’s important is that the angle of the tube is the angle that the needle’s gonna go in. So if you go like this, it’s going to go too deep. If you go this is going to be too shallow, I use. My thumb or a finger to help to guide the needle.

So you wanna keep your fingers out of the way when you’re actually inserting. That way you can get to the correct depth right underneath the muscle. That’s the lateral side. Then you’re going to do the medial side, and usually two needles. Will suffice and I do the one side and then I do the other side and I’m using half inch needles.

You can use one inch needles depending on how big your patience forehead is.

The next muscle group. That I’m going to demonstrate for submuscular needling is the temporalis. So the frontalis is used to raise the eyebrows, and it’s also indirectly involved in raising the eyelids, the temporalis muscle, which is a large. Very thin, fan shaped muscle that’s on either side of the skull and it also goes in front of the ear.

It helps us with our chewing and it helps to, so it helps to elevate the jaw and it can be involved with conditions like TMJ. It can also cause head. Pain. If it is too tight, it can be involved in trigeminal neuralgia because nerves can become entrapped underneath the temporalis. I. And this is what this looks like.

So here’s the temporalis muscle, and what you would do is take needles and put them all around the outside of the temporalis. And I have a video for that as well.

So for the temporalis muscle. The idea is to find the outline of the muscle and it tends to be a very large muscle. It runs all the way from the back of the skull all the way around the front of the face. And you’re literally going to take the needles and you are just gonna work your way around.

The entire line of the muscle, and depending on how tolerant your patient is you can use, you can really thread like 20 of these into this area. I’m just doing a little demonstration here I want you guys to get an idea of what this looks like. And it doesn’t really matter which direction you’re going in.

What matters is that you’re getting, again, underneath the muscle and that you’re working your way all around the perimeter of the muscle in order to relax it. And they should have a nice little circle around. A muscle when you’re done, and this will really help to relax the temporalis muscle if they have TMJ.

Pretty much anything that affects the face. The temporalis muscle helps to pull the face up. I use this technique sometimes and facial rejuvenation when I teach my facial rejuvenation classes because the temporalis muscle can really lift up the face. I’m just gonna do one more again. I’m using serum one inch.

Needles. So that’s what that looks like.

So for the temper, the next. Technique that I use when I’m treating neuromuscular facial conditions is scalp acupuncture. Now, scalp acupuncture can be used and it is used traditionally to treat a multitude of. Conditions, everything from phantom pain to speech issues, to inability to move a body part.

But when I use and teach scalp acupuncture, it involves issues concerning the face. So when we when we would incorporate scalp acupuncture. We could use this in conjunction with submuscular needling or as a standalone technique, so any conditions that involve the face scalp, acupuncture can be very effective.

I. Especially when you’re dealing with a condition like trigeminal neuralgia where it’s very painful to needle directly onto someone’s face, you can use scalp acupuncture and this will treat the face without having to directly put needles in the person’s face. So here we have a cross section of the scalp.

We have the skin, we have the close connective tissue, and this is very heavily vascularized with lots of nerves. Then we have the aosis. Right below that is the loose connective tissue, and this is where you would want to insert the needle. Right below that is the perran and that is the skull. The good news is that when you’re trying to find the right depth to needle, if you just go down as deep as you can along the bone.

Then ’cause it, you, it is impossible to put an acupuncture needle through someone’s skull bone. You can needle right along the bone and if you get into the loose connective tissue, it will not be painful. If you go into the close connective tissue, you’re going through vessels and nerves, and it can be very painful.

So the thing that can be the most important thing to learn when you’re learning scalp acupuncture is how to measure. So the, you’re basically going to, these are not acupuncture points. These are areas of the. Scalp that affect different areas of the brain. And the way you measure is you’re going to get your horizontal and vertical planes, and then you will find the area of treatment based on that.

So the first landmark is from the glabella to the occipital protuberance, and the glabella is at the midpoint. Of you’re gonna get to the glabella is between the eyebrows and you’re gonna measure back to the occipital perturbance. And this will give you your line this way. And then you are going to find the midpoint, and that is the midpoint of the midline.

And if you go a half a centimeter. Behind the midpoint, that is where you’re going to be drawing a line. Right here. So you’re going to find the midpoint of the eyebrow and also go back to the occipital protuberance. And when you go back 0.5 centimeters, you’re gonna draw a line that intersects just like this, and you’re gonna break this up into three sections.

So the lower two fifths. Is this is where you would needle for concerns of the face? The upper extremities is the . Middle two fifths and then the upper one. Fifth is the lower extremities. So the lower extremities are the legs, the spine, the trunk, and the neck. And the upper extremities is just the arms and the hands.

And this bottom two fifths is the face. So this is the area that we would want to needle.

The technique for needling looks like this.

When you’re needling the scalp, it’s important to angle the needle properly so that it goes into the loose connective tissue. I like using a tube. You can freehand if you’d like, but I find that the tube helps me to guide the needle to the correct depth. I tap the needle in, remove the tube, and then I use my free hand to guide the needle

if the needle is improperly. Your patient should not feel any pain. So you’ll know that you’re into the loose connective tissue. If your patient doesn’t have any pain, when you needle, once the needle is in, you stimulate it gently for 30 seconds just like this. Or you can use electricity.

So that concludes our lecture today. So we covered Submuscular needling and we covered scalp acupuncture. Next time we are going to talk about facial motor points, facial cupping, GU Shaw, and derma rolling, and then some protocols for specific conditions. And I look forward to seeing you next time.

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Acupuncture Malpractice Insurance – Hyaluronic Acid: The Key to Hydrated Youthful Skin

Hyaluronic acid is a natural. Substance found in the body. It’s present in large concentrations in the skin where it helps keep complexion hydrated. And plumped, we hear about hyaluronic acid a lot in our social media and regular world today.

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Hi, my name is Dr. Shellie Goldstein. I am here today from Florida. We are going to talk about hyaluronic acid and I wanna thank the American Acupuncture Council for allowing me to give this very exciting presentation today. So let’s go to the slides. Hyaluronic acid, the KE to hydrated youthful skin.

And for those of us in Florida, this is very important, but it’s also important for everybody as you’re about to see, what is hyaluronic acid? Hyaluronic acid is a natural. Substance found in the body. It’s present in large concentrations in the skin where it helps keep complexion hydrated. And plumped, we hear about hyaluronic acid a lot in our social media and regular world today.

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What you may or may not know about hyaluronic acid is it’s a humectant. And what is a humectant hum? A humectant is a protein or a substance that actually draws moisture from the environment, whether it’s from the air or from the water or wherever you are. So it takes it in from the environment and through the skin into the deeper layers of the tissue, what we call the dermal layer and below.

And a , like I said, is a substance that has the ability to attract and retain moisture. Similar to a sponge. Just you put a sponge in water, it just soaks it up and it holds onto it, and that’s what hyaluronic acid does. As we age our body, like other substances in our body, we begin to produce less and less of it.

So what happens? We start to dry out. Our skin looks dry, our tissues get dry. We get fine lines and we can get skin wrinkles. When we think of the body, let’s start with the anatomy of the face. You have the bone, which is your solid core structure of your face, layered and horizontally. On top of that is our layer of muscles.

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Then we have fat and we have skin, and what keeps everything together, it both separates, but it also joins all of the horizontal tissues of the face and the rest of the body is connective tissue or fascia. It’s like a web, as you can see in, in the image. It’s just this woven web that holds everything together in place, but it also holds the individual tissues in place as well.

The primary components of fascia are collagen. So collagen is the integrity and the support system of this tissue. It’s like the mattress. It’s gives you the support, gives you the volume of that you need and see in your skin tissue. Whereas the next in protein is elastin. Elastin isn’t so much volume, but.

It allows that snapback. So if you take your skin and you lift it, and you drop it, elastin is what you need in order like that rubber to snap back into place once you lift and let it go. And then there are fibroblast cells, or small protein. That when stimulated is what produces collagen or what stimulates the production of collagen in the fascia.

It also affects many immune and inflammatory responses, and it’s very important for wound healing as we’re gonna learn in a few minutes. And then there’s hyaluronic acid. It’s the moisture this . Substance that bathes all of the other proteins, the collagen, the elastin, the fibroblasts, and other cells that are in this area, what we call the extracellular matrix.

Hyaluronic acid is in the image, is this a little red line and it has a surrounding it, what we call protio glycans and protio gly cancer. What attracted those water molecules to the hyaluronic acid? It is so effective that hyaluronic acid molecule can hold up to 10 a thousand times of its molecular weight and water, which makes it responsible for th up to 30% of the skin’s national natural moisture retaining ability it has.

So here’s . Hyaluronic acid strand and then attached to what are bound to the hyaluronic acid are protio, glycans, and protio. Glycans are what the water molecules attach to, and you can see it in this area. In the lower image, you can see the hyaluronic acid and green, the protio glycans are those little

Feathers that stick out from the hyaluronic acid. In red, elastin and collagen that woven matrix of different colors of blue. So all of these are in fascia and in the what we call the extra cellular. Matrix in the face, hyaluronic acid is primarily located in the dermal layer of the skin, which is the second layer of the skin.

And we’ll look at this for a minute, and it’s found throughout. This matrix is found throughout loose connective tissue of the superficial layer of the skin. Below the deep layer of fascia, and it’s generally found in places aside from the skin, in places that are moist, like the oral cavity, the cartilage of the nasal structure and blood vessels, and in the mucosa membranes of the face here, although the structure of fascia layers varies across different areas of the phase.

Here we see it where the stars are. So the very top layer of skin is the epidermis. It’s what we see when we look at someone else, when we look in the mirror. And then just below the epidermis is the derma layer, and this is the true health of the skin. So the surface is the surface layer, the epidermis, and just below it is what we call the dermis.

And this is where we see most of the hyaluronic acid, the extracellular matrix, and all of the nutrients and proteins that keep cells nice and healthy. And then underneath that we have the superficial Retin Macular Cuts fibrous. And those are not horizontal. They’re vertical structures like ligaments that hold those horizontal structures in place.

I. Below that, we have a fat layer, which gives our skin plumpness. And then below that we have the superficial fascial membrane. And this membrane actually attaches the above layers to the below layers, another layer of ligaments. And then we have another layer of fascial membranes, which don’t have as much hyaluronic acid, but because of that, underneath it as an entire layer of hyaluronic acid or extracellular matrix.

And then we have the lining of the muscles epimysium and then the muscles themselves. So this is lining, you can see multiple layers of hyaluronic acid, which keeps this entire tissue layering nice and hydrated, nice and wet, so that things slip around and slide more effectively. So in acids, the benefits of hyaluronic acid are that keeps skin nice and plump.

When skin is nice and plump and hydrated, it minimizes wrinkles and fine lines. There are many different types of wrinkles. I’m talking about wrinkles at this. Moment that are related to skin dehydration, it increases skin elasticity and slide remembering that the elasticity is the elastin or the snap back in our skin tissue, and that all of those, that proteins need to stay wet.

In order to work effectively. And then also remembering that wetness allows those horizontal planes to slide back and forth. When we don’t have enough hyaluronic acid in our skin, we get dry. It gets irritated and then you start to see facial redness, irritation, even to the point where you have skin breakouts and dryness.

Like eczema and psoriasis. And then also remembering that we have fibroblasts in that extracellular matrix. And so without that wetness or moisture we have difficulty having our wounds heal. So hyaluronic acid and providing that moist environment helps the fibroblasts development and assisting assist in wound healing.

And here’s an example of this. So in terms of the integrity of hyaluronic acid, you see the image on top. You have tissues that need hyaluronic acid to lubricate and enhance the movement of those adjacent cells. That slide that we were talking about and then without. Hyaluronic acids are changes in that production from either age or other trauma, that type of thing.

We start to lose the production of hyaluronic acid, which leads to skin dehydration, loss of firmness and elasticity, wrinkling, and then again those horizontal planes. What happens if . You don’t have moisture. They get sticky and tight and so things, the lows, layers just can’t move independently of one another.

And that’s when you start to get fascial binding. And there are many ways to improve hyaluronic acid. One is acupuncture. When we are needling to improve the skin layer, so it’s very superficial layers of the tissue we’re not gonna place the needle perpendicular. Why? Because then you go towards the bone area.

We need to go into that superficial tissue. So we’re gonna angle the needles at a 15 to 20 degrees. Relative to the surface of the skin. So for us as facial acupuncturists, we tend to use intramurals more because you can slide them at an angle as opposed to going deeper in, into the tissue and missing it heading into the muscle layers.

So we will use very superficial needling to stimulate the skin to produce more collagen, in which case the, and the hyaluronic acid elastin all of the proteins that are found in that extracellular matrix in order to improve skin elasticity, plumpness, and texture. And then also we use needling.

Anytime you roll or create a, an, and a little channel by puncturing the skin. It allows product or whatever it is on top of the skin to move into those deeper layers of the skin. So we use it. Same microneedling is a very popular treatment that we use. And facial acupuncture. So it’s a number, like a plum blossom, a lot of superficial needles in one small area, and then you rub product into the surface of the skin.

So by superficial needling, we’re creating tiny little channels in the skin that make it easier for topical products, including hyaluronic acid, serums, or creams. To penetrate into the deeper layers through the epidermis, into the germal layer and below, and this will enhance the absorption and the effectiveness of whatever product we’re using.

And then that combination of superficial needling and hyaluronic acid, whether it’s in the form of a serum or a cream, can enhance the skin, make nice and plumb, make it smoother, more even toned with reduced fine lines, wrinkles, and even scarring it at ate layers. When we think about hyaluronic acid and topical products we think of it either as a serum or a cream or a mask. Another conversation, at another time, which I promise I will deliver here. And so we’ll use these products that contain dosages of hyaluronic acid and they go into the surface of the skin and directly moisturize the, those deeper layers and superficial layers.

Their job is to retain water. So again, the protio glycans on the hyaluronic acid proteins bring water into the tissue or wherever the hyaluronic acid sits to improve the skin plumpness and reduce the appearance of fine line and wrinkles. So it’s immediate hydration. You put the product on the moisture, it attracts the moisture and plumps the surface of the skin.

Depending upon the product and depending upon the depth of penetration, if it’s sitting on the surface of the skin, this product, then it’s gonna bring moisture to the surface of the skin, and if you can press it through the deeper layers. Say with the addition of superficial needling, then it actually goes into the tissue below the germal layer, and then it has longer lasting results.

Hyaluronic acid, because it’s naturally produced in the body, in its pure form, it’s very safe to use. Sometimes people will get a reaction to a product and any product which could result in irritation or redness or itching. In most cases, it’s not the hyaluronic acid that’s actually causing the irritation.

I. But it’s other ingredients in the product. Products are made of multiple ingredients. Sometimes an ingredient doesn’t agree with your skin, particularly if you have very sensitive or sensitized skin, and so you may develop some redness. It’s usually not the hyaluronic acid, although if you discontinue it and try a different product with a different formation, it may or not.

When we think of derivatives of hyaluronic acid, we think of them in terms of molecular weight. So all proteins, all ingredients, particularly in the skincare world, are have a certain weight and that’s measured in dass. So a compound. So in its raw form, say hyaluronic acid in its raw form, because it’s raw, it has a very high molecular weight.

Which means that it has difficulty pressing into the surface of the skin. So it remains on the surface to pre and remembering that the hyaluronic acid is, and the proteoglycans are actually gonna pull the water to the place of the hyaluronic acid. So if it’s a high molecular weight, it’s just gonna sit on top of the skin.

It can’t get through the skin, so it’s gonna remain on the surface. And where does the water go on the surface? So it’s going to create a protective film that prevents water from actually evaporating. So it’s gonna keep the moisture that’s in the skin in, and it’s going to put water on the top. So it’s actually going to give you a tightening effect because it’s a locking moisture in.

So it’s gonna look plump, but it’s gonna feel a little tight. For deeper penetration, particularly in skincare world, we look at different forms, say the hydrolyzed, which actually breaks it down a little bit and allows the hyaluronic acid to split into smaller fragments, and that’s usually less than a thousand to 1800.

Das. And so this allows that product to penetrate a little bit deeper into the surface of the skin. So again, drawing that water a little deeper through those tissues. There’s another form, sodium hyaluronic, and this is the salt of the hyaluronic acid that’s used and it’s good for stability when you think of cells.

And molecules that penetrate through the cell wall. Salt is one that actually go, is small enough to go back and forth and back and forth through the cell walls, which is where you want the moisture. And so another form the form of the alkaline foreign sodium hyaluronate is oftentimes used in cosmetic formulas, allowing it to penetrate a little bit deeper into and through the epidermis into this.

Skin area, the deeper layers. And this is actually a, gives you a visible effect of plumpness from underneath the skin surface as opposed to on top of the surface. There are two new forms of hyaluronic acid that are being used right now, sodium hyaluronic cross polymer, and this is even a lower molecular weight than the salt version, and it’s crosslinked to form.

A molecule that is a little bit higher molecular weight, but passes through that barrier quickly. And it’s it’s very interesting because it’s gives you the stability of a hyaluronic salt acid but also the humectant properties of a more superficial, so it’s covering both the surface and a little bit deeper and then to go most deeply or the deepest into the skin.

Is the the new sodium ated Hyaluronate and acetyl hyaluronate is it’s new. And what’s fascinating about this form is that this ingredient or this formulation of hyaluronic acid actually can penetrate into the skin three times. Much deeper, which allows for three times more water and absorption than ordinary hyaluronic acid.

And it keeps it in, it locks it in so that it stays longer. So it’s great for aging skin, dehydrated skin, or people say who live in the desert or in dry climates or even in the winter when you tend to lose a lot of moisture on the surface over your skin from cold. It also inhibits the release of MMP one, which is a degradation of collagen, immature skin.

Skin and it’s also used to help protect the skin from the UV rays and environmental pollution. So it’s lookout for that one. It’s new. It’s coming up and I think it’s gonna. Be really popular. It’s used to reduce crows free and the nasal labial fold of the skin, the wrinkles that run from the corner of the nose to the corner of the mouth.

And keep an eye out. I think it’s gonna be very popular in upcoming formulations of skincare. What’s interesting is this research study, it’s a randomized control trial of the efficacy of cream-based hyaluronic acid at different molecular weights. And this. They’re using water bound hyaluronic acid at a weight, a molecular weight.

So three different weights, 51, 3300, 802,000. That’s more than three, isn’t it? It’s five. And so they applied it around the eyes. 76 female patients between the ages of 30 and 60 years for 60 days. So they measured at 30 and 60 days. And what they, so one eye, they used this cream and then the other at different molecular weights.

And they used placebo on the other side. And then they were taking objective measurements. So they used a semi-automatic morph photometry meter in order to demonstrate the changes, the objective changes. What they did is the measurements were wrinkled depth. They, and then they also compared the size or the amount of change that occurred at 360 days.

And the 60 day measurement, what they concluded was the application of a 0.1% hyaluronic formulation was made significant changes in both skin hydration and elasticity, but they also found that the lower the molecular weight. The more effective it was. So again, going back to those cross pollinations or breakdowns of combined hyaluronic acid products that are coming up, they’re designed to both break down the acid, the hyaluronic acid, into very small, low molecular weights in order for it to penetrate through the skin more effect effectively and efficiently.

The other, another very important way to get hyaluronic acid into your skin is through your diet. So a diet rich in nutrients that support hyaluronic acid production can help improve the health and appearance of your skin. Key factors related to improving hyaluronic acid or getting hyaluronic acid through your food and diet.

A water. Drink as much water as you can. And that will help keep hyaluronic acid functioning properly. And then nutrients to consume are foods high in vitamin c, e, and magnesium to help produce and support the synthesis of hyaluronic acid. So these vitamins help synthesize it, water helps to keep it functioning.

And then antioxidants, such as fruits and vegetables. They actually protect that hyaluronic acid from breaking down. And then collagen rich foods and supplements can support hyaluronic acid by promoting skin elasticity and hydration. So you will need to have nutrients like vitamins C and magnesium to build or synthesize it.

You need antioxidants to help it from breaking down. And then drink plenty of water in order to support or maintain the functioning properties of hyaluronic acid. And then you want to promote, help, promote and support that hyaluronic acid by promoting skin elasticity and hydration by taking collagen rich foods or supplements.

And then here’s a research study. This is a 12 week double blinded placebo study, and 12 weeks is about right because when we talked about the epidermis and the dermis, skin cells start at the base of the dermis and make their way up to the epidermis so that you, what you visibly see. It takes about 30 days to, to migrate up from the cells, from the base of the dermis all the way up to the surface.

So 12 weeks is three rounds of improved production of hyaluronic acid in that germal layer in order to visibly see a difference in the epidermis. After 12. So in this study, this double-blind placebo controlled study, they were using daily hyaluronic acid, 120 milligrams, and it was from High Best.

It’s a company in Tokyo. Taken daily for 12 weeks in 40 healthy Asian men and women ranging in the age of 35 to 64, and they evaluated objective measurements of wrinkles and the stratum cornea water content. That’s the surface of the skin. The amount of transepidermal water loss, that’s through the tissues.

Elasticity and they looked at imaging analysis so that they were objective measurements rather than just asking the people. How do you feel? So this was actually a measurable controlled study. I. After 12 weeks, they noted that skin condition was significantly improved in terms of wrinkle assessment, stratum, cornium, water contact, transepidermal, water loss, and elasticity.

So they concluded that. It makes a difference. What’s very interesting is remembering that when you were applying hyaluronic acid to the surface of the skin, you wanted a low molecular weight. In this one, what’s interesting is another 12 week period they were looking at the benefits of hyaluronic acid.

Applied orally. They did a similar study, 60 Japanese male and females aging, 22 to 59 years old, presenting with crows free and wrinkles. And then they were assigned hyaluronic acid at a me molecular weight of two 300 and 300. Again, 120 milligrams of hyaluronic acid. Now what was so interesting about this.

Is again measuring the skin wrinkling by imaging analysis and skin condition, and that was from a questionnaire survey. Here’s what they found is during that study period, what they found is that the higher molecular weight at 300 K group showed significant, a higher significant. Change in terms of diminishing wrinkles and compared with the placebo group.

So both worked at two and at 300, but the conclusion is that the 300, the higher molecular weight. Worked better. Why? Now? This is a good question. So think about this. If you are applying it to your skin, then those molecular, then the hyaluronic acid molecules have to get through the skin. However, if you’re eating them or ingesting them orally, it has to get through the digestive tract and get absorbed in the digestive.

To track. So when you break them down, a higher molecular weight has more of it. So you actually get a higher delivery of the product as opposed to topically when you can’t a higher molecular weight, it’s not gonna get through. So it’s just gonna sit on the top. So situation, you want a lower one. So I hyaluronic acid is great and.

It just depends how you do it. Whether you stimulate it with acupuncture, you ingest it, or you apply it topically. And so the benefits are really not just the hyaluronic acid but the delivery system. Low molecular weight for application on the surface of the skin topical application, and a higher molecular weight.

When you ingest it, so read your ingredients, read the package you want around a 300 molecular weight of 300 k if you’re gonna consume it, and you’re gonna want a smaller, safe five to 50 if you are going to apply it topically. So if you want more information about hyaluronic acid, I actually will be giving a presentation about tissue and DA fascia at the upcoming Pacific Symposium.

Here’s more information about it, and that’s it. So thank you very much. I appreciate your time here, and I hope you enjoyed this and learned a lot. Again. Thank you American Acupuncture Council for allowing me to present today. .

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Facial Acupressure for Health and Wellness

…when we think about health and we think about wellness and Chinese medicine, we think about yin and yang, cheap blood fluids, the meridian system and the organ systems.

Click here to download the transcript.

Hi, my name is Shellie Goldstein, Dr. Shellie Goldstein. Welcome to the American Acupuncture Council. Today’s presentation is Facial Acupuncture for health and Wellness. I am specialist in cosmetic facial acupuncture, but today we’re gonna talk about health and wellness because they are com overlap and they interlink.

So let’s get started. Let’s start with the PowerPoint presentation.

Most of us know who are acupuncturists, that when we think about health and we think about wellness and Chinese medicine, we think about yin and yang, cheap blood fluids, the meridian system and the organ systems. As a specialist in cosmetic facial acupuncture, what I love about treating

The body and treating the face is the correlation between the face and the rest of the body. We know that we have meridians running up and down the body. We know that we are affected by the state of health of our organ systems. We also know that all of the young meridians. Either start or end on the face.

What we may or may not remember is when you think about the organ systems, each of those systems has a sense system. Now, whether it be the eyes, the nose, the ears, the mouth, meaning, What we see, what we smell, what we hear, what we taste, and they affect and are affected by the state of health of each of the organ systems and the meridians, because remembering that the meridians run through the different organs, assume their name and pick up the characteristics of that.

System, that organ system. But then again, the meridians affect the organs as well. So we know it’s that yin y balance, that the complimentary dynamics between the meridians and the organ systems and the health of our body. But also remember that when you see things, when you hear things, when you smell things, when you taste things, it creates a sensory stimulation, some type of proprioception where we are in the world, but also.

Not just on a physical level, but on an emotional and energetic level as well. So when we surround ourselves with beautiful things visually, we feel relaxed, we feel at peace. As opposed to when we see something that’s awful or horrifying or frightening, then those emotions get reflected in the body as well.

The same with our, or with our sense of hearing. If we hear soft music, like we heard as we were starting the live stream of this presentation, it’s very soothing music. It’s very lovely and it brings peace and harmony within as opposed to seeing, hearing something loud, abrasive, shocking. Disturbing. It sets up that a different dynamic within the body as well.

Same with smell, same with taste. So the emotional activity that gets triggered when we experience something is very much a part of the reflection of what’s going on inside and reflects in terms of affecting how we are. Feelings, feeling both on a physical and emotional and a spiritual level. So in that sense, the face is a very important part of the diagnostic and treatment of health and wellness.

So we can diagnose what’s going on in the body by looking at the face, because remembering that our muscles are tissue. Interstitial tissue, the connective tissue, all of the different aspects of the layering from skin to bone holds that memory, particularly the connective tissue holds the memory of that experience.

If we process that experience and let it go, then it let’s go in the connective tissue of the di of the face. When we hold onto that experience, that also gets reflected in the face. And so we can look at the face as an big organ, one big facial organ map. And when we look at different parts of the face, each of those organ systems are reflected.

For example the forehead and the eye. Browse is related to the liver and the gallbladder system. The spleen and the pancreas is the eyelids and across the bridge of the nose the kidneys run underneath the eyes and on the chin and the ears. The lungs are the cheeks. The heart is the tip of the nose and the stomach and the intestines is, and the reproductive organs are around.

The mouth and what that means is that disharmony in those organ systems is reflected in the face, whether it be in terms of wrinkles tissue sagging skin disharmonies, acne, rosacea, breakouts, or just red pitted skin rosacea. Any disharmony on the surface of the skin or in the deeper layers of the skin is reflected by the organ systems and a reflection of the organ systems in turn of their health and wellbeing.

And then when there’s a disharmony in the organ systems, it is reflected and pass through. The different meridians. So what’s nice about treating the face is that it’s a wonderful tool and an opportunity to both diagnose what’s going on in the body, but also to treat, because as we treat the face, we have an effect on the state of the lungs, the state of the liver, the state of the spleen, the state of the heart, the state of the kidneys.

And we can harmonize both from a meridian’s perspective, but also from an organ. System, we can make a difference just by treating the face. Now, we know from our cosmetic acupuncture world that we’re not when we treat wrinkles, when we treat sagging skin, when we treat different skin conditions, we’re not just treating the surface of the skin, but we’re treating from within as well.

And that means that when we treat. For cosmetic facial acupuncture or for health and healing. We don’t just put points in the face, of course not. What we’re gonna do is we are going to do our diagnostics, tongue pulse pattern of is harmony, and then we’re gonna treat accordingly and we’re going to use the face as a treatment, as a diagnostic tool and a validation of what we find when we do our tongue pulled and questions.

So what I would like to do today is help you to understand how to treat the face by going through a very simple facial exercise. It’s an acupressure exercise, so it’s something that you can do at home. It’s something that you can . Do on yourself. It’s something that you can do with your patient and acupressure.

We know that acupuncture and acupressure are both ancient healing techniques that have been acknowledged for their effectiveness by both Western medicine and eastern medicine, and supported by thousands of scientific studies around the world. We know that acupressure and acupuncture are based on the same fundamental principles of acupuncture point activation across all of the meridians.

We know that acupressure is basically pressure applied with the hand fingers or an instrument assisted device at specific acupuncture points to adjust and balance the flow of energy. And the National Institute of Health Database offers hundreds of studies on the use of acupressure in the treatment of dozens of conditions, including a allergies, chronic fatigue, constipation, insomnia, musculoskeletal disorders, heart disease, pain, and stroke.

And we know as acupuncturist, there are many more health issues that acupuncture and acupressure treat. I wrote a book in 2016 called Your Best Face. Now look Younger in 20 Days with a Do It Yourself Acupressure facelift. And I also created the Touch and Glow Acupuncture assisted. It’s an acupressure assisted tool.

In my book, I outline a number of different techniques for facial harmony. But also for health and body. And the acupressure technique that we’re gonna learn now is based on some of the systems or some of the parts of the book that, that I wrote and the photographs that I took for the book.

So let’s get started. Let’s just have you sit back, relax, take breath. And relax, blow out. Exhale. Let’s lift your shoulders up. Drop them. Lift your shoulders up, drop them. Rotate your neck.

And stretch it out. And I’m actually gonna lift my glasses up so you can see my face, because I’m going to walk you through an acupressure technique that is going to improve health and wellness of not just your face, but your body as well. It’s very relaxing and I think that you’ll enjoy it. So let’s start by opening the neck.

I’m going to. Place my fingers at the top of the Ss c m. So if you go to the jaw area and slide your fingers up to the top of the neck to where the cervical, where the skull meets the cervical vertebra. And slide forward to the top of the Ss c m, the sternum Plato mastoid muscle. And then we’re just gonna massage down the Ss c m to the clavicle.

I just massage. Now I’m gonna do it five to 10 times. And in doing so, what we’re doing is not only we’re relaxing the neck, but we’re also helping to reduce tissue inflammation by improving lymphatic drainage, which means that if you have allergies or if you have any type of congestion in this area, what you’re gonna do is you’re gonna feel that coming down in the form of kind of a saliva on your throat, you may need to swallow good.

Okay, now take your fingers, go behind your neck, and you’re just, you’re gonna take these four fingers and you are going to place them starting at Bladder 12 T, nsu, and Gallbladder 20 Thank Chi and Andon. If you don’t exactly know where they are, it’s okay. Just place your fingers at the base of your oput on the outer, outside of the spine.

And feel for areas that are tight and just gently massage these points with the pressure that feels comfortable for you. And it doesn’t matter if you go clockwise or counterclockwise. Just massage those points five to 10 times good. Make sure that you breathe good, right? Excellent. And now slide your finger to what we call triple heater 17 or yen.

Yen is where the star is on the image. So you you have the corner of the jaw and the lower aspect of the ear lobe. It’s in between the corner of the jaw, directly under the ear lobe. We’re gonna massage this area. This point is the access point to the facial nerve. So the facial nerve is the nerve, the motor nerve that innervates the entire face and controls all the muscle activity on the face.

So by massaging this point, not only does it improve lymph drainage, but it also helps just to relax all of the muscles of the face. Okay. And now with this point we’re going to take our fingers and keep your finger on this point on Triple eight 17. And then just massage up and down the front of the ear.

So we’re covering Teen Quo, teen Gong and Erman Gall butter two small Intestine 19 and heater.

And then slide your fingers around the back of your ear, back to triple heat 17. Massage triple heater 17 again, and continue to massage up and down the ear in front of the ear

about five times, 10 times, and slide your fingers behind your ears again. Let’s do that one more time. Massaging triple leader 17, and then up and down the front of the ear

and behind the ear. Great, and now let’s slide up to T Young T. Is located in the temples at the end of the eye area. You massage that area. So this is great for any type of stress around the eyes and the face.

And then we’re gonna treat The three points on top of the eyebrow, , and sanju. So again, you can do it with your three fingers. 1, 2, 3, and just place them at the end of the eyebrow, the center of the eyebrow and the middle of the eyebrow at the inner campus of the eyebrow sort a massage.

Good.

And big relaxing breath. And now we’re gonna go to our favorite point. It’s yin tongue and we know that yang is the main point for relaxing the body, mind, and the spirit. We don’t do this for about five to 10 times.

And move into the inner aspect of the inside of the corner of the eye to bladder one. And again, this point is used for any type of eye disorder, which we know affects the liver system, and it’s used to relax and open and brighten the eyes. And then we can stomach one and stomach two, or right on top of each other, above and below the orbital bone.

So use the flat part of your finger to capture both of them

and just massage ching cheese. See by feel relaxing.

And then back to

and let’s repeat that sequence again. Oops, sorry. We’re gonna go back up to the eyebrows, the top of the eyebrows.

End tone.

Water one.

Stomach one and stomach two.

Cool. And this time we’re gonna slide down the nose. To lateral to the side. Yeah. Lateral to the side of the nose, and we’re going to type. Stomach. Three is underneath the eyes, lateral to the side of the nose, small intestine. 18 is at the outer canthus of the eye, lateral to stomach three. And then stomach seven is lateral to that in front of the ear, and we’re just gonna massage his points.

Three fingers, just massage his points.

Good. Don’t forget to breathe.

And then slide down to stomach four. Deep tongue. It’s at the corner of the mouth.

We use this point a lot in facial acupuncture. It is the connection to all of the muscles of the face that connect from the mouth to the eyes and to the collar. Very important point. And then take your thumb. Place your thumb underneath your jaw. And then the top and the fingers, the first four fingers, and then just slide out to stomach six stomach sixes.

I use it the corner of the jaw. The angle of the jaw. We’re gonna slide, slide,

slide. And then come back. Come back to the S C M

and slide down to the clavicle.

Now let’s repeat that again. I won’t talk this much. So again, ing your fingers. See on Zoom,

Andon

circling around feeling for those tight areas

and then slide to offense directly into the.

And then massaging

ting gong air mine, and slide behind your ears. Come back to triple heat. 17.

Slide up and down in front of the ears. At this point, you should start feeling new, smooth, relaxed. It’s a great, this combination around the ear is really good. If you can’t sleep at night, great. Insomnia. It’s really relaxing, super smoothing,

and up to nne, massaging, nne.

It carries so much stress in our eyes

and then coming back.

Nice. Get that little extra massage.

Let’s do that one more time. Slide up.

Under the. I wanna use a little lighter pressure under the eyes

tie.

Now to get there, we’re gonna come down. Slide around the corner. Angle of the nose, fingers. Inner canus of the eye. Center of the eye. Center of the eye, outer campus of the eye. And in front of the ear massage

do come.

And thumb under the chin fingers slide out to stomach six, which I g.

And then back down the.

Feel better. I do. So this, again, this is a great short treatment that you can give yourself, you can, and help your patients by showing this to them. It’s very simple, very effective. And I hope you have a nice day. So thank you very much. If you want to learn more about me, you can visit me@hamptonsacupuncture.com or follow me on Instagram.

Again, my name is Shellie Goldstein. I also teach a number of classes through the Pacific College of Health. And we have a symposium coming up. So thank you very much, and again, thank you to the American Acupuncture Council. For having me here today, and I hope you have a lovely, relaxing, peaceful, healthy day.

Thank you. .

Facial Cupping & GuaSha for Cosmetic and Neuromuscular Concerns

And I would like to thank the American Acupuncture Council for this opportunity to speak to you today about facial cupping and GuaSha for neuromuscular facial conditions.

Click here to download the transcript.

Hi, my name’s Michelle Gellis and I am a board certified acupuncture physician. And I would like to thank the American Acupuncture Council for this opportunity to speak to you today about facial cupping and GuaSha for neuromuscular facial conditions. Can you go to the first slide please?

So a little bit about me. I am a former faculty member and clinic supervisor at the Maryland University of Integrative Health, and I was there for almost 20 years. And I’m currently on faculty, on the doctoral faculty at Yoan University in Los Angeles, California. And I teach facial and cosmetic

Acupuncture continuing education classes and have been for almost 20 years as well. So the, I wanna start out today by giving a definition for a neuromuscular facial condition. So what a neuromuscular facial condition refers. To is any group of disorders that affects the nerves and the muscles that are responsible for moving the face, our facial expressions, and also any sort of pain or neuropathy, any sort of dysfunction or abnormality that affects the neuromuscular system.

Which involves the communication between the facial nerves and the muscles that control the face. And our face is the only place on our body where the. Muscles are directly connected to the skin and as a result, we can move the skin on our face without having to move a joint or any other part of the body.

And this brings with it some very unique . Issues such as particular conditions, which can affect either one or both sides of our face and some of the more common . Common neuromuscular facial conditions that I’ve seen in my practice over the years are Bell’s Palsy and also any sort of facial nerve paralysis.

You’ll see this frequently, people who’ve had facial surgery or an injury, myasthenia gravis, which is a degenerative condition. Involving the muscles and it is almost always noticeable on the face as well. Hemi facial spasm, which is any sort of twitching or spasming of part of the face, T M J, which involves the temporal mandibular joint.

Trigeminal neuralgia, which is a very painful neurological condition involving the trigeminal nerve and posis, which when we’re talking about the face, typically involves one or both of the eyelids. So today I’m not going to go into depth about . Different modalities for treating these diseases or about the diseases themselves.

But I am going to talk about facial cupping and gua and how and why these two modalities can be a wonderful compliment to other . Things that you might be doing, your body points, perhaps some facial motor points, submuscular needling, scalp acupuncture, things that you might be doing to help the face to get back to normal functioning.

So here is just a couple of photos from some of my classes me teaching facial gu Shaw and facial cupping. So first I’m gonna talk about facial cupping and the benefits of facial cupping. Facial cupping helps to bring blood just like . Cupping on the body helps to bring blood and cheese circulation to the muscles.

Facial cupping helps to bring blood and cheese circulation to the muscles and therefore to the skin, which means that when the extra blood circulation comes up to the skin, it . Increases the fibroblast activity, and this will stimulate collagen and elastin production. So this is more of a cosmetic benefit.

I. But having that extra collagen can be beneficial. Also, if someone has had long-term paralysis and they’ve lost collagen in their skin and their wrinkling of the skin, doing the cupping can help with that. It also relaxes any tight fascial. . Fascia fascial tissue that is on the face. And by releasing and relaxing the fascia, the face can move more smoothly and function better.

Facial cupping and gua can release nerves that have become entrapped on the face sometimes. . Wi woven within the nerve, the muscle sometimes within the fascia. Cupping helps to move stagnant lymph out of the face, which can take toxins with it and helps the. Reduce inflammation, which can help the nervous system of the face.

It also helps with inflammation on the exterior of the skin. If your patient has redness, heat signs, rosacea, eczema can help with that. And also, just like with any cupping that you would do on a patient facial cupping helps to strengthen the vascular integrity of the face.

So this is a cross section of the cheek. And you can see here we have the skin and then some subcutaneous fat. And then below that is this . S what is called the SMA layer. It is the superficial muscular aporetic system, and this mimetic muscle helps to get the signals from the nerve into the muscle, out to the skin, and it is what allows the skin on our face to move below that.

We have and it’s invested in various tissue and surrounded by fat, and then below that we have a facial nerve. Then in some areas of the face, on the fattier parts of the face, we’re gonna have more fat and then more muscle. This is a picture of a fass of fascia. If you’ve ever taken let’s say chicken and you’ve pulled it apart, that really tough fibrous stuff that you have to cut with a scissor to get the meat off of.

That is fascia and what can happen, especially if there’s paralysis. But sometimes just with aging, the fascia can become very stiff. It can get moved into a place where it really shouldn’t be. It can pull down and . Nerves can get trapped in there by doing facial cupping and facial guha. You can help to break up some of these adhesions and allow for more free movement in the face.

The cups, when you’re doing facial cupping there’s certainly a lot of options for cups out there. The ones that I like are glass cups. They’re much smaller. You could see the size. I use these two sizes depending on where I’m working on the face. But the cups are . Glass. And the reason why I like glass over silicone or any of the other materials, plastic is one of the most important things when you’re doing cupping, is that the cups can glide.

You don’t wanna leave marks on the person’s face. You don’t wanna leave cupping marks. So it’s not like cupping other places in the body where the person is gonna be left with cupping marks. The cups have gotta be able to move and they have to be able to grab enough of the tissue to make a difference.

So they have to be large enough to actually get in there and get that blood and tissue moving, but not so big that they’re too big for the face. So these are the two sizes that I like. And then the rubber part of these . Cups. It fits well in a hand and is easy to squeeze if you’re doing a lot of facial cupping during the day.

If the cup is too hard to squeeze, then it could be very difficult. Your hands can get sore and no one wants an acupuncturist with sore hands, . The Guha tools that I like are made out of Jade and they have different edges on ’em. And when I talk about Guha in a second, I’ll go over that, but there’s like a use shaped section.

There’s a little nobby section on the tops, and then the sides are flat for working on other parts of the face. , there are some contraindications with facial cupping and gua. You do wanna be cautious if your patient has very high blood pressure that’s not controlled well. It can bring a lot of blood and she and energy up to the face and the head.

If the person is on anticoagulants or just has a condition where they. Bruise easily. This could be an issue because even though you’re trying not to make any marks on the face, I. When you’re dealing with the face, the skin is thinner, the tissues are more delicate, the vessels are thinner and more delicate.

So this is something you need to note. If the patient suffers from frequent severe migraines, then facial cupping and gu. Again, brings a lot of energy up to the face and head. It can be an issue if they have a pustule acne. You don’t wanna be running the cups over that. If they’ve had any sort, I. Of treatment done on their face, microdermabrasion, lace, or Botox fillers.

This is a big conversation and I go through, in, in my classes, I go through all the contraindications and all the different types of fillers, but basically in a nutshell, for the purposes of today, if they’ve had any sort of treatment done on their face. , their skin and their face has to be healed.

And in order for you to start doing cupping and you never wanna do cupping over an area where there’s been a neurotoxin like Botox ’cause it can make it wear off or move it. The, for facial herpes, I have never personally had . A person breakout, but it’s certainly a possibility. And then if they’ve had recent dental work or any sort of facial surgery, you want to be gentle maybe some light cupping, but definitely not using guha tools over the area.

So the symbols that I use in my cupping instruction for the slides that you’ll see, I have an X that I use for suction and release, and O if you’re just suctioning and then a line if you’re dragging the cup. So in this example, when you start out, and I’m not going to go through all the steps of facial cupping, but I’m going to give a few examples.

So the first thing you do is you’re going to do a lymphatic drainage. So you would take the cup and you would suction and release down the neck. When you get to around kidney 27 under the clavicle, then you’re gonna drag the cup. Over to the lymph node, which is right around lung two, and you would do this like three times and then you would move to the next area.

I always work on one side of the face and then the other when I’m doing facial cupping. The next would be a suctioning, and then dragging the cup over different parts of the face that have been affected by the paralysis. Now, if the person is having facial pain, like trigeminal neuralgia, you would not want to be doing cupping over the areas that are tender.

In this example, , If the person had Bell’s Palsy, you would be working the cups along the stomach line to help with any facial movement in those areas. In this picture I’m showing you can suction and release and you can drag the cups around the lips, stopping at different acupuncture points and stimulating them, and this is good.

For patients who have any sort of disharmony around the mouth, whether it’s neuropathy or any sort of tension in the mouth, and this can help to release. The orbicularis oris muscle for issues with the eye, things like ptosis, any sort of drooping with the eye, or any sort of inability to open or close the eyes.

You can work gently inside the orbital rim. You don’t wanna point the cup at the eyeball, but gently working around. The orbital rim in order to bring energy into this part of the face. And the orbicularis oculi if the person can’t raise their eyebrows or if the person has a lot of tension in their eyebrow, in their forehead, if they’re having any sort of

Twitching in this area. Then you can go to yin to and suction and then drag the cup up to do 24. Do the same with you Y up to gallbladder 15 and then San Joo 23 up to stomach ache. Next is facial gu sha for facial Gu Shaw. The benefits are that by doing the gu sha on the face, it helps to clear wind, which is part of the metal element and can help with the skin metal and skin, and can also clear the wind, which

Is involved with facial ticks. Also, it helps to expel fire and invigorates the blood. Harmonizes the blood. The Jade gu sha tools are wonderful. They are very much a part of Chinese medicine. I. Only use Jade on the face for this reason. Works with stagnant blood and also helps with microcirculation and does this by causing some microtrauma, which again helps with collagen production.

So here is that tool I was talking about. This is a Jade guha tool and has different corners, this U shape and then flat sides, and then these massage corners. For specific acupuncture points, the technique that you’re going to use are very large scraping strokes, so you’re going to do it gently, evenly, and steady.

I tell my students, you go for the gu, but not the Shah. You don’t wanna bring up all that redness. They’re not going to look like they’ve had Guha, but it will . If you work in one direction other than in between the eyebrows, you can go a little more vigorously, but you are going to release some of those fascial adhesions, really get into the muscles, stimulate acupuncture points, and this is wonderful for young.

Younger patients, needle phobic patients, people who really need to be treated on their face, but are a little reluctant to have needles put in their face. So here’s an example of what it might look like if you were doing gu guha. Now, when I do facial guha, I use two tools and you’re going to put, for the cupping and guha, you’re going to put

Oil. The oil that I use that I like is all organic and vegan. It has C, B, D and Arnica in it, and it allows the tools to glide well without clogging pores. So you’re going to start at l i 20 and you can. Massage there, and then you’re going to move the tools along the sides of the face, and this will break up any sort of stagnation or disharmony that’s going on within the muscles.

And really invigorate the blood and the chi in that area. Same for the eyes. You can massage a bladder two and then use the U part of the tool around the orbital rim and around the braille. I really like, especially for wrinkles between the eyebrows, but . Even if your patient is just having a lot of tension in between their eyebrows, really getting in there with the in tongue, can I.

Relax, the corrugator muscle, the procerus muscle. It allows everything to ease up. It’s great for your patient’s mental health and my patients that have come to me with various sorts of neuromuscular facial conditions from Ms. Myasthenia gravis Bells. Even ptosis, this really can allow the face to relax and when the face is relaxed, it can function better.

I. One of the last steps that I do is I take the flat sides of the Guha tools and I work all along the temporalis muscle and the trigeminal nerve, the facial nerve they can all . Have some disharmony and dysfunction if the temporalis muscle is tight or tense, if someone has T M J or if they have trigeminal neuralgia and you really can’t get in there and work on their face, you can still work on the temporalis.

Relax the temporalis and this will relax their face and their jaw. The very last step that I do is I turn my patient’s head to the side. I start at the base of the Oput and I work all the way down right to the shoulder, right down the trapezius, pressing fairly hard in one direction, and this will release the back of the neck, which releases the occipital frontals, releases the face, and it really is a very relaxing way.

To end treatment for your patients.

If you have any questions about anything that I talked about today, you can put them below and you can also go to facial acupuncture classes.com. My classes are listed there and there’s also a Contact us button, which you can use. So I want to thank the American Acupuncture Council again today, and if you missed any part of today’s recording, you can go to the link and catch us there. .

Michelle Gellis’ Top 10 Facial Acupuncture Points

I am going to be talking to you about my top 10 facial acupuncture points.

Click here to download the transcript.

Hi, my name’s Michelle Gellis, and today I am going to be talking to you about my top 10 facial acupuncture points. I am a licensed board certified acupuncture physician, and I teach cosmetic and facial acupuncture classes internationally. Can you go to the first slide? Great.

So when I’m talking about my top 10 facial acupuncture points, these are both for cosmetic purposes, but some of them have spillover into treating neuromuscular facial conditions as well. So the first point I wanna talk about is and you might be wondering, what does this have to do with facial acupuncture?

When you needle shen men, it helps to calm your patient, which is. great when you’re going to be putting needles in their face, and it also relaxes the face itself when we think about our face and our face aging. We might think it’s a good thing to tighten up the facial muscles, when in reality the facial muscles when they’re tight and constricted, then the skin will wrinkle.

So you really want the face to be relaxed when you’re going to work on the face. So my first favorite facial acupuncture point is ear chan men.

My next favorite point when working on the face is gallbladder 41. And gallbladder 41, although it is on the feet, it helps when you are doing cosmetic and facial acupuncture in a couple of ways. Most importantly is it helps to keep your patient grounded because when you’re bringing a lot of energy up to the face and the neck and the head, you wanna make sure you counter that with some grounding points.

So this is always the first body point I put in when I’m doing cosmetic acupuncture. It also helps to relax the liver and spreads chi throughout the liver and the gall bladder channels. And this will help if your patient is very frustrated or angry because frustration and anger can cause a lot of constriction in the forehead and cause lines between the eyebrows.

My next favorite point when doing cosmetic and facial acupuncture is stomach 36 and stomach 36 is probably my most favorite acupuncture point of all of the points if I had to pick one. And the reason for this is, , it covers so many different things. It’s the chicken soup point for acupuncture, and it helps to infuse all of the gifts of the earth to all of the meridians.

It’s a sea of nourishment point, which is really important when you’re working with the skin. You wanna make certain that all of the. Food and drinks that you take in get digested properly, get into your bloodstream and are spread throughout the body. It also helps to tonify chi and blood, which can become deficient as we get older.

We can get blood deficient and chi deficient and by needling stomach 36, it helps tonify the chim blood. . It also helps to fortify the spleen, which is really important because as we get older and the spleen becomes weaker and not as efficient, we can have sagging. So the spleen holds things up and it also is very much integral with.

Creating nice, healthy blood. So holding things up and making sure that our blood is healthy are two of the spleen’s jobs. So by needling stomach 36, you’re fortifying the spleen and the next. Important thing about Stomach 36, which should have been its own bullet, but it calms the spirit. And when you’re doing cosmetic acupuncture, you want your patient to be nice and calm.

My next favorite facial acupuncture point, which is also on the body, is large intestine four, and this is a command point for the face. So I would never do cosmetic acupuncture without needling large intestine for, and it also allows us to get rid of impurities. Not just on a physical level, but also on a mental level.

So really clearing out all of the impurities on a body mind, and spirit level. I. Next is small Intestine six, and the name for small intestine six is nourishing the old. So if you think about where small Intestine channel runs, it runs right up the neck and then up. In front of the ear and it can help with sagging jowls and chin and neck.

It activates the entire channel because it is a sheet cleft point, and it also helps to nourish us in the face of old pain and allows us to. Taken all of life’s lessons from past traumas and it, it really calls on some of our ancestral chi as well. . Next is gallbladder 18. So gallbladder 18, in case you don’t know where it is.

So you go to the center of the brow, and that’s gallbladder I’m sorry, the center of the frontals muscle and. , which is in the middle of the brow and that’s gallbladder 14. Then you find gallbladder 15 and you’re going to go back along the gallbladder line until you are in alignment with do 20, so where the gallbladder meridian and do 20 intersect on the head.

This is where gallbladder 18 is, and you can see it here. And this is the occipital frontal. So the gallbladder 18 helps to benefit the eyes and the forehead, and it has a direct action on that super orbital nerve. So that’s this right here. and the super orbital nerve, which is C N six runs along the Galea epi erotica, which links the occipital and frontal bellies of the occipital frontalis muscle.

So when you needle that point, it helps to nourish the eyes, lift the brow, and lift. The forehead as well.

Next is stomach four, and the name of this point is receive nourishment. So stomach four is right at the corners of the mouth and it helps to treat the mouth area. Lip lines, naso, labial, folds that. Run right into this area. It’s also right on the Modis, which connects the lader muscles on the face. The depressor, anguli, ORs, the resources muscle, all of these muscles.

Calm together right here at Stomach four. So by needling this point it helps to relax the depressor, angular ORs, which can pull down on the corners of the mouth and Ma make us look unhappy when we are not

Next. Next is small intestine 18 and the name of this point. Is cheekbone and very appropriately named, and this helps to lift the cheek area. The way that I like to needle it is I come over the cheek and then I will needle straight up, so I’ll. Go over the cheek and I like to use tubes when I work on the face.

So I come over the cheek and then I will needle straight up right underneath the bone and this will help to lift up the cheek area.

Next is Yu and I do a combination of points in order to lift the brow and the eyelid. I’ll use Yu and Sano. 23 and Blood are two together, and I have a little video here for how I would needle.

Like really like this. What I’ll do is I’ll pull up, but for her I would just use the tube and push underneath the brow like that. So again, I’m not on the lid, I’m underneath the brow. And you know why they called us you? Yeah. Don’t you? . Ouch. Yeah. You. Yeah.

So you could see in the video, I like to pull the brow up above the orbital rim, and then I will just push the tube underneath the brow and then push the needle straight up. I use a half an inch needle. I usually put a little anika gel there because the orbit is very highly vascularized and you don’t wanna bruise your patient.

and then I will push it in almost up to the handle. And this really helps, works on the lader muscle and helps to treat you. Yeah. And then by using some supplemental points around the brow and the forehead, it really can help to lift this area because one of the biggest concerns that. My patients have had over the years is that their eyelids are starting to get droopy or their brows are getting droopy, like really like my last favorite acupuncture point for.

Facial and cosmetic acupuncture is Yong, and Yong is great for a lot of reasons, and it’s right there between the brows. This helps if your patient has any lines between like wrinkles, deep furrows between their brows. You can use Yong. and it also helps to relax your patient and spread the chi in this area.

It calms the mind. It calms the patient. So this is a great point. I use it on almost everyone, even if they’re not coming to me for facial and cosmetic acupuncture. So there you have it. My top 10 favorite acupuncture points for facial acupuncture, and you can follow me on social media. Michelle Gellis on Facebook, Instagram.

TikTok and on LinkedIn, and I also have a Facebook group called Facial Acupuncture, and my website is facial acupuncture classes.com. I hope you enjoyed this, and thank you to the American Acupuncture Council for providing me with this opportunity to share this with you.

Treating Neuromuscular Facial Conditions-A Multifaceted Approach

Today I am going to be speaking to you about neuromuscular facial conditions and a multifaceted approach to treating them.

Click here to download the transcript.

Hi, my name’s Michelle Gellis and I am an acupuncture physician. Today I am going to be speaking to you about neuromuscular facial conditions and a multifaceted approach to treating them. So a lot of you know me for cosmetic acupuncture.

one of the lesser known things that is really important to have under your belt if you’re doing cosmetic. Acupuncture is a really good working knowledge of the muscles of the face and how they can be affected through different physical conditions. So will you go for the fir to to the first slide?

So I had, many years ago, about 15 years ago, I had started. Researching using some of the different techniques that I was using on my cosmetic patients to help patients with different neuromuscular facial conditions. And I wrote a journal article in the Journal of Chinese Medicine about the topic, so if you’re interested, you can look it up.

It is called a multifaceted approach to treating neuromuscular facial Conditions. And yes, I am outside. I don’t have a bird in my house. I live in Florida, so there are some birds tweeting. So what. Is a neuromuscular facial condition. That is the first thing that we are going to talk about, and then I am going to go through the whole theory of why using a multifaceted approach can be very beneficial.

I’m going to talk about submuscular needling, scalp acupuncture, facial motor points, and then a little bit about facial cupping and guas. So a neuromuscular facial condition is any sort of a disorder that affects the face and it can be muscular meaning it. Prevents you from being able to move any of the muscles of your mouth or your eyes or your cheeks or something that has to do with the neurological system of your face causing pain, twitches a lot of sensation like heat or cold or lack of sensation.

So there’s quite a few different diseases and I’ll touch on some of those that can cause these problems to happen. But the theory that I came up with, that I teach and I’ve been using for many years is that instead of just doing your typical constitutional treatment and maybe a few face points that if you use.

Several different modalities at once. It can really provide for the best results for your patients. So I do a combination of traditional TCM treatment. Then I use facial motor points, sub submuscular, needling, scalp, acupuncture, and , the person is not in too much pain. I can do facial cupping in Gua and even dermal can be incorporated in.

So what are some examples of neuromuscular facial conditions? The most common is Bell’s Palsy. Most of us throughout the course of our treatment career. Through our practice, we will come across at least one patient with Bell’s Palsy and some of them will be, it’ll be a new case and they want help so it doesn’t get any worse or so that it gets better faster.

And for some people they might have had Bell’s Palsy many years ago and they still have some of the residual. Signs and symptoms. Ramsey Hunt Syndrome, which is similar to Bell’s Palsy, but has some additional issues. Ptosis, which is a drooping of the eyelid synkanesis, which is where you try to move one part of your face and another part of your face moves.

Stroke, which can affect the face drooping in the face. Tmj. Any sort of temporal mandibular joint disorder trigeminal neuralgia, which is spatial pain, ms. And there are many others. Okay. . So the face is unique because the face is the only part of our body where the skin is directly connected to the muscle, and that is why we can move.

The skin on our face without having to move any bones. You can blink your eyes, you can smile, you can purse your lips, and you don’t have to move any bones anywhere else on your body if you want your skin to move. You have to actually move a bone in order for it to move. This is a cross section of the face and you can see this is the cheek here.

We have the mimetic muscle, which Goes out to the outer layer of the skin. We have some fat here. And the mimetic muscle is invested in this mass layer. It’s a superficial, muscular, epi neurotic system. And it is what allows the muscles to make our facial express. and the facial nerve is invested deep within the facial fascia.

So by using a submuscular or in some instances an intramuscular needling technique, you can increase the flow of blood and chi in the area. You can break up those fossil adhesions that might exist, and you can stimulate collagen production in the area. . So there are various places in the face where.

Submuscular needling is very beneficial. Not just the face and the scalp. So the auricular muscles, and I incorporate this as part of my cosmetic acupuncture treatments, the temporalis muscles, and this can help a lot with. Headaches and it also can help to get movement back in the face.

It’s very beneficial for T M J and trigeminal neuralgia, the maier. This is great doing submuscular needling underneath the maier for individuals who have tmj. The digastric muscle underneath the anterior digastric, underneath the chin. This can help to lift up underneath the chin area. The frontals can help both with cosmetically, with wrinkles, but can also help.

Lift the eyebrow, get movement going cuz your frontal is connected to your eyebrows. So for individuals who’ve had a stroke or a half bells palsy, by doing the submuscular needling, you can help to get that movement going back in the eyebrows and in turn in the eyelids, the procerus muscle, which. Is in between the eyebrows, the lader muscle, which is underneath the eyebrow, and oh, I missed the platysma.

The platysma, which runs from your jawbone down to your clavicle, and using submuscular needling can help more on a cosmetic level, but with the skin on the. So how this works is I showed you that cross section of the face. The nerves can get trapped, the facial nerve can get trapped and by using needles, let me see if I have it in my next slide.

I don’t using a needle to needle from the skin. Down through the fascia, you are actually helping to break up some of those fascial adhesions and to release any nerves that have been. Entrapped. So for example, let’s say you had a pet patient who had headaches, frontal headaches or ha who had some sort of muscular weakness through MS or Bell’s Palsy in their forehead.

You can take your needles and go right underneath the muscles and do some submuscular needle. . So here is a video, so I gotta get it here.

So when needling the frontals muscle, the,

so when needling the frontals muscle, the. Way that you isolate the muscle is you ask your patient to raise their eyebrows. Go ahead and raise your eyebrows, okay? And then relax and you can find the border of the frontals. Muscle and the way that you needle is you’re going to go from the origin to the insertion.

So the origin is up here and the insertion is here. And typically what I do is I will put in. , usually three needles on the lateral edge, and I will put in two needles. On the medial side, and when you’re needling, what’s important is that the angle of the tube is the angle that the needle’s gonna go in.

So if you go like this, it’s going to go too deep. If you go like this, it’s going to be too shallow. I use. My thumb or a finger to help to guide the needle. So you wanna keep your fingers out of the way when you’re actually inserting. That way you can get to the correct depth right underneath the muscle.

That’s the lateral side. Then you’re going to do the medial side and usually. Two needles will suffice and I do the one side and then I do the other side and I’m using half inch needles. You can use one inch needles depending on how big your patience forehead is.

So as you can see, needling underneath the muscle as I mentioned, will bring energy to the muscle and it can help if there’s any sort of tension in the headache. And on a more cosmetic level, it can help to stimulate collagen in the. Another thing that’s really beneficial to incorporate, and you can incorporate this at the same time you are doing some of your other treatments, is scalp acupuncture.

And scalp acupuncture is part of a class that I teach on treating neuromuscular facial conditions, but I only teach scalp acupuncture as it pertains to the. And neuromuscular conditions with the face. So here is a cross-section of scalp and there are one of the important things when you’re learning scalp acupuncture is how to measure the scalp.

And it is certainly beyond the scope of this short lecture to go through the whole thing. But essentially you when you’re measuring the. it is in different sections. You’re not working with acupuncture points, so you find the horizontal line, you find the vertical line, and then within the motor area or the sensory area, it’s broken up into three sections and the.

Two-fifths is the area that pertains to the face. So you could be needling this and at the same time, so in order to help the motor function, you could be needling this and at the same time doing some local points to help to get some of that movement going.

and this is a short video of what that needling technique looks like

when you’re needling the scalp. It’s important to angle the needle properly so that it goes into the loose connective tissue. I like using a tube. You can freehand if you’d like, but I find that the tube helps me to guide the needle. To the correct depth. I tap the needle in, remove the tube, and then I use my free hand to guide the needle.

If the needle is improperly, your patient should not feel any pain, so you’ll know that you’re into the loose connective tissue. If your patient doesn’t have any pain, when you. Once the needle is in, you stimulate it gently for 30 seconds just like this. Or you can use electricity.

So next up are facial motor points and essentially when. Muscle is not functioning properly. It is either over functioning or under functioning. So it’s either flacid and it’s not firing properly or. It’s over firing and causing too much tension. What the theory behind motor points are is you find the most.

Excitable part of the muscle. It’s essentially where the nerve goes into the muscle and you are gonna place a needle there. Fortunately, for us, many motor points, especially on the face, are actually acupuncture points. So you find the acupuncture point that correlates to the muscle. And in this case, I’ve chosen the frontal.

and the motor point for the frontals is gallbladder 14. So you would needle this, you can stimulate it, and it helps. It serves as a reset switch to get that muscle back into normal functioning.

So I had spoken about Fossil ad Hess. Before, and this is a picture of fascia and here is where the nerve would go. And as you can imagine if you had all of this fibrous fascia, adhesions going on and there was a nerve that was trapped in here, it would be very difficult for. Muscle to function properly for the nerve to do its job.

So one of the things that can really help is facial cupping and facial guha because when you’re moving these small, so these are very uniquely designed glass facial cups, and the rubber part is really easy to squeeze as opposed to. The ones that are more difficult to squeeze and they’re small, and they move around really nicely, they glide on the face and they can help to bring energy back into the muscles to break up the fossil adhesions.

And the same thing with these Jade Guha tools. The Guha tools. When you can use these edges here and you can stimulate different points and you can really get in there up against the bone and help to break up some of the fossil adhesions that might exist.

and I think I just have a picture. There’s no video here, but this would be an example if you were working and you were doing cupping on the face, starting at an acupuncture point, moving the cup up to another acupuncture point. And this has a very lifting effect on the face and. Then going and doing a suction and release down the neck.

You never wanna drag the cup up or down the neck. In my webinar about facial cupping in Guha, I really emphasize safety because it’s so important when you’re working around the neck and the face to be very safe. You don’t wanna cause any bruising. You don’t, you’re working along major vessels, you don’t.

Release any blood clots. So suctioning and releasing down the neck and then just working underneath the clavicle can really have a wonderful lifting, toning, and rejuvenating effect on the face, especially your patients that have some sort of Like degeneration. It’s a wonderful, it’s almost like a massage, and it gets that blood flowing.

It gets the blood up into the muscle and can really help getting that muscle function going again. and the same with Guha. Here’s a picture of me doing some guha along the jawline. This was for cosmetic reasons for sculpting, but can really help to get that movement going. And if a muscle hasn’t been used in a long time, they can get stiff and gua can be.

Now dermal rolling is something that is used on a very superficial, gentle level, but it can help to. Reeducate the nerves and the muscles and the skin, because the skin, if it, let’s say someone has had an injury to the face, maybe they had a facelift and now they have neuropathy and they can’t feel anything.

by doing some of your maybe scalp acupuncture, some body points. And then I sell my patients Dermer rollers and they bring them home and I teach them gently how to use it along some of the channels to stimulate the channel, the meridians, and just to stimulate the skin to reeducate the nervous.

These are some of the publications, my publications, and the one I was talking about was from 2016. It’s a multifaceted approach to treatment of neuromuscular facial conditions, which goes much more into depth about what I was just talking about and. I also teach classes on that and you can find my website, facial acupuncture classes.com if you wanna learn more.

Also on social with my first and last name. And that is it. Thank you for your time. And thank you to the American Acupuncture Council for this opportunity to share with all of you. I look forward to seeing you next time.