J S M T JOURNAL OF SPORTS

2573-1726 MEDICINE AND THERAPY

Review Article More Information

*Address for correspondence:

Exploring Dermatofunctional Weslley Barbosa Sales, Federal University of Rio

Grande do Norte, Natal (RN), Brazil,
Email: weslleysaless8@[Link]
Perspectives beyond Aesthetics: An Submitted: May 24, 2024
Approved: June 20, 2024

Integrative Literature Review Published: June 21, 2024

How to cite this article: Franco T, Sales WB,

da Silva JVB, Leite DG, Vidal GPP. Exploring
Tatiane Franco , Weslley Barbosa Sales *, José Vinicius
1 2
Dermatofunctional Perspectives beyond Aesthetics:
Bulhões da Silva3, Djavan Gomes Leite1 and Giovanna Pontes An Integrative Literature Review. J Sports Med Ther.
2024; 9: 027-031.
Pina Vidal4
DOI: 10.29328/[Link].1001078
1
UNINASSAU (graduated in Physical Therapy from Centro Universitário Maurício de Nassau, João
ORCiDs
Pessoa, Paraíba, Brazil
Sales WB: [Link]/0000-0002-6553-6266
2
Federal University of Rio Grande do Norte, (PhD student in Physical Therapy at the Federal University
of Rio Grande do Norte), Brazil Franco T: [Link]/0000-0003-0063-8357
3
Graduated in Physical Therapy from the University Center of João Pessoa (Unipê), João Pessoa, da Silva JVB: [Link]/0009-0006-2404-0754
Paraíba, Brazil
Leite DG: [Link]/0000-0002-3355-7978
4
Uninassau (MSc in Biotechnology and Innovation in Health, from the Anhanguera University of São
Paulo - UNIAN), João Pessoa, PB, Brazil Vidal GPP: [Link]/0000-0003-1689-3328

Copyright license: © 2024 Franco T, et al. This is

an open access article distributed under the Creative
Abstract Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly
Introduction: Dermatofunctional Physiotherapy is an area of physiotherapeutic specialty that
cited.
aims to promote, prevent, and treat integumentary injuries. However, this ield of action is usually
erroneously limited to aesthetic and cosmetic procedures. However, the scope of Physical Therapy Keywords: Physiotherapy; Aesthetics; Treatment
goes beyond aesthetic procedures.
Objective: To identify the scope of dermatofunctional physiotherapy beyond aesthetics.
Methodology: This is an integrative literature review with the objective of summarizing and OPEN ACCESS
exploring the proposed theme. For this, the PRISMA guidelines were used, as well as the PICOT
strategy for a better delineation of the research question and research theme.
Results and discussions: It was observed that the role of the physiotherapist in this ield is
directly related to aesthetics, which is one of the most prosperous segments within the health area,
due to the great demand for aesthetic procedures. Among the main resources evidenced in this study,
lymphatic drainage, electrothermophototherapeutic resources, myofascial release, and manual
techniques were observed.
Final considerations: The area of physical therapy is not exclusively dedicated to the aesthetic
environment, it was observed that this specialty acts strongly in the promotion, and prevention
of rehabilitation of patients with metabolic, integumentary, and musculoskeletal alterations, in
addition to promoting and preventing diseases related to obesity, scars, geloid edema, laccidity, and
other integumentary dysfunctions.

Introduction These techniques and approaches have evolved over the

centuries, becoming more sophisticated, safer, evidence-
Physiotherapy is an ancient science, that is related to the based, and with their therapeutic goals well de ined. This
study, diagnosis, prevention, and treatment of the most varied evolution is directly related to the expansion of scienti ic
kinetic-functional disorders of various organs and systems of studies, which have generated support for the development of
the human body. Thus, the emergence of Physiotherapy can new techniques, approaches, and physical therapy resources
be evidenced by the numerous ancestors who aimed to use that today have greater and better visibility in the ield of
resources and techniques known today in physiotherapy, to physical therapy and health in general [1,2].
try to mitigate the pain of numerous pathologies of the human
body, essentially diseases related to the musculoskeletal Within this scenario, Physical Therapy was born and
system [1]. consolidated at the end of the twentieth century, when the

[Link] [Link] 027

Exploring Dermatofunctional Perspectives beyond Aesthetics: An Integrative Literature Review

world wars generated an exacerbated number of individuals review, with a descriptive and qualitative approach, which
with serious injuries, which made them unable to continue in will take place through the survey of scienti ic articles that
the war. Having their functional capacity and quality of life were related to the objective of the study [5].
impaired, these soldiers needed a rehabilitation approach to
be reintegrated back into society, and thus have an active and This review was carried out in January 2024, and for the
functional life [2]. consolidation of this research, the following methodological
steps were chosen: identi ication of the research theme and
It is observed that Physical Therapy is a relatively new question; sampling selection; categorization of the selected
science, under construction and that is constantly evolving, studies; de inition of the information extracted from the
always looking for better conducts and resources based reviewed publications; evaluation of the selected studies;
on scienti ic evidence. In Brazil, Physical Therapy began at interpretation of results; and presentation of the results of the
the Santa Casa de Misericórdia de São Paulo in 1929. But it
research.
was only at the end of 1951 that the irst training course in
Physiotherapy appeared, which was a technical level course A survey was carried out according to the above-mentioned
lasting one year, on average [2,3]. searches in the SciELO, PubMed, and LILACS databases. After
inclusion and exclusion criteria, the articles were selected
Despite being a profession with a wide area of expertise,
the specialties of Physiotherapy recognized by Cof ito for the study sample. Data collection took place in the above-
are Acupuncture (Cof ito Resolution No. 60, 97 and 219); mentioned databases, where the words indexed in the
Cardiorespiratory (Cof ito Resolution No. 188); Neuro Health Sciences Descriptors (DeCS) “Aesthetics/Esthetics”,
Functional (Cof ito Resolution No. 189); Chiropractic “Treatment” and “Physiotherapy/Physical Therapy Specialty”
and Osteopathy (Cof ito Resolution No. 220); Functional were used, as well as the Boolean descriptor ‘’AND’’ was
Orthopedic Trauma (Cof ito Resolution No. 260); Sports applied to cross-reference the above-mentioned descriptors.
(Cof ito Resolution No. 337); Occupational Physiotherapy
Articles related to the proposed theme, published
(Cof ito Resolution No. 351); Dermato-functional (Cof ito
Resolution No. 362); Public Health (Cof ito Resolution No. 363); between 2011 and 2021, available in full, without language
Onco-functional (Cof ito Resolution No. 364); Urogyneco- restrictions, were included; as well as theses, dissertations,
functional (Cof ito Resolution No. 365) and Women’s Health and monographs. Exclusion criteria were: literature review
(Cof ito Resolution No. 372) [4]. articles, articles or abstracts that had been published in
conference proceedings; as well as letters from editors
Within this vast ield of physical therapy, the area of and preprints. After applying the inclusion and exclusion
dermatofunctional was recognized in 2009 and was regulated criteria and evaluating the abstracts, the studies that met the
by Resolution 394 of 2011. In turn, this area grew, established criteria were selected, organized, tabulated, and discussed.
itself, and stimulated the development of several research, so The research followed the protocols and guidelines of the
that this area of Physical Therapy was consolidated through its Preferred Reporting Items for Systematic Reviews and Meta-
importance in the rehabilitation processes of several patients
Analyses (PRISMA) [6], as well as the PICO (Population,
with integumentary injuries, which re lects on the importance
Intervention, Comparison, Outcome) strategy [7].
and growing appreciation of the area [3,4].
Within the process of data analysis, Bardin Laurence’s
Dermatofunctional physiotherapy was not such a well-
content was used, and this analysis was divided into 3 stages:
known area as it was, however, this growth arose essentially
through the creation of the active Brazilian Association of research of the material and organization according to
Dermatofunctional Physiotherapy (ABRAFIDEF) in 2005, subthemes; exploration of the data, and later the synthesis
becoming an important historical milestone in Physiotherapy. of the most important aspects of the text; evidence and
There has been an important growth in the rates of obsolescence description of the most important information [8].
and procedural renewal shared by the ields of aesthetics, Results and discussions
cosmetics, stomatology, vascular disorders, and burns, among
others that interface directly with Dermatofunctional [4]. From the selected descriptors, 156 articles were found, but
with the application of the inclusion and exclusion criteria, 147
In view of the above, the following research question
were eliminated. Thus, there were 09 articles consistent with
arose: what are the areas covered by dermatofunctional
the theme of the study, that complied with the pre-established
physiotherapy in addition to aesthetics described in the
criteria for analysis and discussion of the results (Chart 1).
literature? Therefore, the objective of this study is to identify,
in the scienti ic literary indings, all the areas covered by Within a general context, it is observed that in many cases
dermatofunctional Physical Therapy. the community has a limited view of the scope of Physical
Therapy, limiting it only to the services provided to patients
Method who have functional and cognitive dysfunctions, or in other
This study was characterized as an integrative literature cases, associated only with massage therapy and the treatment

[Link] [Link] 028

Exploring Dermatofunctional Perspectives beyond Aesthetics: An Integrative Literature Review

Chart 1: Data collection instrument and results (n = 9).

Title Author(s)/year Objective Methodology Results
The use of galvanic current did not
Effects of galvanic current in the Analyze the effects of galvanic current Observational and
Mondo; Rosas. [16] signi icantly in luence the appearance of
treatment of atrophic striae on stretch marks. descriptive study
striae in this sample.
To evaluate the effects of Treatments
Analysis of the effects of therapeutic
therapeutic ultrasound (TUS) and showed improvement in the visual aspect
ultrasound and electrolipophoresis Prospective randomized
Machado, et al. [13] electrolipophoresis in the treatment of Geloid Fibroedema and in personal
on changes resulting from geloid clinical trial
of changes resulting from geloid satisfaction, but did not change measurements
ibroedema.
ibroedema. perimetric, adipometry, and bioimpedance.
Compare the treatment for wrinkles
There was a decrease in the number and
Dermatofunctional treatment for with the use of a chemical blender, Descriptive,
depth of wrinkles, being
wrinkles with the use of chemical Diógenes, et al. [17] electrolifting, and the association interventionist, and
most evident in the group of associated
blender and electrolifting of these compounds and identify comparative study
resources.
phototypes, skin types, and wrinkles.
Based on the data found in the medical
records and the possible complications, a
Physical therapy protocol for To investigate the physical therapy
This is a descriptive study treatment protocol is suggested
the postoperative period of Silva, et al. [14] protocol for patients undergoing
of the data collection type for the postoperative period of
abdominoplasty abdominoplasty.
abdominoplasty, which follows the healing
phases of biological tissues.

To analyze the importance of physical

The clinical parameters compared,
therapy in the rehabilitation of patients Intervention and ield
Importance of physical therapy in Santana, Brito e Costa. Before and after physical therapy, they
with burns, through the application of study, with a qualitative
the rehabilitation of burn patients. [10] showed signi icant predictive value for
an evaluation protocol before and after and quantitative nature
all variables, con irming the importance of
physical therapy.
this service in rehabilitation.
To evaluate the effects of decongestive Reduction in lymphedema and other
Decongestive physical therapy physical therapy on upper limb symptoms such as pain and
in post-mastectomy upper limb Tacani, et al. [11] lymphedema in postoperative breast Retrospective study alteration of sensitivity by means of
lymphedema: a retrospective study. cancer patients, through retrospective decongestive physical therapy in the
analysis of medical records. population evaluated.
Radiofrequency is an effective and
Analysis of the resources used in
Generate knowledge regarding the safe method, but the greatest dif iculty
the treatment of skin laccidity by Exploratory and
Macário. [15] resources used by physiotherapists in encountered by the professionals was the
physical therapists in Brazil descriptive study
the treatment of skin laccidity. lack of compliance by the patients and the
guidelines in the home treatment.
To demonstrate the effects of the The association of resources
association of three electrotherapy electrotherapeutic used, high frequency, laser
Association of high frequency, low-
resources, high frequency, and
level laser and microcurrents in the Schuh, et al. [12] Case report
microcurrent, and laser in the microcurrent showed satisfactory results in
treatment of pressure ulcers.
treatment of tissue repair in pressure the
ulcers. Treatment of pressure injury.
It was found that the group with
endocrinological treatment associated with
Effects of dermatofunctional To analyze the effects of Comparative,
dermatofunctional techniques obtained
physiotherapy resources on dermatofunctional physiotherapy interventionist,
Araújo, et al. [9] better results than with endocrinological
weight loss and cardiovascular risk resources on weight loss and prospective quantitative
follow-up alone, suggesting the importance of
markers in obese patients. cardiovascular risk markers. Research.
dermatofunctional physiotherapy on weight
loss and cardiovascular risk markers.

of patients or accidents [9]. However, this knowledge should is related to the evaluation, kinetic-functional diagnosis,
not be perpetuated, since the idea of the profession is mistaken. treatment, follow-up, and especially in the prevention of
because Graduation in Physical Therapy is one of the courses dysfunctions and kinetic-functional and aesthetic imbalances
in the area of Health that have the most professional coverage, resulting from pathologies, traumas, surgical interventions,
and within this scenario, the area of dermatofunctional and/or postoperative injuries, which have repercussions on
physical therapy stands out [10,11]. the integrity of human functionality, which is the scope of
physical therapy performance [13].
Dermatofunctional is a specialization of Physical Therapy
that directs its action essentially to the integumentary Among the vast performance of the dermatofunctional
arrangement, that is: it involves several complex aspects physiotherapist, the main activities of this professional are
of the largest organ of the human body, the skin, and its related to the rehabilitation of patients with mastectomy,
appendages. Thus, Dermatofunctional Physical Therapy has burns, and post-traumatic scars, as well as in the pre and
its professional scope related to the treatment of aesthetic
postoperative period of plastic surgeries. In addition, it can
dysfunctions, as well as to the promotion of functionality, thus
also dedicate itself to performing invasive and non-invasive
ensuring a signi icant improvement in the patient’s quality of
aesthetic procedures, highlighting: Flaccidity, scars, stretch
life, well-being, and health [12].
marks, and localized fat; Gholoid ibroedema (cellulitis); Skin
Thus, the scope of Dermatofunctional Physical Therapy aging and in the treatment of pressure ulcers [10-13].

[Link] [Link] 029

Exploring Dermatofunctional Perspectives beyond Aesthetics: An Integrative Literature Review

In view of the above, Silva [14] states that surgical changes in lifestyle habits, cognitive-behavioral techniques,
procedures are a very common practice in the aesthetic pharmacotherapy, bariatric surgery, and dermatofunctional
environment. However, there are risks of complications physiotherapy.
and aggravations, such as infections, bruising, fat embolism,
In this context, dermatofunctional physiotherapy helps to
cutaneous hyperpigmentation, and ibrosis. To mitigate
reduce risk factors, in addition to measures in obese patients,
or prevent these manifestations, Dermatofunctional
in the pre and postoperative periods, using techniques and
Physiotherapy uses different resources, such as stretching
resources that have a positive impact on the patient’s health
and lymphatic drainage.
[14,15].
In addition to surgeries for aesthetic purposes, there are
Physiotherapy has been acquiring more and more space
emergency surgical interventions, such as breast cancer,
and expanding its ield of activities. The physiotherapist,
whose neoplasm is the second most routinely diagnosed
through physical resources, can act on the various changes
type of cancer in the world and the leading cause of cancer
in aesthetic patterns such as obesity, acne, and hypertrophic
deaths in the female population in Brazil. That said, despite
scars, among others. Of these changes, we can highlight stretch
the great scienti ic knowledge that exists, many patients
marks, which are characterized by an atrophy of the skin, due
develop lymphedema in the upper limbs. In this sense, the
to the rupture of the elastic ibers present in the second layer
role of Physical Therapy in this context is evidenced, since
of the skin, called the dermis. These skin tears form parallel
lymphedema affects the patient’s quality of life due to the
lesions, appearing mainly on the thighs, buttocks, abdomen,
physical, psychic, and social changes resulting from this
breasts, and trunk back [16].
condition [14].
That said, the study by Machado [13] demonstrates that
Also in this scenario, it is observed that physiotherapy has
body disharmony syndrome (CDS) includes the presence of
a strong role in the area of burns. Santana, Brito, and Costa [10]
geloid ibroedema (FEG), localized adiposity, increased total
state that burns can promote signi icant deformities, physical
body fat and muscle laccidity, which are often associated,
limitations, and biopsychosocial decline that completely
while these aesthetic disorders represent a threat to the
affects patients and their families. Therefore, the performance
emotional integrity of the individual, and a variety of therapies
of dermatofunctional physiotherapy is essential, since it is are proposed for their treatment.
extremely important to reduce the traumatic consequences
generated by the injury. Finally, it is observed that the aging process is complex,
and involves multiple factors that can alter the structure and
In addition, it is important to work on listening, since in
functioning of the organs. In the integumentary system, for
the rehabilitation of these patients, rehabilitation is not only
example, there are varied and numerous modi ications, such
due to the functional aspect but also to the psychological and
as expression marks. In this ield, the physiotherapist stands
emotional support that the therapist exerts on the individual
out, whose treatment aims to restore the elasticity of the skin.
[9]. Thus, the main aspects of physical therapy rehabilitation
Among the resources for this purpose, electrotherapy and
are to promote the reduction of pain and pain; to maintain
kinesiotherapy are essential for this purpose [15,17].
the patients’ range of motion (ROM); and to prevent
complications resulting from contractures, and respiratory Conclusion
complications, in addition to stimulating autonomy and
Based on the above, this integrative literature
functional independence.
review achieved its objective of identifying the scope of
That said, other hospital complications may require dermatofunctional Physiotherapy in addition to aesthetics.
physiotherapy services, such as pressure ulcers, where It was observed that the physiotherapist’s role in this ield
physiotherapy is of paramount importance, both in the is directly related to aesthetics, which is one of the most
prevention and treatment of these injuries, which are mainly prosperous segments within the health area, due to the great
due to high-frequency, laser, and microcurrent resources. demand for aesthetic procedures.
From a global perspective, obesity is one of the main risk
Among the main resources highlighted in this study,
factors for illness and health problems worldwide. This
lymphatic drainage, electrothermophototherapeutic
condition is now present in several developing countries and
resources, myofascial release, and manual techniques were
is undoubtedly one of the main concerns of health authorities
observed. However, this area of activity of physiotherapy is
[15].
not exclusively dedicated to the aesthetic environment, it was
Overweight and obesity are intrinsically correlated with also observed that this specialty acts strongly in the promotion
increased morbidity and mortality. Obesity and increased waist and prevention of rehabilitation of patients with metabolic,
circumference overload the heart, increasing the risk of heart integumentary, and osteomyoarticular alterations, in addition
dysfunction and stroke. This burden can be mitigated with to promoting and preventing diseases related to obesity,

[Link] [Link] 030

Exploring Dermatofunctional Perspectives beyond Aesthetics: An Integrative Literature Review

scars, geloid edema, laccidity, and other integumentary 8. Laurence B. Content Analysis by Laurence Bardin /. 7. ed. São Paulo:
Saraiva. 2011.
dysfunctions. Finally, this study aims to stimulate the scienti ic
development of new research in the aesthetic area, as well as 9. Araújo CAB, Queiroz LFH, Cavalcante AS, Pontes RB. Effects of
dermatofunctional physiotherapy resources on weight loss and cardio-
promote the empowerment of professionals who work in this
vascular risk markers in obese patients. Brazilian Journal of Exercise
area. Physiology. 2018; 17:3; 156-64.
10. Santana CML, Brito CF, Costa ACSM. Importance of physiotherapy in the
References rehabilitation of burn patients. Rev Bras Queimaduras.2012; 11:4; 240-
1. COFFITO. Federal Council of Physiotherapy and Occupational Therapy. 245.
Fisioterapia.
11. Tacani PM. Decongestive physiotherapy in post-mastectomy upper limb
2. Fernandes MI. The role of dermatofunctional physiotherapy in the lymphedema: retrospective study. Brazilian Journal of Health Sciences -
rehabilitation of burn patients: an integrative literature review. Uningá USCS. 2014; 11:37; 17-23.
Magazine. 2019; 56(3):176-86.
12. Schuh CM. Association of high frequency, low power laser and micro-
3. Inês Serra Pereira Caldas Melo P. Role of the Dermatofunctional currents in the treatment of pressure injuries. Cinergis. 2017; 18:2; 99.
Physiotherapist and its recognition by health professionals in the Lisbon
13. Machado GC, Vieira RB, Oliveira NML, Lopes CR. Analysis of the effects
region [Master’s Dissertation]. Lisbon: Polytechnic Institute of Lisbon
of therapeutic ultrasound and electrolipophoresis on changes resulting
Higher School of Health Technology of Lisbon. 2014; 261.
from Geloid ibroedema. Physiotherapy in Motion.2011; 24:3; 471-479.
4. Mendonça AC, Azevedo KCM, Carvalho RM. Dermatofunctional
14. Silva RMV, Martins ALMS, Maciel SCF, Resende RARC, Meyer PF.
Physiotherapy: scienti ic practice, illegal use of the category’s own resources
Physiotherapy protocol for the postoperative period of abdominoplasty.
and valorization strategies. Cre ito 04 - Regional Council of Physiotherapy
Ter Man. 2012; 10:49; 294-299.
and Occupational Therapy of the 4th region. 2011; 1(1):1-2.
15. Macário FEC. Analysis of the resources used to treat sagging skin by
5. Pereira AS, Shitsuka DM, Parreira FJ, Shitsuka R. Shitsuka R. Scienti ic
physiotherapists in Brazil. 2014; 1-32.
Research Methodology - Degree in Computing. [S.l: s.n.], 2018.
16. Mondo PKS, Rosas RF. Effects of galvanic current in the treatment of
6. Grambro D. Prisma System Manipulator Manual. 1. ed. Italia: PRISMA.
atrophic striae. UniSul. 2010; 1:1; 1-6.
2005.
17. Diógenes GD, Andrade SRR, Cavalcante RR, Alves YM, Kuehner CP,
7. Santos CMC, Pimenta CAM, Nobre MRC. The PICO Strategy for
Dermato-functional treatment for wrinkles using chemical blender and
Constructing the Research Question and Searching for Evidence. Latin
electrolifting. Fisioterapia Brasil. 2012; 13:4; 277-281.
American Nursing Magazine. 2007; 15:3; 508-511.

[Link] [Link] 031