The purpose of this section of the Journal of Massage Science to inform the practitioners about valuable articles that frequently go unnoticed, as well as to point to those authors and publications who exhibit low educational standards. We do not play politics and we are not associated with any publishing company or professional association. We are a completely independent voice and we promise you direct unbiased reviews based strictly on the science.

            If the author of the reviewed article does not agree with our opinion, we will be more than happy to publish his or her response and have a productive discussion over the article’s subject.

            At the end of the year we will recognize and reward the author of the most important publication(s) and point to the authors of the most unscientific publication(s). We hope this will help to raise the bar of published materials in massage journals for the benefit of the entire profession.

 

MASSAGE & BODYWORK MAGAZINE

“Maybe If You Just Press Harder” Touch is a Form of Communication. Massage&Bodywork Magazine, Aug/Sep: 30-31, 2017 

By Douglas Nelson 

            As usual, a very good piece by Mr. Nelson. This article emphasizes the importance of correct assessment and mistakes therapists make when blindly following patients’ complaints.  

 

 

Essential Effleurage, The Key to Smooth Transitions. Massage&Bodywork Magazine, Aug/Sep: 36-37, 2017  

By Cindy Williams 

            A very good review of the meaning and place effleurage techniques occupy in a full body massage session. We may only add that an important goal of effleurage is to enhance lymph and venous blood drainage. This is why it can’t be done back and forth with the same pressure. Even light pressure always directed along the drainage with ‘feathering’ brings hands back into the starting position.  

 

 

Hey, Sugar! A Diabetes Review. Massage&Bodywork Magazine, Aug/Sep: 40-43, 2017  

By Ruth Werner.

            A great article which reviews Diabetes as a medical problem and it correctly addresses issues of MT and Diabetes. 

 

Longus Colli. Massage&Bodywork Magazine, Aug/Sep: 45-46, 2017  

By Christy Cael 

            A good article on anatomy, palpation and client’s homework for Longus Colli muscle. 

 

 

The Posture Window. Using Posture to Guide Assessment and Treatment. Massage&Bodywork Magazine, Aug/Sep: 49-55, 2017 

By Yoni Whitten, DC 

            This article covers the importance of postural evaluation on the example of Forward-Head Posture (FHP). The author is completely correct when he describes a chain of events that happens in the human body when so called ‘text neck’ posture is developed. He also correctly emphasizes that FHP may trigger various secondary syndromes from cervical disk pathology to Carpal Tunnel Syndrome.  

            However, the article covers only 50% of the information associated with FHP and the other 50% wasn’t even mentioned and we think this missing info is the weak part of the article. FHP can also have developed as a protective reaction by the brain to chronic or acute pain syndrome. In such case postural changes, the practitioner will see has nothing to do with the abnormality itself. In such case if the therapist uses “Posture to Guide Assessment and Treatment” he or she is knocking on the wrong door. Here is a very simple clinical scenario we daily observe in our clinic and in clinics associated with SOMI.  

            ALL patients with tension in the anterior scalene muscle (ASM) will exhibit a different degree of FHP. For those patients the postural changes described in the article are a secondary protective reaction the brain developed to take pressure off the brachial plexus irritated by the anterior scalene muscle. For those patients the approach to assessment and treatment recommended in the article will be erroneous since it is targeting consequence (upper body posture) instead of initial trigger (tension in the ASM). 

 

Do Deep Pressure (Using the Least Amount of Effort). Massage&Bodywork Magazine, Aug/Sep: 72-77, 2017 

By Mark Liskey 

            This article covers body mechanics for deep pressure application. If a healthy client would like to enjoy torture from the author, the article has merit. However, the author suggests using deep pressure as a treatment option and this is an example of complete misunderstanding of what clinical aspects of MT are all about.  

            The article tells us that 20 years ago a client named Ramit visited the author’s clinic and since that time he has faithfully returned while the author continues to use deep massage on him all these years trying to relieve his upper back pain and tension. 

            Here is a quote from the article:

“Ramit’s upper back is rock-solid. It’s usually number one on his complaint list. By going to that area first and delivering the deep pressure he likes, I get him to relax.”  

            So, for 20 years (!) instead of actually finding the initial trigger, rearranging soft tissues and completely eliminating or at least controlling his client’s symptoms, the author senselessly used deep pressure as a main clinical tool and considers that a clinical achievement. 

            No one in the field of somatic medicine does that, especially with vertical application of pressure as it is shown in the pictures. Let’s say the author is completely unaware of the reflex mechanism of massage therapy and in his treatment strategy he relies strictly on the local effects of massage therapy. However, in this case he is also wrong because for the mechanical force (in the form of massage strokes) to stimulate local healing processes and re-arrangement within the soft tissue, the pressure must be applied under a 45 degree angle (Shamos and Lavine, 1969) and this fact is completely missing in the article’s pictures. Vertical pressure is only a tool to get to the level of the soft tissues when clinical techniques are used. By applying vertical compressions though out his client’s body the author uses the simple principle of counterirritation which TEMPORARILY reduces pain and uncomfortable sensations. Therefore, Ramit has come to the author for 20 years, but there is no end in sight.  

            Another issue is that excessive application of pressure, besides triggering a protective reaction, damages myofibrils and is a contributing factor to formation of irreversible degenerative changes in the muscles called myogelosis. This is why “Ramit’s upper back is rock-solid” after 20 years of deep compressions.  

            Despite that the author is partially correct when he advocates use of the body weight as a component of the compression, the illustrations in the article confirm the fact that while he works on clients his body become a ‘rigid stick.’ With such body mechanics and the height of the massage table the author advocates he can only use deep compression or combinations of deep compressions and sliding.

            Thus, from the entire technical arsenal of modern massage therapy he mostly relies on two techniques! If we can make following analogy – One may listen to a beautiful Beethoven symphony with full orchestra, i.e. the therapist’s work with a wide technical arsenal, or the same melody is played by drums only, i.e. the author’s vision of dealing with somatic pain. No wonder 20 years of therapy didn’t bring Ramit any stable clinical outcomes.  

REFERENCE

Shamos M.H., Lavine L.S. Piezoelectricity as Fundamental Property of Biological Tissues. Nature, 213:267-269, 1967

 

 

Mind-Body Solutions For Moving Out Of Paralysis. Massage&Bodywork Magazine, Aug/Sep: 78-85, 2017 

By Meir Schneider, PhD 

            Working with paralyzed patients is a very difficult and emotionally draining job. Every small improvement is another big victory. This article is dedicated to the rehabilitation of paralyzed patients with different types of bodywork and movement therapy. It is a very good piece. 

 

 

The Many Faces of Thoracic Outlet Syndromes. Massage&Bodywork Magazine, Aug/Sep: 86-89, 2017  

By Whitney Lowe 

            A good article on an important subject. There are several issues which require corrections: 

1. Quote: “In most cases, the anterior scalene Thoracic Outlet Syndrome variation results from hypertonicity or problems directly in the scalene muscles.” 

            No, they are not. First of all, Anterior Scalene Muscle Syndrome and Thoracic Outlet Syndromes, despite having the same trigger, clinically manifest themselves in completely different ways. In the case of Anterior Scalene Muscle Syndrome when irritation of the brachial plexus is mild to moderate, the clinical symptoms never show themselves in the area of the anterior scalene muscle, but instead trigger havoc throughout entire upper extremity, mimicking clinical pictures starting from Rotator Cuff Injury to Ulnar Nerve Neuralgia on the hypothenar. This is why in somatic medicine the anterior scalene muscle has the nickname ‘silent killer’ since it can mimic any abnormality on the upper extremity. 

            Clinical symptoms on the anterior neck will appear only later in the Thoracic Outlet stage when the brachial plexus is actually compressed.  

2. Quote:  “Note that the subclavian vein does not pass through the scalene triangle so it is not involved in this variation.” 

            Yes, the subclavian vein doesn’t go into the thoracic outlet since it is located in front of the anterior scalene muscle, but it IS involved in the clinical picture. The tensed anterior scalene muscle pushes forward on a subclavian vein, delaying drainage from the arm and triggering peripheral edema which appears mostly on the dorsal hand, but it can affect the entire upper extremity as well. This condition is called Paget-Schroetter Syndrome (Mall et al., 2013) 

3. Finally, the article provides a very limited set of evaluation tools. 

REFERENCES

Mall, N.A., Van Thiel, G.S., Heard, W.M., Paletta, G.A., Bush-Joseph, C., Bach, B.R. Paget-Schroetter Syndrome. A Review of Effort Thrombosis of the Upper Extremity From a Sports Medicine Perspective. Sports Health. 2013 Jul; 5(4): 353–356. 

 

 

Coccydynia and Pelvic Floor Spasm Working with a Sensitized Nervous System. Massage&Bodywork Magazine, Aug/Sep: 90-91, 2017  

By Erik Dalton, PhD 

            A very informative article on the subject. 

 

Working With Golgi Tendon Organs. Massage&Bodywork Magazine, Aug/Sep: 92-95, 2017 

By Til Luchau 

            This article covers the important subject of relaxation of tensed muscles by activating Golgi Tendon Organ Receptors. The article discusses this therapy with the example of treating the sternocleidomastoid muscle. 

 

 

Who’s Assessing Whom? Massage&Bodywork Magazine, Nov/Dec: 26-27, 2017 

By Douglas Nelson 

            This article covers the assessment from the therapist and client perspective. The author is correct when he mentions that the confidence the therapist projects through his or her behavior or touch is immediately assessed by the client and it is the first step in the foundation of a successful therapy. 

 

 

Polymyalgia Rheumatica and Giant Cell Arteritis Common, Dangerous, Treatable. Massage&Bodywork Magazine, Nov/Dec: 36-39, 2017  

By Ruth Werner 

            A very good educational article which informs therapists about two chronic autoimmune diseases which trigger symptoms of somatic pain and discomfort. 

 

 

Pelvic Girdle Suspension System. Massage&Bodywork Magazine, Nov/Dec: 41-42, 2017 

By Christy Cael 

            A very good and informative article. 

 

 

Real-World Massage Research … and Massage Therapist Involvement. Massage&Bodywork Magazine, Nov/Dec: 44-47, 2017  

By Jerrilyn Cambron, DC, PhD 

            A very informative interview with one of the principal researchers of the new study of the MT effect on patients with lower back pain 

 

 

The Brachial Plexus and Thoracic Outlet Syndrome: Understanding Signs and Symptoms. Massage&Bodywork Magazine, Nov/Dec: 60-69, 2017  

By Joseph E. Muscolino, DC 

            This excellent piece written by Dr. Muscolino shows how a clinical article on an important topic must be written. A previous issue of Massage&Bodywork Magazine published an article on the same topic written by W. Lowe and the difference is really striking. 

 

Signs of Change: Understanding Clients’ Pain. Massage&Bodywork Magazine, Nov/Dec: 84-87, 2017 

By Whitney Low 

            This article is dedicated to the modern understanding of pain science. Despite that it provides a lot of correct info, the article is overloaded with concepts and data which are not fully explained to the readers and this is its weak part. 

 

Crick in the Neck From Pathology to Pain. Massage&Bodywork Magazine, Nov/Dec: 88-89, 2017  

By Erik Dalton, PhD

            Generally speaking, the content of this article is correct, but we think the article should more clearly emphasize the need for proper and very methodical training to deal with issues of disk compression, bulging and herniation. From reading of this short article it sounds very simple and the complexity of the situation isn’t emphasized for those who are novices or have limited training. Just following the recommendations from the article, which are illustrated without any warnings, may put therapists and their clients in a very difficult situation. 

 

 

Working with the Vagus Nerve. Massage&Bodywork Magazine, Nov/Dec: 94-97, 2017   

By Til Luchau 

            An excellent article! We highly recommend it to our readers! Thank you! 

 

MASSAGE TODAY MAGAZINE 

Fascial Connections In the Sacroiliac Joint. Massage Today, 17(7), 2017 

By Whitney Lowe, LMT 

            A very good and informative article  

 

 

A Chain Reaction: From Sever’s Disease to Tensor Fascia Latae. Massage Today, 17(7), 2017 

By Debbie Roberts, LMT 

            A very informative article on Sever’s Disease. 

 

 

A Common MT Injury: You Guessed it … Thumbs. Massage Today, 17(7), 2017 

By Ben Benjamin, PhD 

            The author is completely correct. The thumb injuries are one of the major ways therapists can injure themselves. It is great that the author examines thumb injuries from this perspective. 

 

 

A Common MT Injury, Part 2: Assessment Tests. Massage Today, 17(8), 2017 

By Ben Benjamin, PhD  

            Part 2 covers the assessment of the thumb and how therapists can examine themselves to find the degree of tension build up so they can prevent further injuries. 

 

Athletic Rehabilitation: A Therapeutic Approach. Massage Today, 17(8), 2017 

By Don McCann, MA, LMT, LMHC, CSET       

            This article is continued advertising for the author who relies on false clinical assumptions and his own writings as references. Here is a quote:  

“This evaluation of the knee and lower leg in conjunction with the anterior rotation of the left ilium showed how the imbalances of the core distortion were contributing to the injuries of the hamstring.” 

            Did the author ever consider that in the described case the hamstring injury contributed to the core distortion and he dealt with the consequence rather than the original trigger?

 

The Jugular Foramen: The Cradle of Autonomic Stability. Massage Today, 17(8), 2017 

By Dale G. Alexander, LMT, MA, PhD

            The author has a point in this article. It has some over-reaching statement, but the article delivers important data. 

 

 

Axillary Myofascial Release: A Guide to Lymphatic Drainage. Massage Today, 17(9), 2017 

By Leon Chaitow, ND, DO 

            As usual, a very good article by Dr. Chaitow 

 

 

The Continuum of Mechanics: Addressing Mobility Vs. Stability. Massage Today, 17(9), 2017 

By Stacey Thomas, FMS, SFMA, NKT, CF-L2 

            An interesting view on Movement Therapy. Readers may consider exploring this issue more. 

 

Does Massage Spread Cancer? An Update. Massage Today, 17(10), 2017 

By Tracy Walton, LMT, MS 

            Please see a review of this article by clicking here:  https://www.scienceofmassage.com/2018/01/jms-response-to-tracy-waltons-critique-published-in-massage-today/

 

A Major Role in Back Pain: The Multifidus. Massage Today, 17(10), 2017 

By M.L. Tallent, DC 

            The article touches on the rarely discussed subject of the Multifidus Muscle. The author is correct when he emphasizes the importance of the issue and the necessity of strengthening the multifidus for the normal healthy function of back muscles. The set of exercises that are offered in the article is helpful.

            The only issue we would like to emphasize, and this information is absent in the article, is the fact that this set of strengthening exercises can be done ONLY after the therapist has completely eliminated the initial trigger of the back pain including deep fascia and periosteum of vertebrae.   

 

 

Effective Treatment for Plantar Fasciitis. Massage Today, 17(11), 2017 

By Don McCann, MA, LMT, LMHC, CSETT 

            This is a case where treatment suggested by the author actually works and it is good case study. 

 

 

Vagus Nerve Outflow: Essential to the Healing Process. Massage Today, 17(11), 2017 

By Dale G. Alexander, LMT, MA, PhD 

            The author is correct. The vagal tone is one of the key components of our health since it works as a counterbalance to the overactive sympathetic (stress) part of the autonomic nervous system. The author deserves a lot of credit for bringing Polyvagal Theory to therapists’ attention. As we know, this is the first mention of this interesting piece of science in massage literature.  

 

 

A Common MT Injury: Treating the Thumbs. Massage Today, 17(11), 2017 

By Ben Benjamin, PhD 

            Treatment options discussed in this article are helpful tools, but they are not enough to fully address injuries and overloading thumbs because they don’t include work on the periosteum, which covers phalanges and1st metacarpal bone. In clinical reality the periosteum is a key component of the entire thumb’s rehabilitation. It is an especially important subject for therapists. 

 

Trigger Point Release: Thoracic Mobilization Using Tennis Balls. Massage Today, 17(11), 2017 

By Leon Chaitow, ND, DO

            This article describes the basic rules of self-therapy using Tennis Balls.  

 

 

Circling Around the Axis of Rotation: Understanding Joint Movement. Massage Today, 17(12), 2017 

By Whitney Lowe, LMT 

            A good article which covers the basics of muscle interactions.  

 

 

Understanding & Treating Shock: In the Face of Natural Disasters and Other Tragedies. Massage Today, 17(12), 2017 

By Dale G. Alexander, LMT, MA, PhD 

            A very good follow up to the first part of the article published in the previous issue of Massage Today

 

 

A Dangerous Cause of Upper Back & Chest Pain. Massage Today, 17(12), 

By Todd Turnbull, DC, CCSP 

            This article raises awareness about Swimming-Induced Pulmonary Edema which in the earliest stages give misleading symptoms of upper back and chest pain. It is helpful to know for those therapists who work with swimmers or scuba divers. 

 

MASSAGE THERAPY JOURNAL 

Tackling Migraines Head-On. MTJ, Summer 2017, 25-31 

By Katie M. Golden 

            This article doesn’t provide helpful clinical information on how to actually help patients with Migraines, but it gives therapists a reference base on the problem while explaining the basics of Migraine development. 

 

 

Pain And The Mind’s Response. MTJ, Summer 2017, 43-46 

By Michelle Vallet 

            This article explains the brain’s role in the formation of pain perception. Despite that the article raises correct issues it misses some important points: the necessity to identify the initial trigger of pain as the first step in the recovery; it doesn’t suggest any clinical approaches or methods to deal with pain and eliminate the condition of hyperirritability of peripheral receptors.  

 

 

Massage Therapy for Clients With Diabetes. MTJ, Summer 2017, 43-46 

By Nancy Porambo, MS, LMT, CNMT, NCTMB 

            An excellent review of Diabetes and its pathological effects on the body’s systems and organs. It also provides a review of data from medical sources on the effect of Massage Therapy on patients with Diabetes. 

 

 

Inpatient Hospital-Based Massage Therapy. MTJ, Winter 2017, 20-27 

By Renee Zagozdon 

Massage Therapy Complements Inpatient Care. MTJ, Winter 2017, 28-29 

By Martha Brown Menard, PhD, LMT 

            Both articles explore the value of massage therapy for inpatient care. Massage therapy indeed decreases stress and anxiety which accompany any hospitalization due to various pathological conditions. 

 

 

Your Career Is in Your Hands. MTJ, Winter 2017, 36-41 

Maureen Salamon 

            This article provides therapists with basic information on how to reduce tension and overload in hands to have a long productive carrier. 

 

Fascial Therapy: Benefits&Contraindications for Massage Clients. MTJ, Winter 2017, 48-75 

By Martha Brown Menard, Ph.D, LMT, Steve Furch 

            Overall there are a lot of good parts in this article which looks on fascial therapy as an important clinical tool. Such an approach to the material is a positive first step in the integration of fascial therapy into clinical practice by therapists. However, the article doesn’t fully present even basics of Fascial therapy as well as making a very strange recommendation. Here are some examples: 

The article states that:  

“Fascia can be weakened or damaged by: 

–          direct trauma 

–          poor posture 

–          dehydration” 

 

            If the statement about ‘direct trauma’ has merit, ‘poor posture’ and ‘dehydration’ are more consequences of the initial triggers to the fascial tension. The recent interest to the role of fascia is great, but clinically speaking we are coming back to the original concept of Fascial Tension (FT) and frequently the major aspects of it are missed, and the article is a great example of it. The concept of FT has almost 100 years of science and clinical application (Volker and Rostosky, 1949) and if the authors would like to present this concept from a clinical perspective they MUST include the fact that one of the major causes of tension in the fascia is reflex zones formation in superficial and deep fascia (Goats and Keir, 1991). The reflex zones which formed within fascia are called Connective Tissue Zones and their presence is not even mentioned despite that they are a major cause of FT (Ebner, 1956).

            Another aspect which is surprisingly absent in the article is the fact that FT in the form of Connective Tissue Zones (i.e., reflex zones in the fascia) is the first somatic reaction of the body to various chronic visceral disorders. In such case TF formed SECONDARILY to the chronic visceral disorders present in the body for at least 3 months. A lack in understanding of this important component of FT leaves the therapist in limbo if he or she is not informed about it and unable to evaluate FT correctly. 

            That brings us to the ‘poor posture’ concept. Yes, poor posture will contribute to FT, but as soon as a patient feels pain or various pathological symptoms, the poor posture the article suggested to examine is CONSEQUENCE rather than initial trigger. In such case the poor posture becomes a protective reaction of the body to the somatic or/and visceral pain and evaluation and addressing the FT alone becomes chasing your tail since the real trigger of FT is in a completely different part or system of the body. 

            Another surprising factor is the list of local contraindications for Fascial Therapy offered in the article. Many conditions indicated there are correct, but the presence in the list of Osteoarthritis, Acute Brachial Plexus Neuritis, Baker’s Cyst, Peripheral Neuropathy is simply puzzling. Why for example is the Osteoarthritis there despite that Fascial Therapy for cases of OA is one of the MAJOR clinical tools? Reducing tension in the fascia with fascial therapy in combination with other modalities allows the therapist to decompress affected joints and eventually decrease or eliminate pain by removal of periostal trigger points. 

            Peripheral Neuropathy by itself will trigger the formation of FT and the neurological component of Connective Tissue Zones formation is the initial trigger of ‘dehydration’ mentioned in the article as one of the causes for FT. 

            Why did Baker’s Cyst make the list? The article correctly states that “…pressure on the cyst is contraindicated.” However Fascial Therapy doesn’t have anything to do with vertical pressure since it mostly relies on lateral shift and there is no compression force on the Baker’s Cyst during ANY correctly conducted Fascial Therapy. 

            However, the second part of the quote is complete nonsense from a medical perspective:  

“This (massage and fascial work by JMS) may cause the cyst to rupture, which can lead to infection of the synovial cavity (Miller et al., 2000).” 

            First of all, the Baker’s Cyst contains same synovial fluid as a knee joint and it sterile. Thus, infection of the knee due to the cyst drainage inside of the knee itself is absurd. It is a VERY rare case (Drees et al., 1999) when the Baker’s Cyst became infected, but always from OTHER parts of the body, but not from the content of the cyst itself.

            Considering the authors provided reference to their statement we examined the suggested article and to our complete surprise we found that reference mentioned in the article (Miller et al., 2000) doesn’t have anything to do with Baker’s Cyst, but the subject of the cited reference was Brachial Neuritis.  

            The evaluation of Fascial Tension using Postural Grid or ROM suggested in the article provide indirect examination of the FT and it can be VERY misleading. At the same time fundamental manual techniques especially developed to evaluate degree of tension built up in the superficial and deep fascia as Kibler’s Technique, Dickle’s Technique, Opposite Shift Technique, etc. weren’t even mentioned. However, they are informing the therapist with 100% accurate data what actually happened in the different parts of the fascia.  

REFERENCES

Dickle, E.: Meine Bindegewebsmassage. “Marquardt”, Stuttgart, 1953.

Drees, C., Todd L., Mossad S.: Baker’s Cyst Infection: Case Report and Review Clinical Infectious Diseases, Vol. 29(2), July 1999: 276–278

Ebner, M.: Peripheral Vasculatory Disturbances: Treatment by Massage of Connective Tissue in Reflex Zones. Br. J Phys. Med., 19(8): 176-180, 1956.

Goats G.C., Keir K.A.I. Connective tissue massage. Br J Sport Med 1991; 25(3)

Miller, J.D., Pruitt, S., Mcdonald, T.J. Acute Brachial Plexus Neuritis: An Uncommon Cause of Shoulder Pain. Am Fam Physician. 2000 Nov 1;62(9):2067-2072. 

Volker R, Rostosky E. Uber den therapeutischen wert der bindegewebsmassage bei gefasstorungen der gliedmassen. Rheumaforsch 1949; 8: 193.

 

MASSAGE MAGAZINE 

Infant Massage. Considerations for the Medical Environment. Massage Magazine, 225 (Aug):50-54, 2017 

By Tina Allen, LMT, CPMMT, CPMT, CIMT 

            A good basic review of Infant Massage in a medical setting. It can be helpful to therapists who are considering branching into this field of massage therapy. 

 

 

Massage For the Spinal Cord Injury Patient. Massage Magazine, 228 (Oct):44-54, 2017 

Jimmy Gialelis, LMT, BCTMB            

            This article provides very basic information for therapists who work with clients with spinal cord injury. It is especially noticeable in the part of the article which covers massage treatment options. 

 

The distinction between penetrati—-on and absorption is a crucial one where measurement of chemical risk is concerned.

  • Skin Penetration represents the amount of a topically chemical that exists between the top layer (stratum corneum) and the bottom layer (stratum basale.)  During penetration, the body does not yet absorb the chemical, and it cannot affect the body systems.
  • Skin Absorption occurs when the topically applied chemical breaks the skin barrier to reach the bloodstream.  Whether this chemical becomes a risk is determined by what occurs after absorption.  You body can filter (The bouncers!) out the chemical via bodily fluids, or bioaccumulation (build up) occurs.
  • Many variables affect the speed (or probability) of penetration and absorption.  First, the composition of the chemical to which skin is exposed.  The area of skin that is exposed (thinner-skinned areas are more susceptible to penetration and thicker skin is less) and the condition of the skin are all significant factors.

 

This includes transdermal medication patches!  These types of medicine require formulation specifically for this purpose, requiring chemical engineering to create a molecule that is soluble in skin, and small enough to penetrate and absorb into the body.

 


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