The Effect of a Series of Lower-Limb Pressotherapy Treatments on Selected Skin Characteristics in Young, Healthy Women—Preliminary Report

Abstract

Background/Objectives: Pressotherapy is a method of controlled compression using special cuffs designed to improve lymphatic and blood circulation and support aesthetic treatments and therapies. The available literature lacks evidence of the effects of these treatments on skin parameters in healthy, untrained women. It was hypothesized that a series of pressotherapy treatments would positively impact skin firmness, hydration, friction resistance, and transepidermal water loss (TEWL). Methods: The study involved 15 healthy women aged 20–26 years who underwent a series of 10 pressotherapy treatments on the lower limbs (preliminary study, without a separate control group). The effects of the therapy were assessed by measuring skin hydration, transepidermal water loss (TEWL), elasticity, and resistance to friction, with measurements taken in standardized conditions before, during, and after the treatment cycle. Results: The study did not observe significant changes in skin hydration (Chi-square = 0.48; p = 0.923; Kendall’s W = 0.016) (CI 95% 6.07–16.22), transepidermal water loss (TEWL) (Chi-square = 6.24; p = 0.100; Kendall’s W = 0.208) (CI 95% 2.29–14.37) and skin friction coefficient (Chi-square = 6.27; p = 0.099; Kendall’s W = 0.209) (CI 95% 0.06–1.52), while analysis of elasticity and firmness parameters showed a significant improvement in selected biomechanical indicators (R0 (Chi-square = 13.32; p = 0.004; Kendall’s W = 0.440), R3 (Chi-square = 12.39; p = 0.006; Kendall’s W = 0.413), R8 (Chi-square = 9.00; p = 0.029; Kendall’s W = 0.300), Q1 (Chi-square = 11.64; p = 0.008; Kendall’s W = 0.388), Q2 (Chi-square = 7.54; p = 0.050; Kendall’s W = 0.251) (CI 95% 0.01–0.17)). Conclusions: A series of pressotherapy treatments on the lower limbs of young women may affect skin elasticity (selected parameters) but may not have a significant impact on skin hydration, transepidermal water loss (TEWL), or skin resistance to friction.

1. Introduction

Cosmetology is an interdisciplinary field of science encompassing a wide range of activities, from basic skin care, through professional cosmetic treatments, to supportive dermatological treatment [1]. In recent years, it has been increasingly studied by specialists from various medical fields, as aesthetic defects of the skin or body may result from underlying health issues, such as metabolic disorders or microcirculation problems [1]. Therapy that stimulates blood and lymph circulation using controlled pressure is becoming an interesting solution for those seeking effective, non-invasive methods to improve appearance and well-being. Pressotherapy, also known as interrupted pneumatic compression or compression massage, is a non-invasive therapeutic method performed alone or in combination with other procedures [2]. This technique utilizes a device equipped with special cuffs composed of several chambers [3]. A pumping system within the air chambers changes the pressure in individual sections, gradually applying pressure to successive sections of the treatment area [3,4]. Short-term but intense pressure is applied to the treated area, which follows the natural flow of blood and lymph towards the lymph nodes [5]. Pressotherapy is enjoying growing popularity in cosmetology, where it is used to support the fight against cellulite, excess weight, water retention, and swelling caused by venous and lymphatic congestion. The treatment helps shape the body, improves skin firmness, reduces swelling. It is also used in the treatment of conditions such as lymphedema and cyanosis of the limbs. After mastectomy, it helps reduce swelling in the upper limbs resulting from the removal of lymph nodes, improving lymph drainage [6,7]. Pressotherapy is also used in the treatment of scars and keloids. Constant, controlled pressure at the lesion site promotes local ischemia (transient), which reduces the activity of fibroblasts responsible for collagen overproduction. Simultaneously, it increases the activity of an enzyme that breaks down excess collagen, contributing to scar softening and reduction [8].

Transepidermal water loss (TEWL) is the process by which water moves from the dermis to the epidermis as a result of osmotic pressure differences, hydrating it before it evaporates into the environment. This is a natural phenomenon, crucial for maintaining the skin’s water balance. Under normal conditions, this process occurs in a controlled manner, but when the skin’s protective barrier is damaged or weakened, TEWL can increase, leading to excessive water loss and skin dehydration [9]. Skin firmness is a complex phenomenon that refers to skin’s tone, elasticity, resilience, and ability to maintain structural integrity. It is a key aspect of healthy and youthful skin, influencing both its biological functions and aesthetics [8]. Skin firmness is the result of the interaction of collagen, elastin, and fibroblast activity, which together form the skin’s supporting structure. Degradation of these key components due to aging, environmental factors, or disease leads to loss of firmness and laxity [10,11]. The level of skin hydration depends on many factors related to its structure and physiological functions. The primary element crucial to maintaining proper hydration is the stratum corneum, which protects against excessive water loss. Adequate hydration of this layer determines whether the skin will be soft and elastic or dry and susceptible to damage [9].

Skin’s resistance to friction is the result of a complex interaction between its anatomical structure and various external and internal factors. The individual layers of the skin and their components are crucial here, as they work together to provide protection against mechanical damage [12].

The aim of this study was to evaluate the impact of a series of pressotherapy treatments on selected skin parameters, such as firmness, hydration, skin resistance to friction, and transepidermal water loss (TEWL). An important aspect of the study was not only to examine the direct effects of pressotherapy on the skin but also to assess its potential as a cosmetic tool that can improve condition and well-being of young women.

2. Materials and Methods

2.1. Participant Characteristics

The presented prospective study (quasi-experimental pre-post study without a control group), consistent with the assumptions of the Helsinki Declaration; approval number of the Bioethical Committee of the District Medical Chamber in Krakow: 64/KBL/OIL/2024 of 4 July 2024; each volunteer read the information about the study design and was given the opportunity to ask questions, after which he gave informed written consent to participate in the study; Recruitment of the first participant: 1 October 2024. Study completion: 31 December 2024; A physiotherapist took care of the participants’ safety.

The study was conducted on a group of 15 young women aged 20 to 26 years (22.53 ± 1.55), who were healthy women without comorbidities and lower-limb injuries. The study lasted for four weeks, during which the participants received daily pressotherapy treatments lasting 30 min for two weeks (Monday to Friday, in the afternoon). Inclusion Criteria: female gender, age 20–26 years, generally good health, not undergoing regular physical training, no changes in diet immediately before and during the study (participants’ diets were self-reported and were not monitored during the study). Exclusion Criteria: comorbidities (neurological, rheumatological, dermatological, metabolic, circulatory and respiratory diseases), contraindications to participation in pressotherapy procedures, use of other physiotherapy treatments immediately before and during the study. All participants were a consistent group of women who led a moderately active lifestyle, held similarly intense occupations, and were not sedentary. Participants followed a healthy, balanced diet (Mediterranean or DASH (Dietary Approaches to Stop Hypertension)) based on self-reported information collected during the qualification interview. Physical activity level, occupational activity, and dietary habits were assessed through participant declarations obtained during the recruitment process. None of the women had previously undergone pressotherapy.

2.2. Measuring Tools

Measurements were taken at four precisely defined time points as part of the research procedure. The first was taken seven days before the start of the pressotherapy treatment series, which allowed for determining the participants’ baseline skin parameters. The second was taken on the day of the treatment, but before the treatments were performed, allowing for confirmation of the stability of the initial results. The third measurement was taken immediately after the completion of the entire treatment series to assess the immediate effects of the therapy. The final, fourth measurement took place seven days after the treatment session, allowing for the assessment of the durability of the achieved effects.

All measurements were conducted in a single, specially prepared room to ensure controlled environmental conditions and avoid factors that could influence the results. During the measurements, a constant temperature of 24–26 degrees Celsius and humidity of 33–41% were maintained. These environmental conditions were consistent with the manufacturer’s recommendations for the applied measurement devices. Furthermore, measurements were taken at similar times of day, minimizing the impact of circadian rhythms on skin condition [13].

Each measurement was taken on the back of the thigh, precisely in the middle. This location ensured perfect contact of the measurement probes with the skin, allowing for precise and reliable results. We also wanted to examine the area subjected to pressure. The carefully selected location eliminated the risk of measurement errors resulting from improper contact between the devices and the skin, ensuring the highest quality of the conducted tests.

Before each series of measurements, participants underwent a 15 min acclimatization period in the testing room to allow their skin to adapt to the environmental conditions and eliminate any potential impact of changes in temperature or humidity on the results. Each measurement was performed three times using a dedicated probe, and the final result was calculated as the average of the three obtained values. This methodology increased the precision and reliability of the obtained data. All measurements were performed in accordance with the laboratory’s ISO-based quality assurance procedures (Academy of Physical Culture in Krakow, certificate number PN-EN ISO 9001:2015: PW-08606–1). The measuring devices were regularly calibrated and maintained according to the manufacturers’ requirements to ensure the accuracy and repeatability of the obtained results.

A corneometer (Corneometer^® CM 825 (Courage+Khazaka, Cologne, Germany)), a device that precisely measures the hydration level of the stratum corneum, was used to measure the skin’s surface hydration [10]. Transepidermal water loss (TEWL), which is an indicator of the skin’s ability to maintain a protective barrier, was measured using a Tewameter^® TM 300 (Courage+Khazaka, Cologne, Germany). Skin elasticity, a key factor responsible for its ability to return to its original shape after deformation, was measured using a Cutometer^® dual MPA 580 (Courage+Khazaka, Cologne, Germany) [14]. This device allows for detailed analysis of skin’s biomechanical properties, such as elasticity and firmness (R0: Passive skin response to force; R2: Gross elasticity; R3: Maximum amplitude of the last and first curves compared to determine the “fatigue effects” of the skin; R8: Skin’s ability to return to its original state; R9: Fatigue effects of skin after repeated suction; F1: Elasticity; Q1: Elastic recovery, greater with greater firmness; Q2: Viscoelastic recovery.). A Frictiometer (Frictiometer^® FR 700 (Courage+Khazaka, Cologne, Germany)) was used to analyze the skin’s friction coefficient [15].

2.3. Description of the Intervention

The study was conducted at the Academy of Physical Culture in Krakow over a period of four weeks, during which the participants underwent a series of ten pressotherapy treatments and measurements of physiological parameters. Pressotherapy treatments were conducted daily for 30 min, using the CarePump Expert8 device (Bardomed LLC., Krakow, Poland) supporting eight-chamber cuffs for the lower limbs, with a gradient set at 1 mmHg, a 3 s “hold” parameter (a break after the end of filling one chamber, before filling the next one) and pressure individually selected to the participant’s sensations (maximum tolerated pressure without pain—in our subjects in the range of 120–150 mmHg). A standard program was used, which involves sequential filling of subsequent chambers, while maintaining the pressure in previously inflated chambers. The procedure was performed in the supine position. Participants were examined four times: one week before the first treatment, immediately before the first treatment, after the tenth treatment, and one week after the tenth treatment.

2.4. Statistical Analysis

The empirical analysis allowed for the presentation of descriptive statistics for the studied parameter in the form of means, standard deviations, and minimum and maximum values. Prior to repeated-measures ANOVA, assumptions of normality and sphericity were assessed using the Shapiro–Wilk and Mauchly’s tests, respectively. When the assumption of sphericity was violated, Greenhouse–Geisser correction was applied. The Friedman test was used to determine the significance of changes within the study group depending on the time of measurement. In the case of statistically significant differences, post hoc tests (Wilcoxon signed-rank test) were performed. The present study was designed as a preliminary exploratory/pilot investigation aimed at assessing feasibility, generating initial effect estimates, and identifying potential trends that may support the design of future adequately powered studies. Given the exploratory nature of the project and the limited availability of eligible participants, a formal a priori sample size calculation was not performed. Correction for multiple comparisons was not applied, as strict adjustment methods could substantially reduce statistical power. Nevertheless, this approach may increase the probability of type I error and should be considered when interpreting the results. The significance level for the analyses was p = 0.05. All calculations were performed using Statistica 13 software (StatSoft, Dell Inc., Round Rock, TX, USA).

3. Results

The average results of individual measurements are given in

Table 1. Tested indicators.

Parameter		Measurement I (n = 15)	Measurement II (n = 15)	Measurement III (n = 15)	Measurement IV (n = 15)
Corneometer [CU]		31.66 ± 10.76	32.59 ± 9.75	31.84 ± 10.17	26.04 ± 7.53
TEWAmeter [g/m2/h]		12.66 ± 8.27	11.45 ± 8.73	13.40 ± 9.11	10.15 ± 3.13
Frictiometer [AU]		10.17 ± 0.97	10.22 ± 0.24	10.02 ± 0.08	10.04 ± 0.11
Cutometer	R0	0.20 ± 0.05	0.18 ± 0.03	0.25 ± 0.06	0.19 ± 0.03
	R2	0.84 ± 0.07	0.89 ± 0.08	0.90 ± 0.06	0.89 ± 0.07
	R3	0.22 ± 0.05	0.18 ± 0.4	0.25 ± 0.06	0.19 ± 0.04
	R8	0.16 ± 0.05	0.16 ± 0.04	0.22 ± 0.06	0.17 ± 0.04
	R9	0.01 ± 0.1	0.00 ± 0.01	0.01 ± 0.01	0.01 ± 0.01
	F1	0.01 ± 0.02	0.02 ± 0.01	0.02 ± 0.02	0.01 ± 0.02
	Q1	0.74 ± 0.18	0.83 ± 0.05	0.83 ± 0.09	0.84 ± 0.06
	Q2	0.72 ± 0.06	0.73 ± 0.05	0.76 ± 0.11	0.79 ± 0.08

CU—corneometer units; AU—arbitrary units; Measurement I: Baseline (Taken 7 days before treatment starts); Measurement II: Pre-intervention (Taken on the first treatment day (before session), and to confirm stability/reliability of baseline values); Measurement III: Post intervention (Taken immediately after completing the treatment series); Measurement IV: Follow-up (Taken 7 days after the last treatment to evaluate the durability of effects); R0: Passive skin response to force; R2: Gross elasticity; R3: Maximum amplitude of the last and first curves compared to determine the “fatigue effects” of the skin; R8: Skin’s ability to return to its original state; R9: Fatigue effects of skin after repeated suction; F1: Elasticity; Q1: Elastic recovery, greater with greater firmness; Q2: Viscoelastic recovery.

.

Corneometer: Results obtained using the corneometer (Chi-square = 0.48; p = 0.923; Kendall’s W = 0.016) (

Table 2. Analysis of variance for repeated measurement of tested indicators—p-level of significance.

Parameter		Chi-Square	p	Kendall’s W	Effect
Corneometer		0.48	0.923	0.016	Small
TEWAmeter		6.24	0.100	0.208	Small
Frictiometer		6.27	0.099	0.209	Small
Cutometer	R0	13.32	0.004	0.440	Medium
	R2	6.24	0.100	0.208	Small
	R3	12.39	0.006	0.413	Medium
	R8	9.00	0.029	0.300	Medium
	R9	3.06	0.382	0.102	Small
	F1	0.72	0.868	0.024	Small
	Q1	11.64	0.008	0.388	Medium
	Q2	7.54	0.050	0.251	Medium

R0: Passive skin response to force; R2: Gross elasticity; R3: Maximum amplitude of the last and first curves compared to determine the “fatigue effects” of the skin; R8: Skin’s ability to return to its original state; R9: Fatigue effects of skin after repeated suction; F1: Elasticity; Q1: Elastic recovery, greater with greater firmness; Q2: Viscoelastic recovery.

) did not show statistically significant changes in skin hydration.

Tewameter: the results obtained using the tewameter (Chi-square = 6.24; p = 0.100; Kendall’s W = 0.208) (Table 2) did not reveal statistically significant changes in TEWL. The measurement values in the subsequent stages did not differ significantly.

Frictometer: the frictometer results (Chi-square = 6.27; p = 0.099; Kendall’s W = 0.209) (Table 2) indicate that changes in the skin’s coefficient of friction are not statistically significant.

Cutometer: skin elasticity measurements revealed statistically significant changes in several parameters. Significant differences were noted for the following indices: R0 (Chi-square = 13.32; p = 0.004; Kendall’s W = 0.440), R3 (Chi-square = 12.39; p = 0.006; Kendall’s W = 0.413), R8 (Chi-square = 9.00; p = 0.029; Kendall’s W = 0.300) (Table 2 and

Table 3. Post hoc test values for the tested indicators.

Parameters	Measurement	I	II	III	IV
Cutometer R0	I		0.12	0.12	1.00
	II	0.12		0.00	0.85
	III	0.12	0.00		0.00
	IV	1.00	0.60	0.00
Cutometer R3	I		0.00	0.18	0.60
	II	0.00		0.00	1.00
	III	0.18	0.00		0.00
	IV	0.60	0.47	0.00
Cutometer R8	I		0.03	0.17	0.77
	II	0.03		0.95	0.53
	III	0.17	0.95		0.00
	IV	0.77	0.53	0.53
Cutometer Q1	I		0.00	0.03	0.00
	II	0.00		0.77	0.64
	III	0.03	0.77		0.60
	IV	0.00	0.64	0.60
Cutometer Q2	I		0.12	0.21	0.01
	II	0.12		0.42	0.02
	III	0.21	0.42		0.19
	IV	0.01	0.02	0.19

Measurement I: Baseline (Taken 7 days before treatment starts); Measurement II: Pre-intervention (Taken on the first treatment day (before session), and to confirm stability/reliability of baseline values); Measurement III: Post intervention (Taken immediately after completing the treatment series); Measurement IV: Follow-up (Taken 7 days after the last treatment to evaluate the durability of effects); R0: Passive skin response to force; R3: Maximum amplitude of the last and first curves compared to determine the “fatigue effects” of the skin; R8: Skin’s ability to return to its original state; Q1: Elastic recovery, greater with greater firmness; Q2: Viscoelastic recovery.

), indicating that the series of treatments influenced selected biomechanical properties of the skin. The R2 (Chi-square = 6.24; p = 0.100; Kendall’s W = 0.208), R9 (Chi-square = 3.06; p = 0.382; Kendall’s W = 0.102), F1 (Chi-square = 0.72; p = 0.868; Kendall’s W = 0.024) indices (Table 2 and Table 3) did not show significant differences. The parameters defining skin elasticity: Q1 (Chi-square = 11.64; p = 0.008; Kendall’s W = 0.388), Q2 (Chi-square = 7.54; p = 0.050; Kendall’s W = 0.251) (Table 2 and Table 3) also showed statistically significant changes.

4. Discussion

The present study demonstrated that a series of pressotherapy treatments influenced selected skin parameters in healthy young women. Significant changes were observed in several biomechanical skin properties measured using the Cutometer. These findings suggest that pressotherapy may affect skin function and mechanical behavior; however, the underlying mechanisms and clinical relevance of these changes require further investigation.

A study using corneometer measurements revealed no significant changes in skin hydration. Pressure applied to the treated limbs increases blood and lymph circulation, which improves oxygenation and nourishment of skin tissues. Stimulation of the lymphatic system may improve fluid flow in the intercellular spaces, which may enhance the elimination of metabolic wastes and excess water and improve skin cell function [16,17]. Improved blood flow may also influence regenerative processes by increasing collagen and elastin synthesis, which may contribute to the reconstruction and strengthening of the epidermal hydrolipid barrier, resulting in higher hydration levels [18] which was not confirmed in our own results. This finding may be related to the measurement technique employed, which evaluates hydration exclusively within the Stratum corneum layer rather than in deeper skin tissues [19]. Consequently, further studies using alternative measurement methods may be warranted to provide a more comprehensive assessment of skin hydration changes.

The lack of significant differences in the tewameter results suggests that transepidermal water loss (TEWL) was unchanged by the treatments. This may indicate that the epidermal barrier remained intact and there was no increase in water evaporation from the skin surface. In the context of the study, the result can be interpreted positively, as a stable TEWL level indicates that the treatments did not negatively impact the skin’s ability to retain moisture. It is also worth noting that this is a key parameter in assessing the skin’s barrier function. If no significant changes were observed in this respect, it can be assumed that the procedure used did not cause damage to the hydrolipid barrier; however, this issue is complex and requires further research.

Similar to the tewameter results, the frictometer results also showed no significant differences. This suggests that the treatments did not affect the skin’s surface properties. Measurements of skin smoothness showed that the treatments had no significant impact on this aspect. The measurements were stable before and after the series of treatments. The coefficient of friction did not change significantly, therefore, the epidermal barrier was likely not weakened, and the skin retained its natural protection after the series.

The cutometer examination revealed that the maximum deformation of the skin (R0) was higher, indicating reduced skin firmness (stiffness) and increased susceptibility of the skin to deformation under applied suction. Therefore, the increase in R0 should be interpreted as a reduction in resistance of the skin to mechanical deformation. The improved ratio between elasticity and total deformation (R3) may have resulted from fibroblast stimulation, which resulted in increased elastin synthesis, which is responsible for skin elasticity and its ability to return to its original shape [20]. The increased ability of the skin to absorb mechanical energy (R8) indicated improved protective properties, reducing susceptibility to mechanical injury. Although the increase in R0 suggests reduced firmness, the favorable changes observed in other biomechanical parameters indicate that the treatment may have positively influenced selected aspects of skin mechanical behavior, particularly elasticity and energy dissipation capacity. The effects of the treatment series were also visible in skin elasticity parameters. These improvements resulted from the long-term effects of the treatments on the production of structural proteins and from improved microcirculation, which translated into greater elasticity and skin regeneration capacity. The Q2 parameter, determining the mechanical quality of the skin, showed significant differences, suggesting that the treatments had a positive impact on the skin’s resistance to stretching and its overall integrity.

When examining skin parameters, it is important to note the correlation between microcirculation and its healthy condition. Microcirculation is a key element of skin function, responsible for blood flow in the smallest blood vessels: arterioles, venules, and capillaries. They perform essential functions such as delivering oxygen and nutrients to cells and regulating water and electrolyte balance in tissues. In the context of the skin, microcirculation plays an extremely important role in maintaining skin homeostasis, barrier function, and proper cellular metabolism. A crucial aspect in this context is skin hydration. There is a direct relationship between microcirculation and hydration. The capillaries of the dermis are the main source of water and nutrients for the epidermis. Proper microcirculation enables the delivery of essential amino acids, glucose, electrolytes, and lipids, responsible for the formation of NMF and the maintenance of the epidermal lipid barrier, which directly translates into skin hydration. Another aspect of this relationship is the influence of microcirculation on epidermal regenerative processes. Nutrients delivered through microcirculation support the synthesis of structural lipids, such as ceramides, cholesterol, and fatty acids, which are essential for rebuilding and maintaining the integrity of the hydrolipid layer, thus maintaining proper skin hydration. Microcirculation also significantly influences the activity of fibroblasts, the dermal cells responsible for the production of collagen, elastin, and hyaluronic acid. Hyaluronic acid, due to its ability to bind water molecules, plays a key role in maintaining skin hydration. Improved microcirculation therefore promotes fibroblast activation and increases HA content in the skin, contributing to increased elasticity, smoothness, and long-lasting hydration [8,18,21].

Martin et al. (2018) investigated the effect of unilateral external pneumatic compression (EPC) of the lower limbs on bilateral vascular reactivity and skin blood flow [22]. The study involved 32 participants and was divided into two phases. The first phase (AIM1) assessed femoral artery blood flow and vascular reactivity (FMD) before and after 30 min of unilateral EPC. The second phase (AIM2) divided participants into an EPC and placebo group, and then measured mean lower-limb skin temperature (MST) before, during, and after the procedure. The results indicated that, although there were no significant changes in total blood flow, EPC caused a statistically significant increase in vascular reactivity (FMD) bilaterally, despite the unilateral procedure. In AIM2, a significant increase in skin temperature was observed in both the treated and contralateral legs. The maximum increase occurred immediately after the treatment, persisting for another 30 min, and then gradually returned to baseline values. Unilateral pressotherapy also produces beneficial effects on microcirculation and vascular reactivity in the limb not directly exposed to the treatment. These observations confirm the potential of EPC as an effective method for improving blood flow to the skin and peripheral vessels. In the context of the mechanisms described, the increased microcirculation observed in literature studies after pressotherapy may be directly related to increased skin hydration [22]. This relationship is not confirmed by the results of corneometric studies, which showed no statistically significant changes in skin hydration after a series of 10 pressotherapy treatments.

A study by De Vrieze et al. (2022) evaluated the effectiveness of various forms of manual lymphatic drainage (MLD) combined with decongestive lymphatic therapy (DLT), an intensive treatment for lymphedema in patients with unilateral edema following breast cancer treatment [23]. Pressotherapy, like MLD, affects the lymphatic and circulatory systems, contributing to edema reduction and improved skin parameters. Unlike manual lymphatic drainage, pressotherapy is a mechanical method, but its therapeutic effects, such as improved microcirculation and firmness, may be comparable to some extent. The aim of the study was to determine the effect of MLD on fluid accumulation in suprafascial tissues and skin elasticity. Participants (n = 194) were randomly assigned to three groups using different variants of MLD. All participants received standard DLT, including compression therapy, education, and exercises. The therapy lasted for 3 weeks in an intensive setting, followed by 6 months of maintenance therapy. Analysis of the results revealed significant improvements in most parameters over time, particularly in the upper arm, regardless of the type of MLD used. However, differences between groups were not statistically significant, and a significant interaction effect was noted only for skin elasticity assessed by palpation at the upper arm level. Regardless of the type of MLD used, the main therapeutic benefits result from comprehensive DLT. Similarly, it can probably be assumed that pressotherapy can be an effective element supporting the treatment of edema and improving the condition of the skin, including its firmness, by stimulating circulation and reducing water retention; however, our studies included only young and healthy people [23].

Despite the obtained results, it is necessary to acknowledge certain limitations of this study. The relatively small sample size and exclusive focus on young women may make it difficult to generalize the results to a broader population (purposive sampling, without blinding or placebo control). All participants were healthy, which could have influenced the final results and favored the beneficial effects of the therapy. In future studies, it would be worthwhile to monitor participants’ diet, menstrual cycle and physical activity with use of validated methods, the lack of which should also be listed as a limitation of the present study. An additional limitation is the relatively short duration of the treatment, which could have impacted the ability to assess the long-term effects of pressotherapy. Future studies should consider extending the observation period and increasing the number of participants, which would allow for a more accurate and comprehensive assessment of the effectiveness of pressure massage. It would also be important to include a wider age range of study participants, which would allow for an assessment of whether the effectiveness of massage changes with age, as well as to include men in the study (we treat the study of women as a preliminary study). Another valuable aspect of future research could be to consider participants’ body composition, including percentage of body fat and muscle mass. In the future, it would also be worthwhile to adopt a holistic approach to the study subject, considering additional factors such as physical activity, a healthy diet, and combining pressotherapy with other therapeutic methods, such as lymphatic drainage. Such an approach could contribute to more comprehensive and reliable results, confirming the effectiveness of this method in a wide range of aesthetic and therapeutic applications.

5. Conclusions

A series of pressotherapy treatments on the lower limbs of young women may affect skin elasticity (selected parameters) but may not have a significant impact on skin hydration, transepidermal water loss (TEWL), or skin resistance to friction. We consider this study preliminary and require confirmation in randomized, controlled trials. Generalizing the results should be done with caution.