Microdermabrasion is literally a superficial sanding of the skin, resulting in exfoliation of thickened epidermis and results in a smoother more even appearing skin texture and tone. The use of microdermabrasion dates back to the mid 1980's where it began in Europe. Microdermabrasion involves the use of tiny rough particles blown onto the skin and vacuumed away in a closed loop type of system. This helps remove the more superficial skin cells, revealing the fresher, healthier skin below.

How is Microdermabrasion performed?

Microdermabrasion requires a series of treatments; it would be rare that a single treatment would result in significant results. When repeated every week or two for anywhere from 6-16 weeks, the cumulative results can be significant. Microdermabrasion is easy to undergo. It does not require anesthesia either local or general. While you will certainly feel the procedure, the good news is that it is basically painless. While I have heard patients describe it as being rubbed with an emery board or piece of sandpaper, I personally think it feels like being licked by a cat. The procedure typically lasts about a half an hour.

You can expect your treated skin to look slightly pink. However, there should be no obvious skin wounds, weeping, oozing or blistering. For deeper microdermabrasion procedures, your skin may be slightly red and swollen for about a day or two.

What it is used for?

• Hyperpigmentation
• Uneven skin tone or texture post laser
• Reducing skin "dullness" that accompanies aging skin.
• Keratosis Pilaris can be temporarily smoothed out, allowing topicals to penetrate easier and work more effectively.
• Some stretch marks
• Opening blackheads and keeping pores clean. Do not think of this as an acne therapy, although I have heard of several companies that make these claims.
• Softening some saucer like acne scars and some other forms of scarring.
• Smoothing out fine wrinkle lines. Procedure will not make a huge difference on advanced deep wrinkles.

What it should not be used for:

• Not appropriate for keloidal scaring, as it may stimulate further scar formation.
• Not appropriate for jagged ice-pick scars.
• Skin cancers
• Precancerous actinic keratoses (AKs)
• This is not a method for the removal of skin growths.

I cannot tell you the number of questions I receive regarding, which is the "perfect" microdermabrasion machine or how it compares with another brand they saw advertised. The truth is that while microdermabrasion is a very nice procedure performed by the proper individual upon the appropriate client, there is very little difference from a consumer's point of view regarding the actual brand of machine. There are certainly 2 levels of microdermabrasion machines, and most manufacturers produce the 2 different levels for each brand advertised to the consumer. The gentler machines with less power are marketed to estheticians, while more powerful machines with the ability to give more aggressive results are marketed to physicians.

There is so much hype in advertising pitting brands, such as the Parisian Peel against the Power Peel, vs. the Mega Peel; vs. the Ultra Peelwell you get my drift. Anyway, the biggest problem is from the doctor's point of view as to which machine to purchase. They vary widely in pricing and all of the little extras that can throw the most avid gadget shopper into ecstasy, but it makes me feel like I am car shopping all over again. The consumer, however, needs to be aware of a few things that really are not necessarily brand driven.

• Is the technician trained adequately in the use of the machine? There are machines with higher power capabilities that have no business being used by an aesthetician. These more powerful machines are meant to be used under physician supervision and result in the deeper removal of tissue. That also means there is a higher potential for wound formation and resulting hyperpigmentation of the skin. This is not necessarily a bad thing as the results can be far better when used in the proper hands.
• Is the machine being used in a sanitary manner? Not only should the crystals NEVER be reused (this would be a set-up for passing contagious diseases between clients), but it can also diminish the effectiveness of the procedure. Once those crystals have hit the skin, they are now smoother and those necessary jagged edges are now dulled. There are now some machines being marketed that offer sterilizable or disposable hand pieces (the part that contacts your skin) so that sanitary conditions are improved.
• Does the use of Aluminum oxide crystals concern you? This has been a very big controversy, not only in relation to the Alzheimer's issue, but also to problems associated with any inhaled particle. Remember asbestos? The technician is at a worse disadvantage than the client. This again refers back to the choice of machine purchased; it's vacuuming capability, the amount of crystals used by the machine per treatment and how the crystals are disposed of later on. The FDA states there is no concern with regard to the use of Aluminum oxide (also known as Corundum). It is supposed to be a different compound (the metal) than the aluminum powder that has been implicated, but apparently proven not related to Alzheimer's. I credit Aesthetic Lasers, Inc., the manufacturers of the Power Peel who have done a terrific job addressing the Aluminum Oxide debate and providing quality information. Anyway, this remains a controversial area, however, I think that the inhalation of any particulate will be an issue that far outweighs the Aluminum Oxide concern. Many manufacturers have made several changes to their equipment to minimize the particulate matter that is able to escape into the air, especially during disposal and refilling of the containers. In the meantime, a few manufacturers are coming out with machines that utilize salt crystals instead of Corundum.
• Do you have realistic goals? I think microdermabrasion is a great adjuvant treatment to help expedite resolving some forms of skin discoloration. However, for some areas, the pigment containing cells (melanocytes) may be located too deeply for this modality to be effective. Also, this is not a machine that is going to abrade your unwanted tattoo away. The deeper the microdermabrasion, the more likely there will be harm to the dermis and resulting increased skin discoloration.

Microdermabrasion results are best when combined with corresponding skin treatment products. Home exfoliation is almost always used to expedite the improvement. Often the use of a topical vitamin A products for facial treatment such as prescription Retin A, Renova or a non-prescription retinol such as Afirm, Neova Retinol ME 0.30% and DERMAdoctor Poetry In Lotion intensive retinol 1.0 are used. They are often begun approximately 2 weeks prior to starting your microdermabrasion series. In some instances, they may be continued on a maintenance basis.

Kinerase has been widely incorporated into microdermabrasion regimens used to help alleviate fine wrinkle lines. The anti-inflammatory properties of Kinerase seem to diminish the pinkness of the skin and hasten the results. DERMAdoctor Calm Cool & Corrected 2N1 Rosacea Tx combines Hyaluronic Acid, Aloe Vera, Chamomile Extract, Squalane and Shea Butter to protect and hydrate delicate, sensitive skin often seen after medical and spa procedures like microdermabrasion.

The use of topical copper peptides such as Neova and vitamin C products such as Murad and Cellex-C are also beneficial. These provide an antioxidant to the skin as well as help stimulate collagen and elastin formation and deposition within the dermis. The revolutionary antioxidant combination in Cellex-C Advanced-C Serum delivers protection against photoaging. DERMAdoctor Wrinkle Revenge Rescue & Protect Facial Cream delivers skin firming and antioxidant protection while combating fine lines.

If you suffer from hyperpigmentation, the combination of effective bleaching or brightening agents such as Murad Age Spot & Pigment Lightening Gel, DERMAdoctor Immaculate Correction Potent Hydroquinone-Free Skin Brightener, Lightening Gel or prescription alternatives such as Glyquin, TriLuma or Lustra with microdermabrasion treatments can help to achieve more results. Your bleaching agent can also help prevent or diminish potential increased discoloration if you are anticipating deeper microdermabrasion. Sun protection such as DERMAdoctor Body Guard Exquisitely Light SPF 30 For Face & Body and Physician Endorsed must be incorporated to prevent further discoloration while using lightening products or having microdermabrasion treatments.

Treating keratosis pilaris? Products that use glycolic acid (DERMAdoctor KP Duty Dermatologist Moisturizing Therapy For Dry Skin), Vitamin A (Retin A or Afirm), Lactic Acid, (AmLactin Moisturizing Body Cream or LacHydrin), urea (Carmol 20 Cream) or propylene glycol (DERMAdoctor Handy Manum Medicated Skin Repair Serum with 1% Hydrocortisone) are important to use as well when doing microdermabrasion to help treat KP.

It is important to ask your physician or esthetician when you should hold off on using these products before or during your microdermabrasion tretment sessions. It is typically a 36-hour period starting the night before treatment and restarting the morning after the procedure.

Does it work?

The advocates for microdermabrasion have long made claims that the production of collagen and elastin fiber fibers is possible. Recent medical studies have shown documented changes within the dermis, suggesting some basis to this claim. Before and after skin biopsies of treated areas did indeed show pathologic improvement. The use of adjuvant topical therapy and the appropriate selection of patients for this procedure should help maximize results and diminish disappointment for both the clinician as well as the client.

Who Is A Microdermabrasion Candidate?

Anyone who is looking for a method to help improve their skin without having to hide for long periods of time due to extreme redness, raw skin, etc., and has minor skin issues such as irregular pigmentation, small depressed scars, fine lines and faint to moderate stretch marks should be a candidate. Microdermabrasion, particularly if performed with an esthetician level machine, should be fine for any skin type. Those with darker skin tones who seek out a dermatologist is probably wise as the stronger machines do have lower settings and the physician is probably more acquainted with appropriate prescription therapy that should be used throughout the course of the treatment. Certainly anyone with known keloid formation would want to reconsider this procedure.

Cost

As with any cosmetic procedure, you are going to find a wide variety of charges, especially when comparing the Coasts to the Midwest. You may be able to purchase a series of treatments as a "package deal" and save. Don't expect that you will necessarily save by going to see an esthetician. Ask your friends and shop around in advance if possible.

Home Microdermabrasion

DermaNew Total Body Experience Kit or the DermaNew Facial Rejuvenation System can be used at home or on your travels to either substitute for or fill in your series of office dermabrasions. Five days of use of the DermaNew systems actually compare to one medical strength microdermabrasion. It is recommended you use the system for 7 days and then give your skin 5 days off. By using this at-home system, you can keep your skin smoothe and expedite the effectiveness of many of your other skin care products.

Microdermabrasion has become a very popular procedure and has proven itself to have a definite role in cosmetic dermatology. You may find this to be the option you have been looking for to treat more minor aesthetic skin concerns.

Thank you for taking the time to read my article. I hope you have found it informative.

Audrey Kunin, M.D.

(Any topic discussed in this article is not intended as medical advice. If you have a medical concern, please check with your doctor.)

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