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Microdermabrasion: An Evidence-Based Review
Abstract
Microdermabrasion is a popular technique used in the treatment of several skin problems, including acne, acne scarring, striae distensae, and photoaging. This article will review the relevant literature and use an evidence-based approach to evaluate the clinical efficacy of microdermabrasion in skin care. In summary, microdermabrasion appears to be a procedure that can produce changes in dermal matrix constituents and result in improvement in skin contour irregularities. It may also be beneficial in improving transepidermal delivery of certain medications. Its role in the treatment of dyschromias and acne vulgaris is limited.
... Among the benefits of microdermabrasion in skin health are a reduction of mottled hyperpigmentation in photoaging, smoothing of wrinkles, a decrease in roughness, and an improvement in skin texture. [10][11][12] In addition, microdermabrasion has been shown to improve the permeation of different molecules into the skin. 13,14 Different modalities of microdermabrasion are available on the market, which differ in the nature of the abrasive component used (eg, aluminum oxide, diamonds). ...
... A diamond-tip microdermabrasion handpiece allows a more precise exfoliation of hard-to-reach surfaces and leaves no crystal particles on the skin. 11 The DiamondGlow ® (DG) microdermabrasion device simultaneously exfoliates the skin, removes impurities, and delivers a customizable serum to the skin's surface (SkinMedica ® Pro-Infusion Serums) for a treatment tailored to patient-specific needs. ...
... 13,14 This technique is most often used for facial rejuvenation, since it can soften fine lines and wrinkles, decrease hyperpigmentation, and improve skin texture. [10][11][12] However, clinicians are now leveraging the effects of microdermabrasion by combining it with other procedures or products to optimize results and meet participants' expectations. In this study, we demonstrate that combining a proprietary diamond-tip microdermabrasion procedure with HA serums provides immediate and long-term improvements in overall skin appearance in individuals with signs of aging skin. ...
Purpose
There is growing interest in combining topical treatments with aesthetic procedures to combat signs of aging skin. This study aimed to assess the efficacy and tolerability of a novel cosmetic serum containing 5 different forms of HA (HA⁵ DG) when used via a proprietary diamond-tip microdermabrasion procedure (DG) to treat skin dryness, fine lines/wrinkles, rough texture, and dullness.
Patients and Methods
In this open-label, single-center study, participants received HA⁵ DG as part of a biweekly DG procedure on the face and neck for 12 weeks. Study participants also applied another take-home HA⁵ serum to the face twice daily at home, along with a basic skincare regimen. The efficacy of the combined treatment was measured by clinical quantification of multiple skin appearance features, analysis of bioinstrumental measurements, and digital photography.
Results
This study enrolled 27 participants, with an average age of 42.7 years and Fitzpatrick skin phototypes I–III (59.3%), IV (18.5%), and V–VI (22.2%), and 23 participants completed the study. The combined treatment had effects in fine lines/wrinkles, skin dryness, smoothness, radiance, firmness, and hydration 15 minutes post-DG. Furthermore, the significant improvements observed in dryness, fine lines/wrinkles, skin smoothness, and radiance were still visible 3 days after and maintained at week 12. Additionally, smoothing of coarse lines/wrinkles, improvement of skin tone evenness, hyperpigmentation, photodamage, and transepidermal water loss were observed at week 12. The treatment had a favorable tolerability profile and was perceived as efficacious and highly satisfactory.
Conclusion
This novel combined treatment delivered immediate and prolonged skin hydration and high participant satisfaction, proving it can be an excellent approach for skin rejuvenation.
... However, outflow pressures and vacuum suction may need to be decreased over areas of thin skin to avoid injury. 17 Microdermabrasion therapy has been advocated for treatment of photoaging (i.e., wrinkles, dyspigmentation), acne, acne scars, and striae distensae. 17 Multiple authors have investigated the clinical effects of microdermabrasion on skin contour irregularities. ...
... 17 Microdermabrasion therapy has been advocated for treatment of photoaging (i.e., wrinkles, dyspigmentation), acne, acne scars, and striae distensae. 17 Multiple authors have investigated the clinical effects of microdermabrasion on skin contour irregularities. Early studies demonstrated the clinical benefit of subjecting acne scars to aggressive microdermabrasion treatments. ...
... Early studies demonstrated the clinical benefit of subjecting acne scars to aggressive microdermabrasion treatments. 17 Coimbra et al found that patients receiving weekly microdermabrasion treatments for a total of eight treatments reported subjective improvement in rhytides, though plastic surgery-associated observers did not note this improvement. 16 Another study demonstrated a significant improvement in fine wrinkles and overall skin texture, tone, and appearance after weekly microdermabrasion for a total of six treatments. ...
A proper knowledge of noninvasive facial rejuvenation is integral to the practice of a cosmetic surgeon. Noninvasive facial rejuvenation can be divided into patient- versus physician-directed modalities. Patient-directed facial rejuvenation combines the use of facial products such as sunscreen, moisturizers, retinoids, α-hydroxy acids, and various antioxidants to both maintain youthful skin and rejuvenate damaged skin. Physicians may recommend and often prescribe certain products, but patients are in control with this type of facial rejuvenation. On the other hand, physician-directed facial rejuvenation entails modalities that require direct physician involvement, such as neuromodulators, filler injections, laser resurfacing, microdermabrasion, and chemical peels. With the successful integration of each of these modalities, a complete facial regimen can be established and patient satisfaction can be maximized. This article is the last in a three-part series describing noninvasive facial rejuvenation. Here the authors review the mechanism, indications, and possible complications of lasers, chemical peels, and other commonly used noninvasive modalities.
... Innovative dressings play a key role in contemporary wound care by providing a favorable environment for optimal healing. Hydrocolloid dressings, foam dressings, and hydrogels are some of the most commonly used modern dressings, offering benefits such as moisture retention, exudate management, and maintaining a moist wound environment conducive to healing [72]. Additionally, antimicrobial dressings containing silver or iodine have been shown to be effective in reducing bacterial load and preventing wound infection, thereby promoting wound healing [73]. ...
... Oral contraceptives, antiandrogens, and insulin-sensitizing agents such as spironolactone, cyproterone acetate, and metformin are commonly used to suppress androgen levels and reduce hirsutism [71]. Laser hair removal and electrolysis offer effective long-term solutions to reduce unwanted hair growth, complementing drug therapy in the treatment of hirsutism [72]. ...
In recent years, the field of dermatology has seen significant advances in our understanding of disease pathogenesis, diagnostic techniques, and therapeutic interventions. The objective of this literature review is to provide an overview of ten key subtopics in contemporary dermatology research. First, I examined cutting-edge developments in skin cancer detection and treatment, acne and psoriasis management strategies, and the evolving therapeutic landscape for atopic dermatitis. Additionally, we delve into the clinical significance of skin manifestations associated with systemic diseases and analyze emerging trends in cosmetic dermatology. Further on, we discuss innovations in wound healing, diagnosis and treatment of hair disorders, and dermatological conditions unique to pediatric patients. Finally, we explore the role of telemedicine in dermatology practice, highlighting its potential to revolutionize patient care and access to specialty services. Through a synthesis of the current literature, this review offers insight into forefront dermatology research and emphasizes the importance of continued innovation to improve patient outcomes and quality of care.
... [3][4][5] During microdermabrasion procedures, an abrasive component is propelled on the skin's surface with a simultaneous vacuum to remove debris, causing exfoliation and disruption of the stratum corneum. 6 This triggers a cascade of molecular changes that promote dermal and epidermal remodeling, which are thought to lead to the improvements observed in the appearance of aged or damaged skin after microdermabrasion. 7,8 The procedure is non-invasive, well-tolerated, and has no associated downtime, making it a popular choice for skin rejuvenation. ...
... Week 12 Week 6 attributed to dermal remodeling and increased collagen deposition that occurs over time. 6,7 Consistent with this hypothesis, there was a significant and lasting improvement in both periocular and perioral fine lines by week 12. Continued bi-weekly DG treatments accompanied by the targeted take-home product regimens also provided significant long-term improvements in skin dryness, roughness, and radiance. Benefits on overall hyperpigmentation and skin tone unevenness were seen starting in week 4. ...
Purpose
An in-office diamond tip microdermabrasion device (DG) was designed to simultaneously exfoliate, extract, and infuse topical cosmetic serums into the skin to improve its appearance. Combining in-office procedures with take-home skincare may enhance treatment outcomes. This study aimed to assess the efficacy of a novel combination of DG treatments with a take-home cosmetic skincare regimen (DGR) to address facial dryness, hyperpigmentation, photodamage, or acne-prone/oily skin.
Patients and Methods
In this 12-week, open-label, single-center study, participants were assigned to 1 of 4 groups according to skin presentation: dry, hyperpigmented, photodamaged, or acne-prone/oily. All participants received 6 bi-weekly DG treatments with tailored DGR topical products. During the DG treatment, the dry, hyperpigmented, photodamaged, and acne-prone/oily groups received hydrating, brightening, antioxidant, and pore-clarifying serums, respectively. Study endpoints included investigator grading, standardized photography, and participant questionnaires.
Results
Sixteen participants aged 22 to 70 years with Fitzpatrick Skin Types I–V completed the study. Immediately after the first DG treatment, significant improvements in dryness, radiance, texture, photodamage, and fine lines were achieved (P<0.01). At 72 hours, significant improvements were maintained in all these parameters except fine lines (P<0.05). The DG and DGR combination provided significant long-term improvements at week 12 compared to baseline for dryness, radiance, texture, hyperpigmentation, photodamage, skin tone unevenness, and periocular/perioral fine lines (P<0.05).
Conclusion
The combination of DG and DGR showed significant immediate and long-term improvements in skin appearance. These results show that the DG and DGR combination is a well-tolerated and effective intervention to enhance different aspects of facial skin quality.
... It is a safe and well-tolerated method, making it popular in dermatological practice. The effects of the procedure are typically visible after several sessions, and the risk of adverse effects is minimal (18) (19). ...
Acne vulgaris is a chronic skin condition affecting millions of people, especially adolescents. This study analyzes the effectiveness of various acne treatment methods, including pharmacological, procedural, and natural therapies. It compares their mechanisms of action, therapeutic effects, and potential side effects. The aim of this study is to identify the most effective therapeutic strategies to improve patients’ quality of life and mental health. The analysis results suggest that a comprehensive approach to acne treatment, combining different methods, may yield the best outcomes.
... Microdermabrasion is a non-chemical procedure that superficially resurfaces the skin by removing the stratum corneum [123]. This technique utilizes a vacuum system to propel abrasive crystals against the skin, which gently exfoliates the surface, aiding in dermal remodeling [124]. ...
In this narrative review, we sought to provide a comprehensive overview of the mechanisms underlying cutaneous senescence, framed by the twelve traditional hallmarks of aging. These include genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, impaired macroautophagy, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, altered intercellular communication, chronic inflammation, and dysbiosis. We also examined how topical interventions targeting these hallmarks can be integrated with conventional aesthetic medicine techniques to enhance skin rejuvenation. The potential of combining targeted topical therapies against the aging hallmarks with minimally invasive procedures represents a significant advancement in aesthetic medicine, offering personalized and effective strategies to combat skin aging. The reviewed evidence paves the way for future advancements and underscores the transformative potential of integrating scientifically validated interventions targeted against aging hallmarks into traditional aesthetic practices.
... There are alternative treatments for photoaging besides chemical peels: Retinoids, which are topical creams or gels that contain vitamin A derivatives, which help reduce the appearance of fine lines, wrinkles, and other signs of aging [20]; Microneedling, which uses a small, handheld device to create tiny punctures in the skin, stimulate collagen production, and promote skin rejuvenation [21]; Light therapy, also known as phototherapy, which uses different wavelengths of light to target specific skin concerns, such as fine lines and wrinkles [22]; www.jcosmetmed.org Laser resurfacing: which uses a laser to remove damaged skin cells and stimulate the growth of new skin cells [23]; last but not least, microdermabrasion, which is a non-invasive procedure that uses a special device to exfoliate the top layer of skin, revealing fresher, younger-looking skin [24]. It is important to note that the effectiveness of these treatments may vary depending on the severity of the photoaging and individual skin type. ...
... The proposed method of directional-hemispherical reflectance can be used not only to assess the effectiveness of microdermabrasion treatment, but also to examine other procedures and products intended to affect the smoothness of the epidermis [18]. ...
Diamond microdermabrasion is one of the most popular cosmetological treatments in the field of mechanical, controlled abrasion of the stratum corneum corneocytes. In this study, the influence of micropeeling on the optical properties of the skin features was investigated. The directional reflectance of the skin was measured before and after the procedure. The study involved 15 women aged 23–26. The tests were performed on the surface of the skin in 15 spots—on the forearms, arms and lower legs. Post-treatment reflectance increased significantly in the wavelength range of 700–2500 nm. In the remaining ranges it also increased, except for the range 480–600 nm, in which it decreased, but insignificantly. It was found that the optical properties of the skin after microdermabrasion changed, the directional reflectance of the skin increased, especially in the infrared range. The main conclusion from the conducted research is that the directional-hemispherical reflectance method can be used to identify female skin features in response of microdermabrasion treatment.
... However, it has been proven to effectively 46-year-old Fitzpatrick II Italianportuguese female seeking perioral rejuvenation before (left) and after (right) a combination of daily skincare regimen (topical retinoid, vitamin C, and hydroquinone), hyaluronic acid filler to treat the upper lip rhytids, IPL for three sessions, microneedling to a 2 mm depth increase transdermal delivery of active skincare ingredients when these modalities are combined. The main advantage of microdermabrasion is that, unlike lasers and chemical peels, it is safe in most patients including patients with higher Fitzpatrick types or who are otherwise at higher risk of pigmentary changes or scarring [27] . ...
As the demand for noninvasive facial rejuvenation continues to grow, it is imperative that plastic surgeons maintain a mastery of nonsurgical techniques for restoring a youthful facial appearance. In this article, noninvasive interventions for skin resurfacing, tissue tightening, rhytid reduction and volume restoration are discussed with an emphasis on technical outcomes and potential complications. Overall, this review should serve as a primer for the aesthetic plastic surgeon who aims to offer safe, effective facial rejuvenation to patients who desire maximal results with minimal downtime.
... Interestingly, recent studies have discovered good, alternative ways to increase transcutaneous delivery-by using amphiphilic cell penetration peptides (CPP) [374][375][376], attaching a polyarginine chain to a peptide [377][378][379][380], or designing hyaluronic acid (HA) conjugates [379,381]-thus improving peptides' bioactivity and bioavailability [331]. In recent years, other approaches for the transdermal delivery of peptides are gaining popularity, including iontophoresis-which uses small electric currents to enable the passage of charged peptides through the skin-and microdermabrasion, a method that removes some of the layers of the SC in order to improve the absorption of topical peptides, suitable for fine lines and wrinkles [336,355,370,[382][383][384][385]. ...
The “modern” cosmetology industry is focusing on research devoted to discovering novel neurocosmetic functional ingredients that could improve the interactions between the skin and the nervous system. Many cosmetic companies have started to formulate neurocosmetic products that exhibit their activity on the cutaneous nervous system by affecting the skin’s neuromediators through different mechanisms of action. This review aims to clarify the definition of neurocosmetics, and to describe the features of some functional ingredients and products available on the market, with a look at the regulatory aspect. The attention is devoted to neurocosmetic ingredients for combating skin stress, explaining the stress pathways, which are also correlated with skin aging. “Neuro-relaxing” anti-aging ingredients derived from plant extracts and neurocosmetic strategies to combat inflammatory responses related to skin stress are presented. Afterwards, the molecular basis of sensitive skin and the suitable neurocosmetic ingredients to improve this problem are discussed. With the aim of presenting the major application of Botox-like ingredients as the first neurocosmetics on the market, skin aging is also introduced, and its theory is presented. To confirm the efficacy of the cosmetic products on the market, the concept of cosmetic claims is discussed.
... Although many methods have been used to treat striae, such as laser treatment [6,7], intense pulsed light, micro-dermabrasion [8], and some topical cream regimens [9], there is still no established technique for preventing or treating this problem. ...
... Those evolutions may enhance the efficacy of PDT [132]. [116]. ...
Photodynamic therapy (PDT) induced by protoporphyrin IX (PpIX) has been widely used in dermatological practices such as treatment of skin cancers. Clearance rate depends on different factors such as light irradiation, skin oxygenation and drug penetration. The poor penetration of 5-aminolevulinic acid (5-ALA) with topical application is limited and restrains the production of PpIX which could restrict PDT outcomes. This review will focus on techniques already used to enhance drug penetration in human skin, and will present their results, advantages, and drawbacks. Chemical and physical pretreatments will be discussed. Chemical pre-treatments comprise of drug formulation modification, use of agents that modify the heme cycle, enhance PpIX formation, and the combination of differentiation-promoting agent prior to PDT. On the other hand, physical pretreatments affect the skin barrier by creating holes in the skin or by removing stratum corneum. To promote drug penetration, iontophoresis and temperature modulation are interesting alternative methods. Cellular mechanisms enrolled during chemical or physical pretreatments have been investigated in order to understand how 5-ALA penetrates the skin, why it is preferentially metabolized in PpIX in tumour cells, and how it could be accumulated in deeper skin layers. The objective of this review is to compare clinical trials that use innovative technology to conventional PDT treatment. Most of these pretreatments present good or even better clinical outcomes than usual PDT.
... 10 Several pretreatment techniques are thus in clinical use, including ablative fractional laser (AFL), which generates microscopic laser channels through the skin, and microdermabrasion (MD), which provides gross skin resurfacing via inert particles. 16,17 In a recent study of normal skin, we compared PpIX accumulation after a range of standardized pretreatments, finding significantly higher median intracutaneous PpIX fluorescence intensities after AFL [8661 arbitrary units (AU)] compared with alternative physical modalities such as MD (6731 AU), microneedling (5609 AU) and curettage (4765 AU). 18 However, the association between PpIX accumulation and AK treatment efficacy is not definitively established, and simply increasing PpIX by physical skin pretreatment may not alone explain improved dPDT efficacy in diseased skin. ...
Background
Physical pretreatments can potentiate efficacy of daylight photodynamic therapy (dPDT), but clinical comparative studies remain limited.
Objectives
Performed in large skin areas with actinic keratoses (AK) and photodamage, this blinded, randomized clinical trial compares efficacy and safety of dPDT after tailored skin pretreatment using ablative fractional laser (AFL) or microdermabrasion (MD).
Methods
Two ≥50 cm² side‐by‐side areas were randomized to receive a single treatment with AFL‐dPDT or MD‐dPDT. Pretreatment parameters were tailored according to AK grade and skin constitution to ensure standardized immediate endpoints. Subsequently, methyl aminolevulinate was applied, followed by 2‐hour daylight exposure. Primary outcome comprised blinded assessment of AK clearance at three months follow‐up.
Results
In 18 patients with 832 AKs, AFL‐dPDT provided significantly higher AK‐clearance (81% vs 60%, p<0.001), led to fewer new AKs (p<0.001), and showed superior improvement in dyspigmentation (p=0.003) and skin texture (p=0.001) versus MD‐dPDT. Peaking at days 3‐6, AFL‐PDT induced more intensified local skin responses (p=0.004), including instances of s. aureus infection (n=3). Patients nonetheless preferred AFL‐dPDT (p=0.077), due to lower pretreatment‐related pain (p=0.002), superior cosmesis (p≤0.035), and efficacy compared to MD‐dPDT.
Conclusions
AFL‐dPDT is an effective treatment for AK patients with extensive field‐cancerization, though AFL‐pretreatment is associated with intensified local skin reactions.
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... Some of these modalities may be helpful to treat acne scarring as well. These treatments include comedo extraction (Meredith and Ormerod, 2013;Zaenglein et al., 2016), cryotherapy (Fox et al., 2016), electrocauterization (Fox et al., 2016), chemical peels (Dreno et al., 2011;Grover and Reddu, 2003;Ilknur et al., 2010;Kempiak and Uebelhoer, 2008;Levesque et al., 2011;Meredith and Ormerod, 2013;Ramos-e-Silva et al., 2015;Zaenglein et al., 2016; including glycolic acid Atzori et al., 1999;Grover and Reddu, 2003;Ilknur et al., 2010, SA Levesque et al., 2011, and retinoic acid Ramos-e-Silva et al., 2015, microdermabrasion (Karimipour et al., 2010;Kempiak and Uebelhoer, 2008;Lloyd, 2001;Ramos-e-Silva et al., 2015;Tan et al., 2001), laser treatment including pulsed dye, potassium titanyl phosphate, fractionated CO 2, fractionated and nonfractionated infrared, radiofrequency, and intense pulsed light), photodynamic therapy (Barbaric et al., 2016;Gold et al., 2004;Kong and Tey, 2013;Ma et al., 2013;Nast et al., 2012;Pollock et al., 2004;Ross, 2005;Sakamoto et al., 2010;Wang et al., 2010;Zaenglein et al., 2016 including blue-violet light phototherapy and red light phototherapy), narrow-band ultraviolet B phototherapy (Meredith and Ormerod, 2013;Ross, 2005;Zeichner, 2011), intralesional triamcinolone acetonide (Levine and Rasmussen, 1983;Potter, 1971), surgical techniques (Jacob et al., 2001;Ramos-e-Silva et al., 2015;Sanchez Viera, 2015 including punch excision and subcision), and filler (Jacob et al., 2001;Sanchez Viera, 2015). ...
This review focuses on the treatment options for adult female patients with acne. Acne in adult female patients may start during adolescence and persist or have an onset in adulthood. Acne has various psychosocial effects that impact patients' quality of life. Treatment of acne in adult women specifically has its challenges due to the considerations of patient preferences, pregnancy, and lactation. Treatments vary widely and treatment should be tailored specifically for each individual woman. We review conventional therapies with high levels of evidence, additional treatments with support from cohort studies and case reports, complementary and/or alternative therapies, and new agents under development for the treatment of patients with acne.
... Microdermabrasion uses physical agents, typically aluminum oxide, for skin resurfacing. 88 This injury incites neocollagenesis and deposition of elastin, 89 and also disrupting and allowing adjuvant topical therapies to penetrate the dermis more effectively. This review found 2 randomized comparative trials and 2 case series on microdermabrasion. ...
Background:
Striae distensae (SD) are aesthetically troublesome to patients and therapeutically challenging.
Objective:
Herein, the authors comprehensively review the literature pertaining to the history, pathogenesis, clinical presentation, clinical rating scales, and laboratory, imaging, and histologic features of SD.
Methods and materials:
A review of PubMed, MEDLINE, Scopus, Embase, and Google scholar was conducted, including literature published from 1773 to August 6, 2016.
Results:
The authors identified 68 articles that met inclusion and exclusion criteria.
Conclusion:
There are few randomized controlled trials evaluating the long-term efficacy and safety of various topical and energy-based devices. Based on clinical and anecdotal experience, both nonablative and ablative fractionated lasers have shown modest SD improvement compared with other treatment modalities (including Excimer laser, CuBr laser, pulsed dye laser, and 1,064-nm Nd:YAG laser). In the authors' experience, 1,540-nm nonablative fractionated laser is a worthy first-line modality for the treatment of SD. Future researchers may consider greater focus on enhanced study design, including larger, long-term split-body, or split-SD head-to-head randomized comparative trials with objective outcome measures and end points, such as biopsy and molecular studies demonstrating increased collagen and elastic fibers that correlate to clinical improvement.
... By using microdermabrasion on the skin, topical therapeutics can be applied at the conclusion of the treatment, which will reach levels much deeper than when typically applied to the surface of the skin, as the skin barrier function of the stratum corneum is temporarily compromised [18]. Therefore, slightly greater improvements in the histological features of photoaging can be achieved with the combination of microdermabrasion followed by a 5% retinoic acid chemical peel versus a 5% retinoic acid chemical peel administered alone [10]. ...
Background . Tretinoin has been shown to improve photoaged skin. This study was designed to evaluate the efficacy and tolerability of a 5% retinoic acid peel combined with microdermabrasion for facial photoaging. Materials and Methods . Forty-five patients, aged 35–70, affected by moderate-to-severe photodamage were enrolled in this trial. All patients received 3 sessions of full facial microdermabrasion and 3 sessions of either 5% retinoic acid peel or placebo after the microdermabrasion. Efficacy was measured using the Glogau scale. Patients were assessed at 2 weeks and 1, 2, and 6 months after treatment initiation. Results . The mean ± SD age of participants was 49.55±11.61 years, and the majorities (73.3%) were female. Between 1 month and 2 months, participants reported slight but statistically significant improvements for all parameters ( P<0.001 ). In terms of adverse effects, there were statistically significant differences reported between the 5% retinoic acid peel groups and the control group ( P<0.001 ). The majority of adverse effects reported in the study were described as mild and transient. Conclusion . This study demonstrated that 5% retinoic acid peel cream combined with microdermabrasion was safe and effective in the treatment of photoaging in the Iranian population. This trial is registered with IRCT2015121112782N8 .
... Unlike other resurfacing procedures, dermabrasion can be performed on all skin types to address photodamage, superficial rhytides, hyperpigmentation and/or scarring. [39,42,43] Surgical dermabrasion usually involves the use of a power-driven rotating diamond rasp where the skin is pared mechanically. Depth is determined by the operator and can vary from superficial epidermal to deep reticular dermal. ...
Vitamin A-containing products have been used topically since the early 1940s to treat various skin conditions. To date, there are four generations of retinoids, a family of Vitamin A-containing compounds. Tretinoin, all-trans-retinoic acid, is a first-generation, naturally occurring, retinoid. It is available, commercially, as a gel or cream. The authors conducted a complete review of all studies, clinical- and basic science-based studies, within the literature involving tretinoin treatment recommendations for impending facial procedures. The literature currently lacks definitive recommendations for the use of tretinoin-containing products prior to undergoing facial procedures. Tretinoin pretreatment regimens vary greatly in terms of the strength of retinoid used, the length of the pre-procedure treatment, and the ideal time to stop treatment before the procedure. Based on the current literature and personal experience, the authors set forth a set of guidelines for the use of tretinoin prior to various facial procedures.
... Microdermabrasion is a minimally invasive procedure that involves varying degrees of controlled abrasion of the skin to treat a variety of conditions. Although microdermabrasion is generally not used to treat acne vulgaris, it is a commonly employed technique for treating acne scars and can produce mild to moderate improvement in skin contour irregularities [148]. ...
Acne is a very common non-infectious skin condition that is frequently treated in dermatological practices. Because acne is often chronic and may persist for years, safe and effective long-term maintenance therapy is often required. Given the increasing frequency of antibiotic-resistant bacteria and the gravity of the consequences of this trend, it behooves dermatologists to maximize use of non-antimicrobial therapy when treating acne. In this review of the literature we present data regarding the efficacy and appropriate use of non-antimicrobial treatments for acne. A variety of topical and oral treatment options exist that can be used in a step-wise manner according to the patients' severity and therapeutic response. Non-antimicrobial treatments can be highly efficacious at controlling acne, especially when used as maintenance therapy. While antibiotics have a role in acne treatment, they should not be used as monotherapy, and lengthy courses of antibiotic use are discouraged.
... To a certain extent the high efficacy of the chemabrasion may result from a relatively long time of the single treatment (20 minutes), compared to the combined technique (10 minutes). However, this rank of efficacy predominantly results from the fact that, depending on the degree of pressure reduction, treatment time and the size of corundum particles, microdermabrasion may strongly reduce the epidermal barrier [31]. While these changes may bring some clinical improvement and may reduce keratosis pilaris, they may also too much accelerate the penetration of LA (or other active ingredients) through the skin [28]. ...
... Poprawa następuje nie tylko w zakresie naskórka, który pozbawiony martwych warstw odzyskuje gładkość powierzchni, ale również w skórze właściwej. Zastosowanie głowic o grubszej ziarnistości doprowadza do aktywacji markerów procesu zapalnego, co powoduje zwiększenie stężenia cytokin prozapalnych oraz czynników transkrypcyjnych, a co się z tym -wiąże regenerację skóry, taką jak w procesie gojenia [25]. Na rynku dostępne są [26,27]. ...
[Prevention and ways to remove pigmentation spots - review of available methods]
Pigmentation spots are cosmetic defect that appears as a result of an increased amount of melanin and melanocytes (pigmentation cells) in epidermis. They occur most often in women over 50 years of age. The chemical and
mechanical peels, besides pharmacological treatments and light therapy, are often used in beauty parlors as well as dermatological and aesthetic medicine clinics to reduce pigmentation spots. Chemical peels treatments
are carried out with highly concentrated exfoliating acids, such as glycolic acid that is the most active fruit acid. Among all types of mechanical peels, microdermabrasion is the most frequently used treatment causing exfoliation and rebuilding new tissues that results in smooth and brighten the skin. Other therapies are cryotherapy, IPL, pulsed dye laser, ruby Q-switch laser and Nd-Yag Q-swich. It should be also remembered that solar filters are the first line of prevention against pigmented spots.
Facial rejuvenation through chemical peeling is a frequently requested skin rejuvenation treatment. Chemical peels are classified as superficial, medium, or deep, and their effect depends upon the depth of penetration and degree of injury to the skin. Superficial chemical peels are popular treatments commonly used to address rough skin texture, fine lines, melasma, and photodamage. Superficial chemical peels penetrate to the epidermis and dermal-epidermal junction and provide temporary improvement to skin texture and hyperpigmentation. These chemical peeling agents carry less risk of complications than the medium and deep chemical peeling agents.
Medium and deep chemical peeling agents exert their effects beneath the epidermis and into the deeper layers of the skin. Medium-depth peels penetrate to or through the papillary dermis and result in longer healing times. Deep chemical peels penetrate to the reticular dermis and address deeper lines and wrinkles. Both medium and deep peels require longer healing times and carry an increased risk for complications such as hyperpigmentation and scarring.
Microdermabrasion is a popular, noninvasive treatment provided by aestheticians, nurses, nurse practitioners, and other licensed professionals using a closed, controlled system that removes surface debris and dead skin cells from the top layer of the skin. It is used to treat rough skin, discoloration, and mild sun damage and provides regeneration of the epidermis, increased blood flow to the skin, and stimulation of collagen. Patients frequently request this treatment before celebrations or events and report their skin feels smoother and their makeup is easier to apply. The procedure is done with an instrument that resembles a wand with a mildly abrasive tip attached to a small, flexible tube that is connected to a vacuum. It gently scrapes the skin as the vacuum removes the debris and deposits it into a waste compartment attached to the machine.
Microdermabrasion can be confused with an invasive procedure, called dermabrasion, which is performed by a surgeon. Dermabrasion is a surgical procedure that requires anesthesia. The surgeon scrapes off the upper layers of skin and the procedure is followed by a recovery period. Dermabrasion is a procedure used to resurface the skin, smooth scars, and diminish wrinkles, whereas microdermabrasion is a treatment for the superficial removal of debris from the skin.
For dermatologists, diversities of human races result in an opportunity to encounter patients with various skin types. Cosmetic procedures have gained more popularity and become more accessible over the past decades. Thus, the selection of appropriate treatment protocol for each patient becomes inevitable. This review will focus on basic knowledge and key points in performing safe cosmetic-related procedures in patients with dark-complexioned skin. In terms of structure and function of the skin, people of color have equal epidermal thickness, corneocyte size and melanocyte number. However, they have more stratum corneum compaction, melanosome dispersion and melanocyte activity than fair skin individuals. Data regarding drug penetration and cutaneous irritation showed conflicting results. Superficial chemical peels and microdermabrasion can be done safely in dark-skinned patients. Medium-depth peel should be used with extreme caution. While deep-depth peel should be avoided at all times due to pigmentary and textural complications. Prolonged treatment interval, use of priming agents and sun protection are recommended. Injectable materials including botulinum toxin and soft tissue augmentation by hyaluronic acid filler can be done harmlessly in dark-skinned patients. Lasers and energy-based devices should be done with caution. Higher melanin dispersion and melanocyte activity acts as competitive chromophore. Pigmentary or textural changes can occur after aggressive treatment protocol. High energy setting, pulse stacking, short wavelength lasers and short treatment interval should be avoided in dark-skinned patients.
Atrophic scars are a complex problem, covering a huge number of patients with striae gravidarum, acne, atrophic surgical scars, and striae due to hypercortisolism and other metabolic disorders. Taking into account patients’ social status (pregnant women, adolescents, people with chronic hormonal disorders), our goal was to systematize the literature data on the least invasive treatment modality – atrophic scar therapy with inorganic gels – to identify new chemical classes with potential anti-scar activity. When summarizing research data over the past 10 years, it was found that the effect of anti-scar therapy depends on the atrophic scar color – hyper- or hypopigmented, its type – wedge-shaped, scaphoid, or rectangular, its origin – post-acne, cicatricial alopecia, infectious scars, stretch marks, or post-traumatic atrophic. The stage of pathogenesis also plays a significant role: aseptic inflammation, infiltration of hematogenous differential cells, mast cell degranulation, release of bioactive substances and changes in the VEGF, TGF-β1, EGF, FGF, PDGF growth factors, migration of activated macrophages, damage to elastic and collagen fibers, perivascular lymphocytic infiltration, impaired hemorheology, chronic inflammatory process, increased number of senescent fibroblasts, decreased synthetic activity of atrophic scar cells, decreased cellularity and vascularization of the atrophic scar area. In case of high bioinertness of inorganic gels, the anti-scar effect is achieved due to the exfoliating effect, epidermal-mesenchymal interactions, and the impact of the mesoporous gel structure on scar hydration. In addition to the well-known silicone gel, sol-gels based on aluminum dioxide have similar properties, which makes it possible to consider sol-gel as an alternative to silicone gel.
Background:
The popularity of social media appears to be increasing the acceptance of cosmetic treatments, prompting more consumers to seek cosmetic treatments. As the estimated prevalence of acne vulgaris among adult women may be as high as 54%, acne is commonly observed among patients presenting for cosmetic treatments. Concomitant treatment of acne in the aesthetic patient population will improve overall clinical outcomes.
Aims:
The goal of this work was to deliver a high-quality ethical and evidence-based educational program to physicians and adjunctive health care providers to advance patient care.
Methods:
This paper is based on a webcam presentation with roundtable discussion by several notable experts in their field.
Results:
A range of topical medications, injectable products, chemical peels, and energy-based devices are available for treating acne vulgaris. In most instances, these are compatible with rejuvenation procedures in the aesthetic patient.
Conclusion:
The growth of social media is raising awareness of aesthetic procedures and appears to be increasing the number of patients seeking aesthetic treatment. Educating patients about the importance of treating acne vulgaris can improve overall treatment outcomes. In most instances, the presence of acne is not a barrier to aesthetic care.
Nonsurgical facial rejuvenation is becoming more popular with patients in recent years, as the technological and procedural advancements in the medical field allow for improved results with minimal side effects. The increased safety and short recovery time allow for these patients to achieve their desired results without incurring risks of invasive surgical augmentation. Today, there are many available treatments designed to target the hairline, facial contour, wrinkles, and volume replacement, most of which are relatively quick outpatient procedures. This chapter will discuss the current available nonsurgical modalities for facial rejuvenation, including hairline augmentation, skin treatments, injectable fillers, and neuromodulators.KeywordsNonsurgical facial rejuvenationAdvancements in nonsurgical facial aestheticsPharmaceutical approaches to hairline rejuvenationAdvancements in nonsurgical hairline rejuvenationTopical therapies for aesthetic skin rejuvenationThreadlifting for nonsurgical skin liftingAnatomy of the hair follicleAnatomy and physiology of the facial tissuesInjectable therapy and facial rejuvenationPsychological assessment of aesthetic surgery candidates
In this report the use of eye cosmetic products and procedures and how this represents a lifestyle challenge that may exacerbate or promote the development of ocular surface and adnexal disease is discussed. Multiple aspects of eye cosmetics are addressed, including their history and market value, psychological and social impacts, possible problems associated with cosmetic ingredients, products, and procedures, and regulations for eye cosmetic use. In addition, a systematic review that critically appraises randomized controlled trial evidence concerning the ocular effects of eyelash growth products is included. The findings of this systematic review highlight the evidence gaps and indicate future directions for research to focus on ocular surface outcomes associated with eyelash growth products.
Beauty and youth are the most critical and challenging issues in medicine and beauty science, and humans always seek to find a new method for the elixir of youth. Innovative technologies based on physical principles have also been presented in recent years. In the meantime, cold plasma technology, which previously showed exciting results in the skin, is currently being investigated due to its remarkable ability to treat diseases and skin care. This study used the FEDBD plasma device for skin rejuvenation in animal samples. There were two groups of six male Wistar rats. One group was treated with plasma with a power of 3.3 W, and the second group was considered the control group for a better comparison. Plasma processing was done on the back of the neck of mice with an area of 18 square centimeters. So far, complete quantitative measurement has not been done, and few studies have been done. Before starting the treatment, immediately after the treatment, the fourth week, and the tenth week of follow-up, biometric tests were performed, including moisture level, evaporation from the skin surface, erythema and melanin, skin elasticity and firmness with an MPA9 device and cutometer. The thickness and density of the epidermis and dermis, an essential indicator in rejuvenation, were evaluated with a skin ultrasound device. Also, the level of oxygen, perfusion, and interstitial water (edema) was checked using a Tivita tissue hyperspectral camera at a depth of 6 mm of the skin. Active species produced by plasma, plasma temperature, and device power were investigated and recorded using physical tests.
Eve Casha explores five popular skin treatments and reveals the potentially detrimental long-lasting effects of each
The pathogenesis of striae distensae (SD) is complicated and has not yet been fully elucidated. Hormonal changes, overstretched skin, and structural and functional changes in the skin may be crucial factors in the development of SD. Therapy aims to stimulate dermal collagen synthesis and improve skin texture. Mainstream treatments include topical medications, chemical peeling, laser and radiofrequency therapy, microdermabrasion, microneedle therapy, and filler injection therapy. In the present review, we summarize current perspectives on the pathogenesis and clinical therapy of SD.
Striae distensae, or stretch marks, are common linear lesions of atrophic skin characterized histologically by epidermal atrophy, absent rete ridges, and alterations in connective tissue architecture. Hormonal excess, mechanical stress, and genetic predisposition are all associated with striae distensae, but their exact pathogenesis remains unknown. Despite a multitude of options, no single treatment has yet proven effective. In this article, the authors describe an up-to-date overview of striae distensae in terms of their etiology, pathophysiology, and therapeutic options. Further research is required to better elucidate their pathophysiology and to develop targeted effective treatments.
Nonsurgical facelifts are a term for a heterogeneous group of procedures used by physicians to improve facial rejuvenation without the use of operative techniques. Patients demand these services due to the reduced recovery time and generally lower risk. However, nonsurgical techniques, to be effective, must induce conformational change in the cells and tissues of the face. Therefore, these techniques are significant procedures that have associated risks. Understanding the tissue modifications and mechanisms of action of these techniques is vital to their safe and effective use. The purpose of this article is to provide a background of tissue modification in nonsurgical facelift options.
Background
Non‐energy based devices used in aesthetic medicine include treatments such as microdermabrasion, microneedling, threads, and chemical peels. Practitioners may use these devices to address signs of facial photo‐ and chronological aging (fine lines, wrinkles, pigmentary, and skin textural changes). Currently, consensus papers or guidelines are lacking in peri‐procedural measures or their potential role in the prevention or treatment of adverse events in non‐energy based aesthetic procedures.
Aims
To explore current practices using non‐energy devices, a survey was developed to identify trends in peri‐procedure treatment measures.
Patients/Methods
The survey was sent electronically to 2000 dermatologists and 388 plastic surgeons. Randomly selected sites included those practicing medical aesthetics using non‐energy devices for facial rejuvenation. The survey gathered information related to practitioner demographics, types of devices used, and peri‐procedural measures for non‐energy device‐based treatments.
Results
The survey was active from February to May 2019. Nine hundred and twenty clinicians opened the survey, and 109 surveys were completed, providing a total response rate of 11.8%. The results revealed inconsistencies with regards to skin preparation strategies and post‐procedure care. While the majority of clinicians indicated a need for topical treatments to reduce inflammation, prevent scarring, and shorten time to healing, a standard of care was not observed.
Conclusions
The results of this survey confirm a lack of standardized measures for peri‐procedural care when using non‐energy based devices for aesthetic medicine treatments. These findings emphasize the need for evidence‐based recommendations for optimizing patient outcomes, reducing and managing adverse events, and shortening time to healing.
Facial rejuvenation through chemical peeling is a frequently requested skin rejuvenation treatment. Chemical peels are classified as superficial, medium, or deep and their effect depends upon the depth of penetration and degree of injury to the skin. Superficial chemical peels are popular treatments commonly used to address rough skin texture, fine lines, melasma, and photodamage. Superficial chemical peels penetrate to the epidermis and dermal–epidermal junction and provide temporary improvement to skin texture and hyperpigmentation. These chemical peeling agents carry less risk of complications than the medium and deep chemical peeling agents.
Microdermabrasion is a popular, noninvasive treatment provided by aestheticians, nurses, nurse practitioners, and other licensed professionals using a closed, controlled system that removes surface debris and dead skin cells from the top layer of skin. It is used to treat rough skin, discoloration, and mild sun damage and provides regeneration of the epidermis, increased blood flow to the skin, and stimulation of collagen. Patients frequently request this treatment before celebrations or events and report their skin feels smoother and their makeup is easier to apply. The procedure is done with an instrument that resembles a wand with a mildly abrasive tip attached to a small, flexible tube that is connected to a vacuum. It gently scrapes the skin as the vacuum removes the debris and deposits it into a waste compartment attached to the machine.
Superficial skin resurfacing is a process causing controlled injury to the epidermis. Processes can be chemical or mechanical and classified as laser or nonlaser. Although our armamentarium for skin resurfacing ranges from topical medicaments to ablative lasers, superficial skin resurfacing with chemical peels and microdermabrasion (MDA) has maintained its popularity. These well-established therapies have proven safe and effective, offer minimal risk, low cost, and are well-tolerated by patients often with little to no post-procedure downtime. Potential benefits extend to all Fitzpatrick skin types and if done appropriately are highly unlikely to cause significant dyspigmentation or scarring. Indications for treatment are acne vulgaris, rosacea, post-inflammatory hyperpigmentation, melasma, and photodamage including lentigines, fine rhytides, and actinic keratoses. Superficial resurfacing with chemical peels or MDA can be used in combination with other therapies (e.g., laser) and may enhance the efficacy of other topical treatments. A superficial depth of penetration may be of significant benefit to the patient but does have limitations. It is important for patients to understand the likely need for a series of treatments, the importance of pre- and post-care regimens, and expected outcomes.
This overview on skin delivery considers the evolution of the principles of percutaneous absorption and skin products from ancient times to today. Over the ages, it has been recognised that products may be applied to the skin for either local or systemic effects. Major changes have occurred in our understanding of the skin and the sophistication in our technology to effectively and quantitatively deliver solutes across this barrier to specific target sites in the skin and beyond. We focus on these technologies and their role in skin delivery now and in the future.
Objective: The aim of this study was to assess objectively the effects of the combination of corundum microdermabrasion and cavitation peeling in the therapy of seborrheic skin with visible symptoms of acne punctata.
Material and methods: The study involved a group of nine women. A series of six treatments with the combination of microdermabrasion and cavitation peeling were performed within facial skin at 10–14 days intervals. Corneometric measurements examining skin hydration level and sebumetric measurements analyzing skin sebum level were made before the series of treatments and after second, fourth and sixth procedure in five facial areas. Clinical assessment of the efficacy of the therapy was performed on the basis of photographic documentation (Fotomedicus). Anonymous questionnaires were used in order to evaluate patients’ satisfaction rate.
Results: Statistically significant improvement in skin sebum level was observed in all examined areas (forehead p = 0.002; nose p = 0.001, chin p = 0.01, left cheek p = 0.009, right cheek p = 0.007). In case of skin hydration, significant improvement was found only in the area of chin (p = 0.03). 78% of participants estimated that the improvement was in the range of 55–70%, while 22% of participants of 75–100%. The reduction in the amount and visibility of comedones and pimples were demonstrated on the basis of questionnaire and photographic documentation.
Conclusions: Combined microdermabrasion and cavitation peeling treatments improve the condition of seborrheic skin.
As we gain a greater understanding of acne pathogenesis, both new agents as well as new uses for established drugs are being considered for the treatment of acne vulgaris. Multiple clinical trials assessing new formulations or combinations of established acne treatments have been conducted, and novel uses of antimicrobials such as modified diallyl disulfide oxide and nitric oxide are being assessed in clinical trials. There are also a multitude of new therapies currently being studied that target the inflammatory cascade of acne pathogenesis, including sebosuppressive and anti-inflammatory phytochemicals, and small molecule inhibitors targeting sebaceous glands and enzymes, among others. Laser and light therapy is also being modified for the treatment of acne through combination methods with metal nanoshells and vacuum assistance. Probiotics have gained popularity in medicine as greater knowledge of the microbiome and its effects on multiple organ systems is being elucidated. Studies describing the positive effects of certain ammonia-oxidizing bacterial strains in the regulation of the skin's inflammatory response are ongoing. Therapies for acne are constantly evolving and current gold-standard acne therapy may be supplemented with novel treatment modalities in the near future.
Background Striae distensae is a challenging cosmetic problem for which various treatment modalities have been applied. The treatment of striae distensae has not been satisfactory. Objective To compare the therapeutic efficacy and tolerability of microneedling versus microdermabrasion in the treatment of striae distensae. Patients and methods Thirty patients with striae distensae were divided into the following groups: group I was treated with microneedling and group II was treated with microdermabrasion. Each patient received at least six sessions of treatment with a 2-week interval and followed up for 3 months. Skin biopsies were taken from some patients before treatment and after the end of the follow-up period to study the histopathological changes. Results In group I, 40% of patients showed excellent improvement, 26.7% showed marked improvement, 13.3% showed moderate improvement, and 20% showed minimal improvement. In group II, 20% of patients showed marked improvement, 26.7% showed moderate improvement, and 40% showed minimal improvement. There was a statistically significant improvement in group I than group II. There was a statistically significant improvement in patients with striae rubra than striae alba. Conclusion Microneedling was more effective but less tolerable than microdermabrasion in the treatment of striae distensae. Both microneedling and microdermabrasion were more effective for the treatment of striae rubrae than striae alba.
Microdermabrasion (MDA) is a safe, effective, and noninvasive skin rejuvenation tool that acts by mechanical exfoliation of the stratum corneum (Cosmetic dermatology, Berlin, 2005; Plast Reconstr Surg 113(5):1438–43, 2004; Plast Reconstr Surg 125(1):372–77, 2010; Aesthetic medicine, Berlin, 2011). Regeneration of this layer results in a more evenly textured skin surface (Cosmetic dermatology, Berlin, 2005; Plast Reconstr Surg 113(5):1438–43, 2004; Plast Reconstr Surg 125(1):372–77, 2010; Aesthetic medicine, Berlin, 2011). The basic unit is a dual-channel handpiece that blows micro-sized, sharp crystals (e.g., aluminum oxide, magnesium oxide, sodium chloride, etc.) onto the skin surface for superficial abrasion. In this closed-loop system, a second channel suctions the crystal particles along with skin debris (Plast Reconstr Surg 125(1):372–77, 2010). Several histological and molecular studies have confirmed a net overall thickening of the epidermal and dermal layers with increased alignment of collagen fibers in the latter attributed to the suction (Cosmetic dermatology, Berlin, 2005; Plast Reconstr Surg 113(5):1438–43, 2004; Aesthetic medicine, Berlin, 2011).
Acquired disorders of hyperpigmentation affect individuals of all skin types. However, pigmentary lesions may be more visible in skin of color and are often resistant to treatment. Dyschromias, in addition to acne, eczema, alopecia, and seborrheic dermatitis, are among the most common diagnoses in black patients seen by dermatologists. Etiology, diagnosis, treatment, and recommendations for melasma, postinflammatory hyperpigmentation, nevus of Ota/Ito, and periorbital hypermelanosis are reviewed.
Today's aesthetic clinics feature a vast range of non-surgical facial aesthetic procedures on their treatment menus. From laser and light modalities to chemical peels and platelet-rich plasma, there are several options for practitioners to endorse to improve the appearance of their patients' skin. Victoria Manning highlights the role of rejuvenating skin treatments in facial enhancement
Microdermabrasion is a popular technique for superficial resurfacing of the skin [1]. It involves the propulsion of abrasive microcrystals on to the treatment area in short strokes using a special handpiece. The handset simultaneously vacuums away the used abrasive particles and skin debris. The speed of the particles (and the vacuum suction) can be adjusted by the operator to control the volume of particles bombarding the skin. Other factors influencing the intensity of the treatment are the speed of movement of the handpiece and the number of times it is passed over the skin. An increased depth of microdermabrasion is achieved when the handpiece is moved slowly and repeatedly over a specific site [2]. Overall, the technique is considered to be minimally invasive with few complications [2]. Particle-free microdermabrasion units have become extremely popular. Such units utilize a disposable or reusable diamond wand to induce abrasion. Numerous microdermabrasion units are available globally.
This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects of interventions for established stretch marks.
Aluminium and silicon were found to be colocalised in the central region of senile plaque cores in studies with energy dispersive X-ray microanalysis. The distribution of these elements was similar in cores isolated from the cerebral cortex of patients with senile dementia of the Alzheimer type and in cores studied in situ from tissue sections from the cerebral cortex of presenile and senile patients with Alzheimer's disease, and elderly, mentally normal patients. High-resolution solid-state nuclear magnetic resonance techniques showed aluminium and silicon to be present as aluminosilicates. The presence of aluminosilicates at the centre of senile plaque cores contrasts with the distribution of other inorganic constituents and suggests that they may be involved in the initiation or early stages of senile plaque formation.
BACKGROUND Aluminum oxide crystal microdermabrasion, a newly developed technique, has the advantages of less bleeding, fewer complications, better compliance, and no need for local anesthesia or high surgical skill in comparison with traditional dermabrasion.
OBJECTIVE To demonstrate the effectiveness of this new technique in the treatment of facial scarring.
METHODS A total of 41 patients were treated by this technique during the past 2 years (July 1992 to June 1994).
RESULTS All patients treated had good to excellent clinical improvement with 9.10 mean treatment sessions.
CONCLUSION From our experience and results, we think aluminum oxide crystal microdermabrasion is a safe surgical procedure and will be a good supplement to traditional dermabrasion especially in this era of HIV infection.
Microdermabrasion is a widely performed skin rejuvenation procedure. Few studies have examined its efficacy.
To evaluate the clinical and histopathologic effects of microdermabrasion.
Fourteen patients underwent microdermabrasion treatments over 12-14 weeks. Self-rated questionnaires were given before and after the treatment series and were evaluated by a paired t-test. Three of the 14 patients were treated for moderate to severe acne scarring. Acute histologic effects were assessed ex vivo on human abdominal skin. Chronic histopathologic effects were examined in three volunteers who underwent skin biopsies before and after a treatment series on the dorsal forearms.
By patient assessment, there was statistically significant improvement in roughness, mottled pigmentation, and overall improvement of skin appearance, but not in rhytides. Acne scarring sometimes improved, but required deeper ablation. Acutely the stratum corneum was homogenized and focally compacted. Chronically there was epidermal hyperplasia, decreased melanization, and some increase in elastin.
Microdermabrasion improves some aspects of photoaging and select cases of acne scarring.
Background:
Microdermabrasion is a superficial peeling modality that has become quite popular with our patients and the media.
Objective:
To evaluate the use of microdermabrasion in patients with acne.
Methods:
Twenty-five patients with grade II-III acne were enrolled into this pilot study. All patients were under dermatologic care and were maintained on their acne medications throughout the study. Patients received eight microdermabrasion treatments at weekly intervals. The results were documented with before and after photographs and evaluated for clinical improvement.
Results:
Twenty-four patients completed the study with 38% (9/24) having excellent results, 34% (8/24) with good results, 17% (4/24) with fair results, and 12% (3/24) with poor results. Ninety-six percent (23/24) of patients were pleased with their peel results and would recommend this procedure to others.
Conclusion:
The use of microdermabrasion in this pilot study appeared to produce a positive effect on the improvement of acne.
Background:
Microdermabrasion is a widely performed skin rejuvenation procedure. It can partly ablate and homogenize the stratum corneum (SC) layers.
Objective:
The effect of microdermabrasion treatment on the skin permeation of hydrophilic and lipophilic drugs was examined in this study.
Methods:
5-Fluorouracil (5-FU) and clobetasol 17-propionate were used as the hydrophilic and lipophilic permeants, respectively. In vitro skin delivery using porcine skin and in vivo topical application employing nude mouse as the animal model were both used to examine the effect of microdermabrasion. The vacuum pressures used in this study (15-25 cmHg) were much lower than those used for therapeutic purposes.
Results:
The 5-FU permeation across microdermabrasion-treated skin was 8- to 24-fold higher than that across intact skin and depended on differences in treatment pressure and duration. An intensity of 15 cmHg for 10 seconds showed the greatest enhancement of 5-FU delivery via the skin. In contrast to the results for 5-FU, microdermabrasion reduced the skin permeation and deposition of topically applied clobetasol. The partitioning effect of clobetasol from the vehicle to the SC may have predominated this result. Microdermabrasion also enhanced the skin delivery of the hydrophilic 5-aminolevulinic acid (ALA). Confocal laser scanning microscopy (CLSM) of microdermabrasion-treated skin revealed intense red fluorescence of ALA-transformed protoporphyrin (PpIX) within the epidermis and upper dermis.
Conclusions:
Microdermabrasion can improve the skin permeation of hydrophilic molecules.
Epidemiologic surveys have indicated an excess of nonmalignant respiratory disease in workers exposed to aluminum oxide (Al2O3) during abrasives production. However, clinical, roentgenographic, histologic, and microanalytic description of these workers are lacking. This is a report of nine Al2O3-exposed workers with abnormal chest roentgenograms (profusion greater than or equal to 1/0, ILO/UC) from a plant engaged in the production of Al2O3 abrasives from alundum ore. Mean duration of exposure was 25 yr, and time since first exposure was 28 yr. in a subgroup of three, the severity of symptoms, reduction in the forced vital capacity (67% predicted) and diffusing capacity (51% predicted), and progressive roentgenographic changes (profusion greater than or equal to 2/2) prompted open lung biopsy. Lung tissue was analyzed by scanning electron microscopy and electron microprobe analysis. In each of the three biopsies, interstitial fibrosis with honeycombing was seen on routine section. In one biopsy, silica and asbestos fiber counts were at the low end of the range seen with silicosis and asbestosis; however, the absence of asbestos bodies and silicotic nodules suggested that the fibrosis was due to another cause. Metals occurred in amounts several orders of magnitude above background, and the majority was aluminum as Al2O3 and aluminum alloys. The findings in these nine workers suggests a common exposure as the possible cause. The nonspecific pathologic findings, absence of asbestos bodies and silicotic nodules, and the striking number of aluminum-containing particles suggest that Al2O3 is that common exposure. The possibility of "mixed dust" fibrosis should also be considered.
Aluminum oxide crystal microdermabrasion, a newly developed technique, has the advantages of less bleeding, fewer complications, better compliance, and no need for local anesthesia or high surgical skill in comparison with traditional dermabrasion.
To demonstrate the effectiveness of this new technique in the treatment of facial scarring.
A total of 41 patients were treated by this technique during the past 2 years (July 1992 to June 1994).
All patients treated had good to excellent clinical improvement with 9.10 mean treatment sessions.
From our experience and results, we think aluminum oxide crystal microdermabrasion is a safe surgical procedure and will be a good supplement to traditional dermabrasion especially in this era of HIV infection.
Striae distensae (striae: stretch marks) are a common disfiguring condition associated with continuous and progressive stretching of the skin--as occurs during pregnancy. The pathogenesis of striae is unknown but probably relates to changes in those structures that provide skin with its tensile strength and elasticity. Such structures are components of the extracellular matrix, including fibrillin, elastin and collagens. Using a variety of histological techniques, we assessed the distribution of these extracellular matrix components in skin affected by striae. Pregnant women were assessed for the presence of striae, and punch biopsies were obtained from lesional striae and adjacent normal skin. Biopsies were processed for electron microscopy, light microscopy and immunohistochemistry. For histological examination, 7 microns frozen sections were stained so as to identify the elastic fibre network and glycosaminoglycans. Biopsies were also examined with a panel of polyclonal antibodies against collagens I and III, and fibrillin and elastin. Ultrastructural analysis revealed alterations in the appearance of skin affected by striae compared with that of normal skin in that the dermal matrix of striae was looser and more floccular. Light microscopy revealed an increase in glycosaminoglycan content in striae. Furthermore, the number of vertical fibrillin fibres subjacent to the dermal-epidermal junction (DEJ) and elastin fibres in the papillary dermis was significantly reduced in striae compared with normal skin. The orientation of elastin and fibrillin fibres in the deep dermis showed realignment in that the fibres ran parallel to the DEJ. However, no significant alterations were observed in any other extracellular matrix components. This study identifies a reorganization and diminution of the elastic fibre network of skin affected by striae. Continuous strain on the dermal extracellular matrix, as occurs during pregnancy, may remodel the elastic fibre network in susceptible individuals and manifest clinically as striae distensae.
Aluminum oxide crystal microdermabrasion has recently become popular for facial rejuvenation. Although it is a widely used technique with perceptible benefits, the clinical efficacy on photodamaged skin has yet to be established.
To measure and quantify the effect of microdermabrasion on photodamaged skin.
Ten subjects underwent one treatment a week for five to six treatments. Skin surface roughness, topography, elasticity, stiffness, compliance, temperature, sebum content, and histology were analyzed.
Subjectively, seven patients noticed a mild improvement. Physician analysis of clinical photography indicated mild improvement in the majority of patients. Objectively, immediately following treatment skin temperature increased, sebum content decreased, and a temporary increase in skin roughness and mild flattening of some wrinkles occurred. Dynamic skin analysis demonstrated a perceptible decrease in skin stiffness and an increase in skin compliance. Histology showed slight orthokeratosis and flattening of rete ridges and a perivascular mononuclear cell infiltrate, edema, and vascular ectasia in the upper reticular dermis 1 week after completion of the series of treatments.
Immediately following the procedure, changes occurring in skin characteristics can be measured that are consistent with mild abrasion and increased blood flow. Objective biomechanical analysis demonstrated a statistically significant decrease in skin stiffness and an increase in skin compliance consistent with persistent edema. Subjectively, patients and physicians report a mild improvement in the majority of subjects. Histology showed dramatic vascular changes in the reticular dermis below the level of direct abrasion. The effect of negative pressure may result in these vascular changes.
This article will review the rationale for early use of topical retinoids alone or in combination with topical antimicrobials in light of the pathogenesis of microcomedones and later lesions. Knowledge of the pathogenic processes in acne vulgaris has risen dramatically over the last three decades. It is now widely accepted that acne is the result of four distinct processes: increased proliferation, cornification, and shedding of follicular epithelium; increased sebum production; colonization of the follicle with Propionibacterium acnes; and induction of inflammatory responses by bacterial antigens and cell signals. Clinical focus of disease management has shifted toward earlier treatment targeting these fundamental processes. Elimination of microcomedones, the precursor to all subsequent lesions, would optimize acne therapy by preventing the later inflammatory stages of disease. With the exception of oral isotretinoin, no single first-line agent addresses all pathogenic mechanisms. Topical retinoids have comedolytic and in some cases anti-inflammatory effects, but have no direct impact on P. acnes. Thus treatment with a combination of topical retinoid and topical antimicrobial is warranted. The former can also enhance penetration of the latter by increasing microcomedonal extrusion. In selecting a combination, one must consider efficacy, cost, and likelihood of compliance. Once thought to be effective primarily for treating comedones, topical retinoids have also been demonstrated to be effective in reducing inflammatory lesions. The activity of a topical retinoid combined with an antimicrobial agent has been shown to clear more lesions and to clear them more rapidly than antimicrobial therapy alone. Topical retinoids are also used effectively to maintain remissions.
Glycolic acid peels and microdermabrasion are widely recommended by dermatologists and others for facial skin rejuvenation, but few studies have assessed their clinical efficacy.
To compare the relative efficacy of glycolic acid peels and microdermabrasion for facial skin rejuvenation.
An unblinded, randomized controlled trial was used. Each of 10 patients received paired treatments with glycolic acid peels (20%) and microdermabrasion (mild setting) for 6 consecutive weeks. The right and left sides of the face were treated with different modalities. Once a patient was assigned to receive a particular modality to a particular side of the face, all subsequent treatments were delivered in the same manner. Patient ratings, investigator ratings, and photographs were obtained before the first treatment and 1 week after the last treatment.
In terms of overall preference for a given type of treatment, seven patients chose glycolic acid peels, one selected microdermabrasion, and two had no favorite treatment. The relative preference for glycolic acid peels approached significance (P =.0578). Investigator ratings and photographic comparisons did not reveal treatment-specific differences or significant improvement from baseline. No serious side effects were seen with either treatment, and even mild effects were seldom reported.
In this study, patients appeared to prefer low-strength glycolic acid peels to low-intensity microdermabrasion for facial rejuvenation. Differences in patient satisfaction were subtle and may be technique dependent.
Microdermabrasion is widely performed in a number of clinical settings, including medical offices, salons, and spas. This procedure is generally regarded as safe and easy to perform.
To determine if latex exposure caused an acute urticarial response following microdermabrasion in a latex-allergic patient.
The patient was prick tested to saline and histamine controls, latex, and sterile medical grade 100 m aluminum oxide crystals that had been passed through the microdermabrader.
The strongly positive latex prick test confirmed latex allergy in our patient. Negative prick testing to aluminum oxide crystals that had passed through the microdermabrader make it unlikely that the patient was exposed to latex via this system.
Physicians need to carefully evaluate patients who are considering microdermabrasion and appreciate that unexpected serious complications can occur.
Biochemical and ultrastructural approaches were used to assess collagen changes in photodamaged skin. Extensive collagen fragmentation, clumping of the fragmented collagen, and interaction of fibroblasts with the damaged matrix were observed. Similar, though less extensive, collagen damage was also observed in sun-protected skin-individuals aged 80 y or older (naturally aged skin). In comparison, sun-protected skin from young individuals (18-29 y of age) demonstrated little damage. A uniform distribution of collagen fibrils was seen. Interstitial fibroblasts were embedded in the collagen matrix and in close apposition with intact collagen fibrils. In additional studies, three-dimensional lattices of type I collagen were exposed in vitro to matrix metalloproteinase-1 (interstitial collagenase), and examined for biochemical and ultrastructural alterations. Under conditions in which enzyme treatment produced fragmentation in 30-40% of the collagen molecules, the lattices demonstrated collagen fragmentation and clumping of the damaged matrix. Recent studies have demonstrated a loss of procollagen production by fibroblasts in contact with collagen fragments in vitro. This study demonstrates similar changes in collagen structure in vivo in aged and photodamaged skin. We suggest that collagen fragmentation in vivo could underlie the loss of collagen synthesis in photodamaged skin and, to a lesser extent perhaps, in aged skin.
This article addresses the concern of cross-contamination with the use of microdermabrasion equipment. After performing microdermabrasion on a patient with acne scarring, the instrument was examined for debris on the plateau of the hand piece. Bloody material was noted, indicating that it is not sufficient to only sterilize the distal cap of the hand piece or to use disposable caps. The hand piece itself must be sterilized to prevent the transmission of infectious particles to the next patient receiving treatment with this equipment.
The objective of this study was to evaluate the ability of lasers and microdermabrasion, both of which are skin resurfacing modalities, to enhance and control the in vitro skin permeation and deposition of vitamin C. The topical delivery of magnesium ascorbyl phosphate, the pro-drug of vitamin C, was also examined in this study. All resurfacing techniques evaluated produced significant increases in the topical delivery of vitamin C across and/or into the skin. The erbium:yttrium-aluminum-garnet (Er:YAG) laser showed the greatest enhancement of skin permeation of vitamin C among the modalities tested. The laser fluence and spot size were found to play important parts in controlling drug absorption. An excellent correlation was observed in the Er:YAG laser fluence and transepidermal water loss, which is an estimation of skin disruption. Permeation of magnesium ascorbyl phosphate was not enhanced by the Er:YAG laser. The CO2 laser at a lower fluence promoted vitamin C permeation with no ablation of the stratum corneum or epidermal layers. Further enhancement was observed with the CO2 laser at higher fluences, which was accompanied by a prominent ablation effect. Microdermabrasion ablated the stratum corneum layers with minimal disruption of the skin barrier properties according to transepidermal water loss levels. The flux and skin deposition of vitamin C across microdermabrasion-treated skin was approximately 20-fold higher than that across intact skin. The techniques used in this study may be useful for basic and clinical investigations of enhancement of topical vitamin C delivery.
Aged skin is characterized by rhytides but also by epidermal and dermal atrophy, rough skin texture, irregular pigmentation, telangiectasias, and laxity. Microdermabrasion is an office-based mechanical resurfacing technique alternative to traditional dermabrasion. It has been used in Europe since 1992 with great acceptance. The purpose of this study was to evaluate and quantify the degree of visible improvement in photodamaged skin and fine rhytides following a series of microdermabrasion treatments. A single operator treated 20 patients with varying degrees of photodamage and rhytides with a series of eight microdermabrasion treatments at 1-week intervals; 17 subjects completed the entire study protocol. Standardized photographic documentation was performed before and after each treatment, and a survey questionnaire was completed by each subject. Punch biopsy specimens (3 mm) were collected on treated and matched nontreated control sites and evaluated for histological characteristics. Preprocedure and postprocedure photographs were rated on a 5-point scale by independent blinded observers. A total of 30 blinded observers (16 plastic surgeons and 14 laypersons) rated all photographs. The results showed that all observers rated a significant improvement of hyperchromic discoloration (p = 0.004), while only nonmedical observers observed improvement in fine rhytides. All patients were very satisfied with the results. Common side effects were mild to moderate discomfort occurring on bony areas during the treatment and an itching and tingling sensation for 2 days after treatment. No infections or scars were observed postoperatively. The average epidermal thickness in the untreated samples was 103 +/- 23 microM (mean +/- SD) before treatment compared with 148 +/- 41 microM after treatment (p < 0.001). Histologic analysis of the matched punch biopsy specimens showed an increase in organized collagen in treated versus nontreated sites. Treatment of aged skin using a series of microdermabrasion treatments is an effective, noninvasive method of skin rejuvenation with minimal risk and patient downtime. It is safe and improves skin quality by minimizing certain hyperchromic pigmentations.
5-aminolaevulinic acid (ALA) is used as a protoporphyrin IX-precursor for the photodynamic therapy of superficial skin cancer and cutaneous metastases of internal malignancies. However, the permeability of hydrophilic ALA across the skin is very low.
The objective of this study was to optimize and enhance the in vitro skin permeation of ALA by two resurfacing techniques: erbium:yttrium-aluminium-garnet (Erb:YAG) laser and microdermabrasion. Light microscopic changes in pig skin caused by these techniques were also compared. The electrically assisted methods, iontophoresis and electroporation, were also used to facilitate ALA permeation across laser- or microdermabrasion-treated skin.
Among the modalities tested in this study the Erb:YAG laser showed the greatest enhancement of ALA permeation. The laser fluence was found to play an important role in controlling the drug flux, producing enhancement ratios from 4-fold to 246-fold relative to the control. The skin permeation of ALA across microdermabrasion-treated skin was approximately 5-15-fold higher than that across intact skin. Both the ablated effect of the stratum corneum (SC) and ALA flux were proportional to the treatment duration of microdermabrasion. The application of iontophoresis or electroporation alone also increased the ALA permeation by approximately 15-fold and 2-fold, respectively. The incorporation of iontophoresis or electroporation with the resurfacing techniques caused a profound synergistic effect on ALA permeation.
This basic study has encouraged the further investigation of ALA permeation by laser or microdermabrasion.
Microdermabrasion is a popular method of superficial skin resurfacing. It is unclear if dermal remodeling actually occurs.
To rigorously investigate the molecular alterations observed following a single microdermabrasion treatment.
Forty-nine subjects received a single microdermabrasion treatment to buttock skin. Serial in vivo biochemical and immunohistological analyses were performed. Reverse transcriptase real-time polymerase chain reaction and immunohistochemistry assays were used to evaluate changes in transcription factors (AP-1, NF-kappaB), primary cytokines (interleukin-1beta, tumor necrosis factor-alpha), matrix metalloproteinases (MMP-1, MMP-3, MMP-9), barrier repair enzymes (acetyl-coenzyme A carboxylase, 3-hydroxy-3-methylglutaryl coenzyme A reductase), and type I procollagen. Results Elevation of transcription factors, primary cytokines, and matrix metalloproteinases occurs rapidly after a single microdermabrasion treatment. Two of 11 subjects also demonstrated increased type I procollagen messenger RNA and protein levels 14 days after treatment. No alteration in stratum corneum thickness was detected.
Microdermabrasion activates a dermal remodeling/wound healing cascade with minimal epidermal disruption. Evidence now exists to further study manipulation of variables such as number and timing of microdermabrasion sessions.
Microdermabrasion (MDA) is a recently introduced noninvasive, nonsurgical, office-based esthetic procedure for revitalizing and rejuvenating the skin. It is a closed-loop vacuum-assisted abrasive procedure, which uses the physical action of inert crystals to exfoliate the skin.
The aim was to evaluate the procedure of MDA in postacne scarring, melasma, and facial rejuvenation, and review the relevant literature.
Ten patients each of postacne scarring, melasma, and facial rejuvenation were treated by a series of weekly MDA sittings alone or in conjunction with a topical retinoid. The results were assessed by patient questionnaire and an objective assessment by two independent observers. The literature was reviewed to find indications and efficacy of MDA.
All the patients of postacne scarring, melasma, and facial rejuvenation reported a mild but definite improvement, which increased when MDA was performed in conjunction with a topical retinoid. Most of the literature based on subjective and patient-dependent assessment parameters points toward a marginal improvement in the skin appearance following repeated procedures.
Reappraisal of this potentially useful procedure points toward a need for well-designed clinical trials and studies with a long follow-up based on objective assessment parameters.
The primary function of the skin is to protect the body for unwanted influences from the environment. The main barrier of the skin is located in the outermost layer of the skin, the stratum corneum. The stratum corneum consists of corneocytes surrounded by lipid regions. As most drugs applied onto the skin permeate along the lipid domains, the lipid organization is considered to be very important for the skin barrier function. It is for this reason that the lipid organization has been investigated quite extensively. Due to the exceptional stratum corneum lipid composition, with long chain ceramides, free fatty acids and cholesterol as main lipid classes, the lipid organization is different from that of other biological membranes. In stratum corneum, two lamellar phases are present with repeat distances of approximately 6 and 13 nm. Moreover the lipids in the lamellar phases form predominantly crystalline lateral phases, but most probably a subpopulation of lipids forms a liquid phase. Diseased skin is often characterized by a reduced barrier function and an altered lipid composition and organization. In order to understand the aberrant lipid organization in diseased skin, information on the relation between lipid composition and organization is crucial. However, due to its complexity and inter-individual variability, the use of native stratum corneum does not allow detailed systematic studies. To circumvent this problem, mixtures prepared with stratum corneum lipids can be used. In this paper first the lipid organization in stratum corneum of normal and diseased skin is described. Then the role the various lipid classes play in stratum corneum lipid organization and barrier function has been discussed. Finally, the information on the role various lipid classes play in lipid phase behavior has been used to interpret the changes in lipid organization and barrier properties of diseased skin.
Topical 5-aminolevulinic acid (ALA) and various light sources have been used to treat actinic keratoses and acne. Many of these regimens have required long incubation times due to the penetration qualities of ALA. This study tested the effectiveness of ALA in producing erythema when applied for 10 minutes after 2 passes of microdermabrasion versus an incubation time of one hour without microdermabrasion. The areas were treated with a 595-nm pulsed dye laser at 15 J/cm2 or 22.5 J/cm2. Photographs were taken at 24 and 48 hours after the treatment. The data indicated consistent superior results with the use of microdermabrasion prior to the application of ALA for 10 minutes. It appears that incubation of ALA with microdermabrasion for 10 minutes is as effective as, or more so than, ALA applied alone for one hour in producing erythema.
Skin appearance is a primary indicator of age. During the last decade, substantial progress has been made toward understanding underlying mechanisms of human skin aging. This understanding provides the basis for current use and new development of antiaging treatments. Our objective is to review present state-of-the-art knowledge pertaining to mechanisms involved in skin aging, with specific focus on the dermal collagen matrix. A major feature of aged skin is fragmentation of the dermal collagen matrix. Fragmentation results from actions of specific enzymes (matrix metalloproteinases) and impairs the structural integrity of the dermis. Fibroblasts that produce and organize the collagen matrix cannot attach to fragmented collagen. Loss of attachment prevents fibroblasts from receiving mechanical information from their support, and they collapse. Stretch is critical for normal balanced production of collagen and collagen-degrading enzymes. In aged skin, collapsed fibroblasts produce low levels of collagen and high levels of collagen-degrading enzymes. This imbalance advances the aging process in a self-perpetuating, never-ending deleterious cycle. Clinically proven antiaging treatments such as topical retinoic acid, carbon dioxide laser resurfacing, and intradermal injection of cross-linked hyaluronic acid stimulate production of new, undamaged collagen. Attachment of fibroblasts to this new collagen allows stretch, which in turn balances collagen production and degradation and thereby slows the aging process. Collagen fragmentation is responsible for loss of structural integrity and impairment of fibroblast function in aged human skin. Treatments that stimulate production of new, nonfragmented collagen should provide substantial improvement to the appearance and health of aged skin.
Microdermabrasion as a novel tool to enhance drug delivery via the skin: an animal study Prevention of cross-contamination when using microdermabrasion equipment
- Wr Lee
- Ry Tsai
- Cl Fang
- Cj Liu
- Ch Hu
- Fang
Lee WR, Tsai RY, Fang CL, Liu CJ, Hu CH, Fang JY. Microdermabrasion as a novel tool to enhance drug delivery via the skin: an animal study. Dermatol Surg. 2006;32:1013–1022. 5. Shelton RM. Prevention of cross-contamination when using microdermabrasion equipment. Cutis 2003;72:266–268.
The evaluationofaluminumoxidecrystalmicrodermabrasionfor photodamage
- Mh Tan
- Jm Spencer
- Lm Pires
- J Ajmeri
- Skover
Tan MH, Spencer JM, Pires LM, Ajmeri J, Skover G. The evaluationofaluminumoxidecrystalmicrodermabrasionfor photodamage. Dermatol Surg. 2001;27:943–949
Efficacy of microdermabrasion preceding ALA application in reduc-ingtheincubationtimeofALAinlaserPDT
- Katzbe
- Truongs
- Maiwalddc
- Frewke
- Georged
KatzBE,TruongS,MaiwaldDC,FrewKE,GeorgeD.Efficacy of microdermabrasion preceding ALA application in reduc-ingtheincubationtimeofALAinlaserPDT.JDrugsDermatol. 2007;6:140–142