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Microdermabrasion and Dermabrasion
By: Zoe Draelos, MD, and Peter T. Pugliese, MD
Posted: June 28, 2011, from the July 2011 issue of Skin Inc. magazine.
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Common substances used after microdermabrasion for infusion include vitamins and antioxidants. Vitamin C is a popular infusion ingredient, but must be formulated as an acid to have biologic activity, and may cause stinging and burning. Vitamin E is also sometimes used in combination with other vitamins creating an anti-aging cocktail. These vitamins may be used with antioxidants, such as green tea, blueberry extract and ginkgo, to improve the appearance of the skin. Infusion microdermabrasion does not offer a clear benefit over manually applying materials to the skin immediately following the procedure. It is a new trend, and the skin care professional will need to determine if the added expense provides benefit to clients.
Uses and misuses of microdermabrasion
Microdermabrasion may provide noticeable improvement in clients’ skin texture, but there are other uses of microdermabrasion that are less effective. Microdermabrasion is very good at improving skin radiance and providing a smooth surface for even cosmetic application. Some have advocated its use to treat stretch marks. Indeed microdermabrasion can make all skin surfaces smoother, including stretch marks, but it does not eliminate stretch marks, which are scars, and no currently available treatment can eliminate scars. Be sure to understand the best uses of the technique so you can advise your clients properly, and do not overpromise results where they cannot be achieved. This will result in an unhappy client.
Microdermabrasion can temporarily lighten some brown spots on the face. Be aware that if the lesion is a skin growth, it will become brown again before the next treatment. It is also risky to treat pigmented growths on the face, as they may be precancerous or cancerous growths. In general, aggressively treating brown spots on the face to lighten them should be avoided. Ask the client to seek advice from a dermatologist before proceeding with specific spot treatments.
Some skin care professionals have also tried to treat the common condition of cellulite with microdermabrasion. This too is fraught with problems. Since cellulite is a condition related to the structure of the deeper dermis and subcutaneous fat, a surface treatment cannot produce results. Microdermabrasion only works on the surface of the skin, not deeper tissues. Keep this in mind when identifying conditions for treatment. You cannot achieve results if the problem is deeper that your microdermabrasion tool can reach.
Microdermabrasion has been advocated for the treatment of acne scars. Indeed, medical dermabrasion was first developed as an acne scar treatment. Acne scars are defects in the dermis; any scar is a defect in the dermis, because only dermal injury results in scarring. The epidermis can completely regenerate, which is why epidermal wounds are less likely to scar. Because the microdermabrasion equipment should not enter the viable epidermis or dermis, dramatic improvement in acne scarring is not possible with this technique. Indeed, acne scars may feel and look smoother after microdermabrasion, but they will not disappear. Again, be careful in explaining the anticipated results to your client.
Selecting the microdermabrasion client
The most important issue is to select a microdermabrasion client who has realistic expectations. Sure, everyone would like to have all discolorations, wrinkles and acne scars removed with one microdermabrasion treatment, but you know this is impossible. Be sure your client has been properly educated about the realistic result and make sure they are listening to your instructions. Some people seem to have difficulty grasping reality, and they make poor clients.
Be wary of the clients who have seen many different skin care professionals and come to your facility stating that they heard from friends that you are the best. You may be able to please a client, but someone who has been dissatisfied with numerous others may leave your facility dissatisfied as well. Listen to what prospective clients are telling you and watch for danger signs. Follow your instincts. If the client makes you uncomfortable and is looking for unrealistic results, take note and tailor your treatments accordingly.
The best clients are those with a realistic, positive outlook, and who are not looking for miracles. They are comfortable with their self-image and are not trying to seek esthetic procedures for some other need. Clients who have recently divorced or broken up with a boyfriend may be looking to improve their appearance to attract another companion. These are challenging clients because microdermabrasion will not find them a companion; it will only temporarily smooth their skin. Try to select clients who will have a positive experience at your facility and spread the word to their friends.