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Mechanical Exfoliation Vs. Microneedling
By: Terri A. Wojak
Posted: September 3, 2013, from the September 2013 issue of Skin Inc. magazine.
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When to choose microdermabrasion. Microdermabrasion is an effective form of skin rejuvenation for those with a thicker epidermis, hyperkeratotic buildup, superficial pigmented lesions and noninflamed forms of acne (acne grades I and II). It is also a proficient method to use for a boost in exfoliation between other skin-maintenance treatments. Although microdermabrasion undeniably has its place in skin care, it is not always the best choice for all skin types. This technique, like anything else, can be overused or performed in the wrong circumstances. Microdermabrasion should never be used on inflamed conditions of the skin, including rosacea or acne vulgaris (acne grades III and IV). Rosacea, in particular, can worsen through physical means of exfoliation and stimulation. In addition to excess inflammation, capillary walls are often weak in rosacea-sufferers; therefore, utilizing a device that produces suction can cause additional broken capillaries and increased redness. The same could be said for inflamed acne—adding a stimulating component with harsh abrasives could cause increased inflammation, the spread of bacteria and even scarring.
Dermaplaning is another form of mechanical exfoliation that has been used for thousands of years. This simple and safe procedure is used for removing dead skin from the epidermis and has the added benefit of removing fine vellus hair, known as “peach fuzz.” When clients hear the word “dermaplaning,” they may associate the term with the procedure dermabrasion. Dermabrasion is a medical procedure in which the skin is often abraded down to the dermis using a whisklike device. Dermaplaning is a light shaving of the epidermis using a scalpel. Although it is ultimately a simple procedure, it is the opinion of many that estheticians should not perform dermaplaning unless under the direction of a medical provider; dermaplaning legalities vary from state to state. Be sure to check with your state before offering dermaplaning services. (Editor’s note: To access a complete list of contact information for each state board, log on to www.SkinInc.com/education/statelicensing.)
When to choose dermaplaning. Dermaplaning is most beneficial for clients with hyperkeratotic buildup, superficial pigmentation, fine lines, uneven texture and vellus hair, and to remove surface skin cells so topical products can penetrate more effectively. It is a good option for clients looking for a surface exfoliation but who are too sensitive for the vacuum associated with microdermabrasion. This treatment can be safely done on mild forms of rosacea, without the presence of papules and pustules, although it has not been shown to directly improve this condition. Dermaplaning is also a viable option for clients who are pregnant or nursing, and looking for a deeper exfoliation without the risk of applying topical products that could potentially be absorbed into the bloodstream. This treatment leaves the skin feeling smooth, which makes it a great option before events.
Microneedling, or collagen induction therapy, is quickly gaining popularity as the go-to treatment for skin rejuvenation. The difference between this treatment and the other methods is that there is no removal of the outer layers of skin. The premise of microneedling is to create a controlled wound response in the skin to stimulate growth factors without abrading the epidermis. Skin-needling was first recognized in 1995 when Norman Orentreich, MD, and David S. Orentreich, MD, used dermal needling as a method to repair scars. Des Fernandes, MD, introduced a stamplike needling device as a method of skin rejuvenation to his patients in 1996. Later, Fernandes designed a dermal roller (a drumlike rolling device with protruding needles) for ease of use.2
Similar to microdermabrasion, there are several factors that can affect the outcome of this procedure. Ensure the device is from a reputable company; and be wary of inexpensive devices seen on the Internet. The latest device to come to market is an automated needling system. This system was developed to provide a more consistent treatment through vertical insertion of needles, reducing the risk of skin tearing commonly associated with the rolling method. The automated needling system also allows for customized depth during treatment, giving the user multiple options for needle length on specific areas of concern. Dependent on the device chosen, there are typically varying needle lengths and gauges, which greatly affect the procedure outcomes. There are some needling devices available for consumers at 0.2 mm, but esthetic devices are typically around 0.5 mm, and medical devices can go as deep as 3 mm, reaching the reticular dermis. Please note that microneedling regulations vary from state to state and it is the responsibility of the technician to ensure they are working within their scope of practice. (Editor’s note: To access a complete list of contact information for each state board, log on to www.SkinInc.com/education/statelicensing.)