Clinical and histologic changes determine optimal treatment regimens for microdermabrasion.

OBJECTIVE To analyze the onset and extent of the dermatological changes associated with microdermabrasion. METHODS Eleven volunteers, aged 31-62 years old, underwent a series of six aluminum oxide microdermabrasion facial treatments spaced over 7 to 10-day intervals. White light photography and digital ultraviolet fluorescent photography and skin biopsies were obtained prior to the study, after three treatments, and after six treatments. A 90-day no-treatment period ensured, after which biopsies and photographs were taken. RESULTS Clinical improvements in dyschromia, actinic changes and fine rhytides were observed after six treatments. Compared with the controls, the treated areas demonstrated the following histological changes: epidermal thickening with basal cell hyperplasia and mitotic activity; flattening and widening of the rete pegs; papillary dermal thickening with deposition of collagen and elastic fibers; and perivascular inflammation in the dermis. After the no-treatment period some of the clinical and histologic changes persisted although they were less than those present immediately after the last treatment. Serial ultraviolet photography following microdermabrasion treatments revealed changes in the skin's pigmentation pattern that correlated clinically with improvements in dyschromia. CONCLUSION Clinical and histological changes are most likely secondary to a mechanism resembling a reparative process. The persistent changes after a period of no-treatment suggests that some of the changes could be permanent. Clinicians can use this data to better determine the optimal interval frequency and treatment intervals with microdermabrasion.