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Dermabrasion is a type of surgical skin planing, generally with the goal of removing
acne Acne, also known as ''acne vulgaris'', is a long-term skin condition that occurs when dead skin cells and oil from the skin clog hair follicles. Typical features of the condition include blackheads or whiteheads, pimples, oily skin, and ...
, scarring and other skin or tissue irregularities, typically performed in a professional medical setting by a
dermatologist Dermatology is the branch of medicine dealing with the skin.''Random House Webster's Unabridged Dictionary.'' Random House, Inc. 2001. Page 537. . It is a speciality with both medical and surgical aspects. A dermatologist is a specialist medica ...
or
plastic surgeon Plastic surgery is a surgical specialty involving the restoration, reconstruction or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery includes craniof ...
trained specifically in this procedure. Dermabrasion has been practiced for many years (before the advent of lasers) and involves the controlled deeper abrasion (wearing away) of the upper to mid layers of the
skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other animal coverings, such as the arthropod exoskeleton, have different ...
with any variety of strong abrasive devices including a wire brush, diamond wheel or fraise, sterilized sandpaper, salt crystals or other mechanical means. Dermabrasion should not be confused with microdermabrasion which is a newer and non-surgical cosmetic procedure performed by non-physician personnel, nurses, aestheticians and medical assistants. Dermabrasion procedures are surgical, invasive procedures that typically require a
local anaesthetic A local anesthetic (LA) is a medication that causes absence of pain sensation. In the context of surgery, a local anesthetic creates an absence of pain in a specific location of the body without a loss of consciousness, as opposed to a general a ...
. Often, they are performed in surgical suites or in professional medical centers. Since the procedure can typically remove the top to deeper layers of the epidermis and extend into the reticular dermis, there is always minor skin bleeding. The procedure carries risks of scarring, skin discoloration, infections and facial herpes virus (
cold sore Herpes labialis, commonly known as cold sores or fever blisters, is a type of infection by the herpes simplex virus that affects primarily the lip. Symptoms typically include a burning pain followed by small blisters or sores. The first atta ...
) reactivation. In aggressive dermabrasion cases, there is often tremendous skin bleeding and spray during the procedure that has to be controlled with pressure. Afterward, the skin is normally very red and raw-looking. Depending on the level of skin removal with dermabrasion, it takes an average of 7–30 days for the skin to fully heal ( re-epithelialize). Often, the procedure is performed for deeper acne scarring and deep surgical scars. Dermabrasion is currently rarely practiced and there are very few doctors who are trained and still perform this surgery. Dermabrasion has largely been replaced by technologies including lasers, CO2 or Erbium:YAG
laser A laser is a device that emits light through a process of optical amplification based on the stimulated emission of electromagnetic radiation. The word "laser" is an acronym for "light amplification by stimulated emission of radiation". The ...
. Laser technologies carry the advantage of little to no bleeding and are often less operator dependent than dermabrasion. The purpose of surgical dermabrasion is to help diminish the appearance of deeper scars and skin imperfections. Often, the goal is to smooth the skin and, in the process, remove small scars (as from acne), uneven skin tone from scars or birthmarks, sun damage,
tattoo A tattoo is a form of body modification made by inserting tattoo ink, dyes, and/or pigments, either indelible or temporary, into the dermis layer of the skin to form a design. Tattoo artists create these designs using several tattooing ...
s, age spots,
Stretch marks Stretch marks, also known as striae () or striae distensae, are a form of scarring on the skin with an off-color hue. Over time they may diminish, but will not disappear completely. Striae are caused by tearing of the dermis during periods of r ...
or fine
wrinkle A wrinkle, also known as a rhytid, is a fold, ridge or crease in an otherwise smooth surface, such as on skin or fabric. Skin wrinkles typically appear as a result of ageing processes such as glycation, habitual sleeping positions, loss of ...
s. Dermabrasion is a mechanical surgical skin planing method which has remained popular partially because it may afford an overall lower cost and may provide similar or superior results as newer laser methods for certain skin conditions.


Microdermabrasion

Microdermabrasion is a light cosmetic procedure that uses a mechanical medium for exfoliation to remove the outermost layer of dead skin cells from the
epidermis The epidermis is the outermost of the three layers that comprise the skin, the inner layers being the dermis and hypodermis. The epidermis layer provides a barrier to infection from environmental pathogens and regulates the amount of water rel ...
. Most commonly, microdermabrasion uses two parts: an exfoliating material such as crystals or diamond flakes, and a machine-based suction to gently lift up the skin during exfoliation. It is a non-invasive procedure and may be performed in-office by a trained
skin care Skin care is a range of practices that support skin integrity, enhance its appearance, and relieve skin conditions. They can include nutrition, avoidance of excessive sun exposure, and appropriate use of emollients. Practices that enhance appea ...
professional. It may also be performed at home using a variety of products which are designed to mechanically exfoliate the skin. Many salon machines and home-use machines use adjustable
suction Suction is the colloquial term to describe the air pressure differential between areas. Removing air from a space results in a pressure differential. Suction pressure is therefore limited by external air pressure. Even a perfect vacuum cannot ...
to improve the efficacy of the abrasion tool. Microdermabrasion is considered a relatively simple, easy, painless and non-invasive skin rejuvenation procedure. Typically there are no needles or anesthetics required for microdermabrasion. The vacuum pressure and speed are adjusted depending on the sensitivity and tolerance of the skin. Microdermabrasion is often compared to the feeling of a cat licking the skin - a rough but gentle texture. Typical microdermabrasion sessions can last anywhere from 5 to 60 minutes. Minimal to no recovery time is required after microdermabrasion and most people immediately return to daily activity after a session. Makeup and non-irritating creams can usually be applied within a few hours or right after microdermabrasion. Since there is an often immediate increased minor skin sensitivity after microdermabrasion, irritating products such as
glycolic acid Glycolic acid (or hydroxyacetic acid; chemical formula HOCH2CO2H) is a colorless, odorless and hygroscopic crystalline solid, highly soluble in water. It is used in various skin-care products. Glycolic acid is widespread in nature. A glycolate (s ...
s,
Alpha Hydroxy Acid α-Hydroxy acids, or alpha hydroxy acids (AHAs), are a class of chemical compounds that consist of a carboxylic acid with a hydroxyl group substituent on the adjacent (alpha) carbon. Prominent examples are glycolic acid, lactic acid, mandelic ac ...
s,
Retinoid The retinoids are a class of chemical compounds that are vitamers of vitamin A or are chemically related to it. Retinoids have found use in medicine where they regulate epithelial cell growth. Retinoids have many important functions throughout ...
products or fragranced creams and lotions are typically avoided right after the procedure. Traditionally, a "crystal" microdermabrasion system includes a pump, a connecting tube, a hand piece, and a vacuum. While the pump creates a high-pressure stream of inert crystals (aluminum oxide, magnesium oxide, sodium chloride, or sodium bicarbonate) to abrade the skin, the vacuum removes the crystals and exfoliated skin cells. Alternatively, the inert crystals can be replaced by a roughened surface of the tip in the diamond microdermabrasion system. Unlike the older crystal microdermabrasion system, the diamond microdermabrasion does not produce particles from crystals that may be inhaled into patients' nose or blown into the eyes. Hence, diamond microdermabrasion is regarded as having higher safety for use on areas around the eyes and lips. Generally, the slower the movement of the microdermabrasion handpiece against the skin and the greater the numbers of passes over the skin, the deeper the skin treatment. One of the safest methods of microdermabrasion involves the use of corundum or aluminum oxide crystals suspended in an antioxidant cream. This version of microdermabrasion is generally the most cost efficient as it involves the use of a small handheld skincare tool instead of expensive equipment used by a salon. This method of microdermabrasion rose to popularity in the early 2000s and is widely available today. Often called "microderm" for short, microdermabrasion is a procedure to help exfoliate or temporarily remove a few of the top layers of the skin called the stratum corneum. Much like brushing one's teeth, microdermabrasion helps to gently remove skin "plaque" and skin debris. Since human skin typically regenerates at approximately 30-day intervals, skin improvement with microdermabrasion is temporary and needs to be repeated at average intervals of two - four weeks for continued improvement. Multiple treatments in combination with sunscreen, sun avoidance and skin care creams yield best results. Dermabrasion is generally used to refer to a true surgical procedure that aggressively abrades away the top to mid layers of the skin. The term microdermabrasion generally refers to a non-surgical procedure that abrades less deeply than dermabrasion. Although the mechanism of the two procedures is similar, the difference in the depth of the abrasion results in different recovery times. Dermabrasion recovery time may take as much as several weeks to several months whereas microdermabrasion recovery time may be as little as one to two days. After microdermabrasion, skin will be much more sensitive to sun exposure. It is best to keep out of the sun and wear sunscreen at all times after the procedure. Microdermabrasion may be performed to help diminish the appearance of superficial
hyperpigmentation Hyperpigmentation is the darkening of an area of skin or nails caused by increased melanin. Causes Hyperpigmentation can be caused by sun damage, inflammation, or other skin injuries, including those related to acne vulgaris.James, William; Be ...
or photo-damage (sunburn), as well as diminish fine lines, wrinkles, acne and shallow acne scars. A further benefit of microdermabrasion is enhanced skin penetration by skin creams and serums. Removing dead skin (stratum corneum of the epidermis) will aid in the penetration of skin care products and medications by up to 10-50%. The controlled skin exfoliation afforded by microdermabrasion will allow make-up and self-tanning products to go on much more smoothly. Microdermabrasion treatment carries minimal to very few possible side effects or complications. However, some patients may experience temporary mild dryness, sun sensitivity and rarely temporary bruising or scratches in the area of skin treated.


Microdermabrasion units

The first microdermabrasion unit was developed in
Italy Italy ( it, Italia ), officially the Italian Republic, ) or the Republic of Italy, is a country in Southern Europe. It is located in the middle of the Mediterranean Sea, and its territory largely coincides with the homonymous geographical ...
in 1985, using small inert aluminium oxide crystals to abrade the skin. In 1986, other European markets had introduced the technology which was immediately adopted by physicians for mechanical exfoliation. There were 10 microdermabrasion units on the market in Europe by the end of 1992. In 1996, Mattioli Engineering partnered with one of the Italian designed machines and started working towards meeting FDA requirements for the USA. By the end of 1996, the
Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...
, (FDA) issued the first approval letter for microdermabrasion machines. In January 1997, the first microderm machine was being sold and marketed in the US. The diamond tip was introduced in 1999 and the bristle tip brush was introduced in 2005. The first standard vacuum based microdermabrasion system called Vacubrasion was introduced in 2012 in the US and world markets, and provides diamond tip exfoliation and suction. Vacubrasion's patented air regulator delivery system was designed and underwent extensive testing by US dermatologists and physicians. Its straightforward design revolutionized microdermabrasion to permit use of almost any type of suction source (primarily retail brand vacuums with a standard round hose such as Eureka, Stanley vacuums) with a non-disposable, attached electroplated fine diamond abrasive tip. While traditional, older crystal based microdermabrasion and home microdermabrasion systems are sometimes fraught with clogging issues and potential loss of suction, the crystal-free Vacubrasion systems utilize a universal, larger and more powerful suction source that avoids many of these issues.


Abrasive material

Microdermabrasion has evolved from rocks, stones and shells to
crystal A crystal or crystalline solid is a solid material whose constituents (such as atoms, molecules, or ions) are arranged in a highly ordered microscopic structure, forming a crystal lattice that extends in all directions. In addition, macro ...
s, particle-free diamond tips and particle-free bristle tips. Once the desired amount of exfoliation has been reached, some microdermabrasion units will then spray or infuse a skin enhancing solution into the skin. Since microderm essentially manually removes limited layers of the stratum corneum (dead layers of the outer layer of the skin), any serum or topical product applied in any fashion to the skin following microdermabrasion will potentially have a greater opportunity for penetration into the skin. Microdermabrasion crystals are typically made of a very fine, abrasive material like aluminum oxide. Other inert microderm crystals include magnesium oxide, sodium chloride, and sodium bicarbonate. All ultra-fine white crystals are disposable and should be discarded after each use. The microdermabrasion vacuum removes the crystals and exfoliated skin cells. Inhalation of crystals should be avoided and masks are sometimes worn by the operator doing the treatment. Ocular injury may occur if crystals are inadvertently sprayed in the eye or if crystals remain around the eye and cause a corneal abrasion. There are some possible concerns of inhalation exposure and basic safety precautions should be taken. Patient goggles or eye shields, as well as operator face masks are recommended when treating with crystal based systems. Alternatively, microderm crystals can be safely replaced by the roughened surface of a diamond tip microdermabrasion system. The newer diamond based systems like Vacubrasion utilize a fine diamond dust that is essentially electroplated onto a stainless steel round tip that comes in contact with the skin.


Microdermabrasion media

* Aluminium oxide crystals: 100 micrometres; aluminium oxide is relatively chemically inert and generally recognized as safe. *
Bristle A bristle is a stiff hair or feather (natural or artificial), either on an animal, such as a pig, a plant, or on a tool such as a brush or broom. Synthetic types Synthetic materials such as nylon are also used to make bristles in items such a ...
tips: bristles are pliable, so they move with the skin allowing for aggressive treatments without added irritation. *
Diamond Diamond is a solid form of the element carbon with its atoms arranged in a crystal structure called diamond cubic. Another solid form of carbon known as graphite is the chemically stable form of carbon at room temperature and pressure, b ...
tips: can be natural but usually synthetic for lower costs;
erythema Erythema (from the Greek , meaning red) is redness of the skin or mucous membranes, caused by hyperemia (increased blood flow) in superficial capillaries. It occurs with any skin injury, infection, or inflammation. Examples of erythema not asso ...
(Redness) is partially due to circulation rather than only irritation. * Liquid: water-based sprays in combination with a rough plastic tip spray liquid against the skin to help gently exfoliate. *
Magnesium oxide Magnesium oxide ( Mg O), or magnesia, is a white hygroscopic solid mineral that occurs naturally as periclase and is a source of magnesium (see also oxide). It has an empirical formula of MgO and consists of a lattice of Mg2+ ions and O2� ...
* Organic
grain A grain is a small, hard, dry fruit ( caryopsis) – with or without an attached hull layer – harvested for human or animal consumption. A grain crop is a grain-producing plant. The two main types of commercial grain crops are cereals and legum ...
s: used to buff and polish; made from trees, plants, agricultural crops, straw, reeds, maize, sunflower or
cane sugar Sucrose, a disaccharide, is a sugar composed of glucose and fructose subunits. It is produced naturally in plants and is the main constituent of white sugar. It has the molecular formula . For human consumption, sucrose is extracted and ref ...
. *
Sodium bicarbonate Sodium bicarbonate ( IUPAC name: sodium hydrogencarbonate), commonly known as baking soda or bicarbonate of soda, is a chemical compound with the formula NaHCO3. It is a salt composed of a sodium cation ( Na+) and a bicarbonate anion ( HCO3− ...
and
sodium chloride Sodium chloride , commonly known as salt (although sea salt also contains other chemical salts), is an ionic compound with the chemical formula NaCl, representing a 1:1 ratio of sodium and chloride ions. With molar masses of 22.99 and 35. ...
crystals.


References

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External links


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