Microdermabrasion. Do You Get What You Pay For?

It is important to distinguish between dermabrasion and microdermabrasion. Dermabrasion is a much more invasive procedure performed using special sanding devices. Dermabrasion causes as much or more damage to the skin as laser resurfacing or deep chemical peels. The skin recovery after dermabrasion takes several weeks or more. Dermabrasion has been used in cosmetic surgery for decades. However, its use has been declining since the advent of laser resurfacing. Microdermabrasion, on the other hand, is only a mildly invasive procedure. It causes virtually no downtime and the patients can usually return to their regular activities the same day. In fact, some call microdermabrasion a lunchtime peel. Convenience and minimal recovery period account for much of the popularity of microdermabrasion. Some people are also enticed by seemingly low cost of a microdermabrasion treatment (usually in the range of $100-$300 per session). Is there a catch? Unfortunately, there is. First, the effect of microdermabrasion is generally modest. Some people see no effect whatsoever. Others see a small effect, and only a relatively small percentage of people report substantial benefits. Actually, this is understandable: a mild mechanical treatment like microdermabrasion is unlikely to cause major skin restructuring required for a dramatic reduction in wrinkles. Repeated treatments may provide cumulative improvement in some cases, but often produce little or no benefit. (And the cost is cumulative whether you get cumulative benefits or not). Since its effects tend to be modest, microderabrasion is generally believed to be more useful for early signs of aging and minor skin lesions. In particular, it is often recommended for mild acne scarring, uneven pigmentation, poor skin texture, fine lines and dull skin. Unfortunately, clinical research substantiating the benefits of microdermabrasion is somewhat scarce. In one study published in the journal Dermatol Surgery in 2001, Dr Freedman and colleagues from Plastic Surgery Associates of Northern Virginia analyzed the onset and extent of the dermatologic changes associated with microdermabrasion. Ten volunteers, ages 31-62 years, underwent a series of six aluminum oxide microdermabrasion facial treatments 7-10 days apart. The researchers reported improvement compared to the control group: Compared to the controls, the treated areas demonstrated the following histologic changes: thickening of the epidermis and dermis, flattening of the rete pegs, vascular ectasia and perivascular inflammation, and hyalinization of the papillary dermis with newly deposited collagen and elastic fibers…. This study suggests that microdermabrasion produces clinical improvement by a mechanism resembling a reparative process at the dermal and epidermal levels.
Notably, microderabrasion appears to enhance the effects of topical treatments. In fact, when microdermabrasion is combined with topical antioxidants (and perhaps other topical agents), the benefits appear to be synergistic. In another study, published in the Journal of Dermatological Treatment in 2009, Dr Freedman from Plastic Surgery Associates of Northern Virginia investigated whether the addition of a polyphenolic antioxidant serum enhanced the dermatologic changes seen following microdermabrasion. Ten female volunteers, aged 38-52 years, underwent a series of six microdermabrasion facial treatments spaced 7-10 days apart. An antioxidant serum rich in polyphenols was pneumatically applied to half the face immediately after each microdermabrasion treatment. The researcher reported significantly greater improvement in the group that received antioxidant serum in addition to microdermabrasion: Compared with the skin treated with microdermabrasion only, the skin treated with microdermabrasion plus antioxidant demonstrated significantly increased epidermal and papillary dermal thickness, and increased fibroblast density (p < 0.01). There was increased hyalinization of the papillary dermis with newly deposited collagen fibers. Skin polyphenolic antioxidant levels increased 32% in the skin treated with the polyphenolic antioxidant serum after microdermabrasion (p < 0.01). Clinical efficacy variables were significantly more improved in the antioxidant group when compared to baseline (p < 0.01)... The addition of a polyphenolic antioxidant serum to a facial microdermabrasion regimen enhanced the clinical and histological changes seen following microdermabrasion alone. Bottom line

Microdermabrasion does appear to have some skin rejuvenation benefits but they are are usually relatively modest and individual results may vary considerably. Most people may do as well or better using retinoids (e.g. tretinoin a.k.a. Retin) or other topical treatments. On the other hand, combining microdermabrasion with topicals, such as antioxidants, may produce greater benefits than microdermabrasion or topicals alone. The cost of multiple microdermabrasion treatments allegedly required for optimum results is comparable to that of ablative laser skin resurfacing. The latter is more risky but also significantly more effective. Depending on your treatment goal, many other noninvasive treatments may also be worth considering as a cost-comparable alternative to a series of microdermabrasion treatments.