Microdermabrasion and Mechanical Exfoliation
How it works
Microdermabrasion mechanically removes the stratum corneum using aluminum oxide crystals delivered under vacuum or a diamond-encrusted tip used with vacuum alone. Crystal systems are either open-loop, where crystals and debris are collected in a waste canister, or closed-loop with a sealed handpiece. Depth is controlled by tip grit, vacuum strength, number of passes, speed of movement, and how taut the skin is held. Typical protocols use one to three passes in one direction, with cross-hatch passes only on resilient, nonreactive skin.
Indications and realistic claims
Good candidates have dull texture, mild photoaging, superficial hyperpigmentation, or mild post-acne texture. Improvement is gradual and temporary; results build with a series spaced two to four weeks apart. Marketing language such as erases scars or removes wrinkles is both inaccurate and, in a licensed setting, a compliance problem.
Contraindications
Avoid active or cystic acne, rosacea, couperose and telangiectasia, sunburn, open lesions, recent retinoid or AHA use, recent waxing, isotretinoin therapy, keloid tendency, uncontrolled diabetes, immunosuppression, and fragile or thin skin. Avoid bony areas near the orbital rim and never treat over the eyelid or lip margin. Post-treatment, apply a calming moisturizer with SPF and instruct the client to skip actives and heat for about 48 to 72 hours.
Traps: treating directly over active pustules, assuming more passes always means better results, and forgetting that the vacuum itself can bruise or petechiae on thin or medicated skin. Rule of thumb: the tip touches, the vacuum lifts - light tension and steady motion beat heavy pressure; if the skin turns bright red, stop and reassess.