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by Isabel Dassinger
Dermascope
May 2001

Microdermabrasion continues its high ranking as a new source for increased revenue. Learn how to integrate safe, innovative applications for expanded services and marketing advantages.

Microdermabrasion, first introduced to the American skin care market almost four years ago, has delivered amazing results time and time again. Skin rejuvenation is now at a level once only dreamed of; skin conditions previously looked at as untreatable or only "manageable," have been corrected to the degree that they no longer recur.

Resurfacing treatments that create trauma to the skin and questionable days of recovery have been replaced with the safe, rejuvenating, non-invasive approach of microdermabrasion. This procedure originally was called microepi-dermabrasion because the dermis is not actually being abraded; however, the term microdermabrasion has become the identifying term for this skin care technology. The average initial series of treatments is five to eight sessions, but the universal enthusiasm for this treatment and its unparalleled long-term benefits have kept men and women of all ages coming back for more.

The unequivocal success of microdermabrasion has opened up questions such as
- How much is too much?,
- What is the long-term protocol?, and
- How do I sustain these amazing results?

Preserving Youth
Microdermabrasion has the distinction of bringing a new approach to skin care. Its' ability to gently yet effectively refine and smooth the skin surface while stimulating healthy vital reactions in the deeper layers of the skin is unprecedented. One main key to its success is the micromassage action of the treatment. While the focus is on the epidermis, the suction used to remove crystals or grains creates action below the surface to stimulate blood flow with its essential nutrients and oxygen to nourish the skin and fortify cells. The flushing movement generated below the surface by the lymph flow provides cleansing and balancing benefits. It is this cleansing action that is directly related to microdermabrasion's corrective contributions to clearing many acne conditions. The lymphatic drainage of the face also helps to reduce puffiness, particularly around the eyes; for a more toned and healthy appearance following treatment.

Science Confirms Regeneration
Last year we saw the results from one of the most recent clinical reports on microdermabrasion. The results verified what we all have been experiencing: significant collagen accumulation i.e., an increase in superficial papillary dermal collagen (new collagen formation), characterized as a renewed plumpness of the skin resulting in a more youthful appearance of the complexion.
One result we were not expecting to see was a thickening of the epidermis. This related to the collagen accumulation as well as the healing response from the skin treated by microdermabrasion. The following excerpts from the Mark Rubin M.D., and Steven Greenbaum, M.D. report on microdermabrasion (Histologic Effects of Aluminum Oxide Microabrasion on Facial Skin) published last year in the JOURNAL OF AESTHETIC DERMATOLOGY and COSMETIC SURGERY further emphasizes the breakthrough that:
It is easy to understand why this therapy has been successful in the treatment of epidermal lesions, because this technique, like superficial chemical peeling, removes part of the epidermis. However, the improvement seen in some wrinkles and scars is markedly better than would be expected from a purely epidermal treatment. These clinical signs imply that there are some dermal changes occurring as well.

What is interesting to keep in mind is the idea that a dermal wound is not necessarily needed to create dermal changes...

Repetitive intraepidermal injury has the ability to improve a photodamaged epidermis gradually. Additionally, through an unidentified pathway, these intra-epidermal injuries stimulated changes in the dermis leading to increased fibroblast activity and new collagen deposition.

We believe those unidentified pathways to be directly related to the below-surface activity created by the micromassage of the system. Other studies underway show the positive effects of microdermabrasion on different stages of acne, deep lines and wrinkles (rhytids) and basic rejuvenation. The results from microdermabrasion continue to be universally positive because the treatments bring skin to a healthy state. Whatever the condition, with a healthier skin as its base many conditions begin to heal themselves. The fact that microdermabrasion is performed in a series of treatments allows the technician to gradually and safely take the skin to new levels of health and beauty without compromising its delicate nature.

Managing Surface Skin Renewal
When the skin surface is disrupted a cell division takes place. This is the principal behind glycolics and other products that deliver a fast turnover of surface skin cells. This division stimulates fibroblast activity, one of the rejuvenating mechanisms in the skin that slows with age, resulting in the loss of skin elasticity. Fibroblast activity also creates the protein fibers, which are the building blocks of collagen.

Microdermabrasion treatments can create these effects in varying degrees and still offer so much more because they include a thickening of the epidermis.

Repeated microdermabrasion treatments maximize this process because of their unique ability to deliver outstanding reproducible results both above and below the surface. Before microdermabrasion we did not have a multilevel approach to skin care. Now we continually see its effects on long-term skin health. Discovering new ways to maximize this new technology offers great opportunity to all of us.

Long Term Approaches - Innovative Techniques
Here are some proven techniques and approaches to ensuring you and your clients get the most from microdermabrasion:

How Deep?
Establishing long-term protocol has to include an understanding of the variations that are used to complete a treat-ment. The depth of treatment is a critical component and the three main factors are the following:

1. Number of passes
2. Length of passes
3. Speed of passes

The slower and longer the connection of the pass the deeper the peel and the more dermal action is stimulated. In order to have sustained connection make sure your system has dual controls so you have the ability to control your depth of treatment and your volume of crystals. This allows you to treat all skins from temperamental teen skin to fragile senior skin. The ability for the system to give powerful effects delivered in a way that is still gentle and comfortable for the skin is essential for long term protocol and business relationships. For the areas of thinner skin, i.e., under eyes, neck, upper lips, you need to reduce suction while maintaining good crystal flow. Efficient vacuum for crystal removal is state of the art technology that should be available in every modem system. You need to clearly see the skin and over abrasion of the skin caused by re-working the crystals into the skin impede quick healing. Use shorter, more refining strokes in these areas.

How Often?
After the initial series of microdermabrasion treatments have been completed scheduling should be every two to three months. Think seasonal as a good guideline. Avoid treatments during high summer months when the sun is brightest. Intersperse microdermabrasion treatments with basic rejuvenating facials or with other new skin technology advances such as electro-muscular-stimulating (EMS) facial toning and exercising equipment. Reduce or eliminate the daily use of rapid skin exfoliators and allow skin to rebuild its outer mantle. Use sun block every day.

Face Sculpting
Try the Perimeter Peel and Face Sculpting techniques to fully utilize the collagen rejuvenating benefits by focusing on key "lifting" areas of the face.

Face Area Setting
Eyebrow area 35-40
Between brows 25-30
Upper eyelid 25-30
Temple area 35-40
Under eye 15-25

*(Setting adjustment is based on client comfort, skin thickness and skin response. You can always increase the number of passes to increase the skin exfoliation) .

Super Eye-Lift Treatment:
Bring back youthful brightness to the eyes by revitalizing the surrounding skin and giving lift and tone to the area. Start with an aggressive peel to the skin under the eyebrow, working the area in between the brow as well. Next, pull up the skin of the upper lid to the brow bone and peel. The next area to treat is the temples with back and forth passes from the cheekbone area to the upper temples. Use cross patch strokes (at least eight each), and the renewed elasticity of the skin will uplift the eye corners beautifully. Complete with under eye sweeps, from the inner comer out, using half strokes at least three to four times. Don't forget the inner comer/nose area.

Lip Treatment
The lip response to microdermabrasion has been outstanding. Not only do we see the fine lines diminish but the plumpness and "pout" of the lips is restored. Use handpiece positioned so the lip line is in the middle of the opening. Hold taut and follow lip outline with short inch-long strokes. Do the upper lip and bottom lip two times. Work with short brush strokes to refine lines around the lips. Great for chapped Iips too. Use the Perimeter Peel diagram to focus on areas that give height and lift to the face but, as indicated, restrict work on the projected areas of the face such as the cheekbones and nose and center of the forehead.

Extend neck in an upward
direction for tautness.

Finally! Rejuvenation for the Neck -Tone for the Jaw
Areas that can benefit greatly from microdermabrasion are the neck and jaw. These are areas that are quick to show the signs of aging and are not as easy to treat. The skin on the neck is very thin and can be easily damaged by aggressive treatments, such as laser and chemical peels, leaving facial surgery as the traditional alternative. The skin on the jaw area however is thick and heavy and is constantly fighting against the pull of gravity and nature of time. The jaw area is quick to lose elasticity, so employing the theory of collagen rejuvenation with concentrated work on this area helps to combat the "pull" of time by thickening the supporting tissue.

The neck and jaw offer a unique opportunity for microdermabrasion, which lengthens the look of the neck by smoothing and refining the skin. It also stimulates the collagen to help give support and tightness to the skin on the neck. The need to use low suction and higher media projection is important to ensure good results. Don't forget to treat behind the ears.

A unique benefit of microdermabrasion is the openess it brings to the skin surface.