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Ep 43: Microdermabrasion – Benefits, Procedure, Side Effects
Dr.TWL: Hi guys and welcome to this week’s episode of Dermatologist Talks: Science of Beauty. I’m Dr. Teo Wan Lin of TWL Specialist Skin & Laser Centre, and today we’re gonna be talking about microdermabrasion facial.
Chelsea: This is a topic I’ve always wanted to find out more about. From my knowledge, microdermabrasion is usually performed in a dermatologist’s practice. It’s been touted to leave you with visibly smoother skin, and an effective method to reduce fine lines and wrinkles. While booking a microdermabrasion facial appointment may not be an option right now during the pandemic, or just not as practical for busy individuals, investing in an at-home microdermabrasion device might be the best option.
Well I do know that your brand Dr.TWL Dermaceuticals does have a microdermabrasion device – Silkpeel Home Medifacial Kit. Before we go into that though, can you tell us more about the practice of microdermabrasion?
What is microdermabrasion? How did it all start?
Dr.TWL: Microdermabrasion is a type of skin resurfacing procedure performed by practitioners in an outpatient healthcare setting. This is usually in a dermatologist practice. It’s essentially used to treat certain signs of photoaging, such as uneven, dull skin tone, acne scars and superficial wrinkles. It is one of the most common cosmetic procedures that’s performed worldwide. Just a little bit of background about it. It was first introduced in 1985 by 2 dermatologists, as a less aggressive form of skin-resurfacing compared to chemical peels and dermabrasion. It has become quite a popular cosmetic treatment mainly because of its ease of use, minimal downtime and good results.
Microdermabrasion facial occurs by the release of crystals through a handpiece. It is combined with a vacuum-assisted process. This applies gentle suction to remove the topmost layer of your skin, known as the stratum corneum.
Chelsea: That’s interesting to hear about how it all started.
What can microdermabrasion facial do and what kind of results can we expect?
Dr.TWL: The common reasons we recommend microdermabrasion facial is for the improvement of certain skin signs of ageing. Photoageing is the term we use for sun-induced ageing. Biological skin-related due to chronological age itself can result in uneven skin tone, texture, pigmentation, spots and wrinkles. This is essentially due to the loss of the ability of the skin to combat oxidative stress. For individuals who suffer from acne scars and slightly deeper skin wrinkles, they also respond well to the resurfacing process. As those with more superficial type of acne scarring, post-inflammatory hyperpigmentation as well as those with superficial wrinkles.
Fractional CO2 laser for acne scars
Compared to traditional forms of skin resurfacing, fractional CO2 laser in this instance, is a lot deeper and is traditionally indicated for individuals who have moderate to severe photoaging as well as deeper dermal acne scars mentioned in the first part. But microdermabrasion on its own is something that has value. Because it has minimal downtime, a nurse or an aesthetician can perform the procedure. It’s also a tool that can augment the results of a fractional CO2 laser procedure.
In a sense, many seem to think microdermabrasion facial is an equivalent to a chemical peel. When we remove the topmost layer of the skin (stratum corneum) through this process, it stimulates skin wound healing process. This is a key part of the treatment outcome as well. We are not just talking about exfoliating, removing the topmost layer. This is the reason why we do not recommend exfoliating with harsh beads or any sort of rough abrasive substance. These cause skin damage without stimulating collagen production. However in specific treatments used in our practice, microdermabrasion, chemical peels, fractional resurfacing. All these evidence-based methods actually stimulate collagen production. Ideally, after the microdermabrasion facial, skin that grows back will be healthier overall. There’ll be less appearance of dullness, greater radiance, less fine lines, wrinkles, and more even pigmentation.
Chelsea: Well I’ve actually watched a video on the microdermabrasion process. It looks like the skin is first prepped with a toner to clean off the residual skincare products used before. Then a diamond tip wand is runs across the skin. After that, the cleansing of the skin.
What usually happens for a microdermabrasion procedure?
Dr.TWL: The entire area of skin to be treated with microdermabrasion, whether performing it at home or in the clinic. This entire area of skin should be cleansed with a gentle cleanser. We will then place a moist gauze over the eyes to prevent any accidental contact. This is for the abrasive diamond tips the dermatology practices use. With negative pressure emitted from the head of the device, it will then pull the skin into the hand piece. That’s when the release of the abrasive crystals occurs at a controlled rate. Something to note here is that we do not expect a lot of skin irritation with this process. However, individuals with pre-existing eczema, facial eczema or a tendency to develop eczema, active acne, severe forms of cystic acne should not use this procedure on their skin.
For the implementation of microdermabrasion facial in the outpatient setting, it’s very straightforward. There is no need for any numbing cream as it is not particularly uncomfortable. The abrasive crystals basically push against the skin with a handheld vacuum system. Overall, with very gentle mechanical abrasion, the surface of the skin sheds the topmost layer, the stratum corneum.
Chelsea: Ah, so it shouldn’t be an overly uncomfortable or painful process. Well I can definitely see a lot of benefits of either at-home or in clinic microdermabrasion facial for the skin, especially in the sense of improving skin texture and smoothness!
Can microdermabrasion also help with other skin issues like acne and skin ageing?
Dr.TWL: We know that a lot of your skin’s inherent radiance, elasticity, appearances of youthful-looking skin, lose with age. Part of it is because skin cells retain and this comes with an increase in chronological age. Something to note is that for acne-prone patients, there is retention of dead skin cells around the hair follicles. This is a phenomenon we call follicular hyperkeratosis. That is the reason why chemical peels and microdermabrasion are treatment adjuncts for individuals who suffer from active acne too. But to note, usually not the type of cystic or infected types of acne.
Chelsea: So those with acne can go ahead and try out this procedure as well, as it may actually work as part of treatment too! Well in that case, what can we expect after microdermabrasion facial?
What is the aftercare like?
Dr.TWL: Well that is a very good question. What happens after the microdermabrasion facial is equally important to what happens during the procedure. Part of the wound healing process is essentially the regrowth of your skin, the new epidermis. It will look more radiant and refreshed, simply because the cells are younger. This overall leads to a better cosmetic effect, something that we also see in superficial and medium depth chemical peels.
Chelsea: On that note, you’ve also talked a little bit about microdermabrasion facial being compared with chemical peels in the sense that they are both exfoliation procedures.
Is there a difference between microdermabrasion and chemical peel? Which treatment is better?
Dr.TWL: It is really important to put this in the context of Asia. As a dermatologist practicing in Singapore, most of my patients belong to the category of skin of color. We are actually very cautious about using medium, or even deep chemical peels in our practice. In fact I don’t use any of those in Asian patients. Because unlike in Caucasian patients, there’s this inherent risk of developing hyperpigmentation.
The benefit of microdermabrasion facial is because the process is a mechanical one. Hence, in a sense, we can perfectly control the depth of penetration unlike using the chemical peel. Whereas if you leave it on for a little bit longer, you actually may develop irritant contact dermatitis, for example. Sometimes with inexperienced users, the assessment of skin types is not accurate, may cause adverse events arising from chemical peels. Because it is a mechanical process, it has nothing to do with the length of time or changes in concentration that a layperson or a non-specialised personnel, if they mess up, can cause adverse reactions. It is generally safe for all Fitzpatrick skin types, including skin of color.
Enhanced delivery of cosmeceuticals
Chelsea: Well I did a little bit of homework before coming here, and I did actually read a paper by Zhou et al, published in the Journal of Cosmetic Dermatology on the enhanced delivery of cosmeceuticals by microdermabrasion. Can you tell us a little more about that?
Dr.TWL: Firstly, your skin can actually absorb cosmeceuticals and medications much better with microdermabrasion. This has been proven in studies. It is also important to note that it enables active dermocosmetics that usually do not penetrate the skin barrier very well, to absorb better. There are several ongoing studies which show good results using microdermabrasion as a tool to enhance transdermal drug delivery. All of these, we want to emphasise that its in the field of cosmetic science we are applying it to. Rather than delivery of medications for systemic illnesses.
Chelsea: Well with so many benefits mentioned, in all, is microdermabrasion good for your skin?
Are there any situations or certain skin types where it is not recommended?
Dr.TWL: The answer is yes, in the context of improving the science of photo ageing. And as an adjunct in the treatment of moderate to severe acne scars. It is a relatively low costing, safe and efficient way to stimulate new skin cells to grow. However, it is really important to note that for in clinic microdermabrasion, the tools are a lot more abrasive than the home kits. This should be under medical supervision even if it’s by a non-medical personnel.
There are some pre-existing skin conditions that dermatologists would usually be aware of and ensure that we do not perform this procedure on such patients. This would be skin infections, people with active cold sores or even with a history of cold sores, they would be a poor candidate for microdermabrasion. If they have any other form of active lesions or broken skin on their face, active acne, for example those with cystic acne, these individuals do not suit the procedure. For individuals who suffer from certain types of pigmentation, such as melasma, we have to be very careful in using microdermabrasion in skin of color, with the condition of melasma, it is often a hit and miss, because sometimes we find that the mechanical trauma to the skin can activate the melanocytes which causes more hyperpigmentation.
Chelsea: So there are a few specific concerts about microdermabrasion, especially in Asian skin – you mentioned hyperpigmention.
What should I look out for when I’m using microdermabrasion?
Dr.TWL: Well, it is very helpful for individuals who want an adjunct to their current anti-ageing regimen to include microdermabrasion in their skincare routine. For chemical peels, between the at-home microdermabrasion kits and trying an online version of illegal chemical peels, I feel that it’s definitely safer to use a home device. For skin of colour, we worry about hyperpigmentation, and I do see a number of patients who buy chemical peels online and as we know that it is not legal for non-medical personnel to own chemical peels of a certain concentration in Singapore. These people actually ended up with chemical burns. Hyperpigmentation arises from chemical burns via the process of post-inflammatory hyperpigmentation.
For microdermabrasion, theoretically, if the depth of abrasion is not suitable, for example, it is a very abrasive tool for sensitive skin, then you are also at risk of developing post inflammatory hyperpigmentation, which is greater in Asian skin and skin of color. I think it is important for a home device to be well-designed and catered for individuals with a little bit more sensitivity. So if you are belonging to skin of color, our silkpeel actually has 3 different modes of microdermabrasion which you can self-adjust and is super gentle.
Living in Singapore, I just want to highlight that there is a specific type of climate at the equator, talking about near 100% of UV ray exposure and whether you are undergoing a chemical peel or microdermabrasion procedure, it is going to make you photosensitive. So using sunscreen and aftercare is extremely important and also I feel that something we need to emphasise as part of longer term maintenance regime rather than just a touch and go cosmetic procedure.
The SunProtector is includes physical blockers like titanium dioxide and zinc oxide that effectively blocks blue light emitted by indoor devices. Portulaca Oleracea (Purslane) and Oligopeptides in our SunProtector are potent antioxidants which actively fight free radicals generated by blue light as well as airborne pollutants – for comprehensive protection.
Chelsea: Wow yeah that’s really important to keep in mind. Apart from the photosensitivity that we should be careful of, is there any chance of skin allergies with microdermabrasion?
Allergies associated with microdermabrasion
Dr.TWL: Allergies with microdermabrasion are actually quite rare. There are individuals with contact allergy to the crystal itself. The most common crystal is aluminum oxide and that would actually mean that when you use the tool on the individual’s face, there would be an allergic sensitive reaction. An alternative metal oxide should be used, now in the case of Silkpeel, we developed it with copper oxide. The reason is because of the structure of the compound. It is overall less abrasive and we know that the release of copper ions actually stimulates collagen production. In a sense, it is killing two birds with one stone and as a home microdermabrasion tool, it is important that it is easy to use, gentle, fail proof and foolproof, so there can be no accidents.
Chelsea: Well the Silkpeel is unique in that it utilizes a proprietary copper-infused Microcrystalline tip that delivers skin healing cosmeceutical benefits, has collagen-stimulating functions, and is ultra-gentle on the skin. What is the difference between a home microdermabrasion device, and the in-clinic microdermabrasion treatment? Can a home device really replace the need for in-office treatments?
What are the differences between at home and in-clinic microdermabrasion treatment?
Dr.TWL: About the difference between at home microdermabrasion compared to an in office treatment, it’s a very relevant question. So, when we launched the biomaterials arm in late 2019, the silk peel is a home microdermabrasion device that we developed for our overseas patients who were unable to follow up with us, when they come in to do their medical microdermabrasion procedures and then they leave and they feel like they want an equivalent, which they can also have access to at home and you know we’ve COVID-19 I think this at home device has become even more relevant.
I just want to share about the key concept that differentiates home kits versus in-office microdermabrasion tools. It should be less abrasive in the clinic, the usage of the diamond tip is also horribly expensive so you can’t incorporate that into a home device that you want to sell for a reasonable price that the general public can afford.
Microdermabrasion safety tips
Also, in the clinic setting, another person needs to use the diamond tip, you can’t do it on yourself, you need to protect your eyes, etc. If you’ve any of these contraindications, which we discussed before then nobody will pick it up, and that can be very dangerous and they can really aggravate your condition. The home kits often use aluminium oxide, in this case, copper oxide. There will be a release of these crystals during microdermabrasion.
We talked about the handpiece that comes with it with vacuum suction that helps to remove the topmost layer of your skin in the process. The whole purpose of this home microdermabrasion kit is similar to the clinic microdermabrasion procedure. We want to stimulate skin cell renewal, but at the same time for the home device because we perform more frequently, it’s much gentler on skin, easy to use, better access, it is like a one-time purchase. We also want to highlight the fact that you can use it to increase the absorption of cosmeceutical serums.
Chelsea: We can layer a few different products into our skin, but make sure each step is getting absorbed and is bringing the most benefits to our skin. One of the benefits of the Silkpeel is the increased absorption of cosmeceutical active ingredients into the skin. Can you tell us more about the science behind this?
The science behind increased skincare absorption with microdermabrasion
Dr.TWL: Now, it’s probably not as well publicised, the fact that microdermabrasion remains a very effective tool to increase delivery of dermal cosmetics. Cosmeceuticals are essentially in my realm of research. We are constantly looking for ways that would help active ingredients penetrate the skin barrier more effectively.
Well what do you think of the technology behind home devices that are are all the rage in the skincare and beauty world right now?
Dr.TWL: As you grow older, you’re less able to absorb active ingredients. With microdermabrasion, it is actually the perfect sort of home device to introduce into your skincare regimen. Let me explain why. For all other types of home facial devices, including the popular LED light home devices, I do not think that it contains enough wattage in comparison to what has been studied and practiced in offices for the treatment of either acne or increasing skin radiance with this photo biological effects of LED lights.
Firstly, the device itself is a home use advisor. It is actually pretty small and also the cost of manufacturing has to be taken into consideration. With microdermabrasion, I feel that it fulfils many of the criteria, including safety, efficacy, ease of use, and actually having a real function in terms of fighting the ageing process and even as the adjunct treatment of common skin conditions such as acne scars. Hence, it’s certainly my top choice for a home device.
When we develop the silkpeel medifacial kit, we also incorporate medifacial solutions our pharmacy compounds. That’s what we have been using in our clinic with our vacuum microdermabrasion system. If you understand the Korean medifacial, hydrafacial, these are all forms of microdermabrasion that use this vacuum technology to infuse antioxidants and other dermal cosmetic ingredients into your skin.
Depending on your skin concern, be it hyperpigmentation, other types of pigmentation, oily skin, acne-prone skin, or even sensitivity and eczema. The choice of the ingredients we put in the medifacial solution are specific in addressing those concerns. You know that the vacuum microdermabrasion process which you can use with a device at home is going to increase the absorption of these active ingredients, which actually is the main point, whatever you apply in your skin.
Dermatologist’s advice on treating an active pathology
Frankly, this is a point where I just have to highlight that, if we were to think of it in the sense of feeling lazy about doing all of these things, and I just can’t imagine doing all these things for myself. Why can’t I just put one cream, and that’s it. Well, the reason is this. If you’re trying to treat an active pathology, you have to deliver the correct therapy, and for skin, you are going to apply the active ingredients, in order for it to exert an effect but that’s not just the end of the story, you also need it to penetrate the skin barrier.
Besides all we’ve spoken about in the realm of dermocosmetic formulation, the efficacy and the evidence behind these active ingredients, we do need to talk about increasing the absorption of these active ingredients.
Chelsea: Now, the amazing thing about microdermabrasion is that one does not need to attend a clinic for the treatment anymore. We actually have incorporated this technology into a handheld device we call the Silkpeel, which essentially uses an abrasive crystal copper oxide, which helps to resurface the skin as the vacuum action is released through the handpiece.
The SilkPeel Microdermabrasion Kit is engineered with CUIONS™️ Technology. It includes a copper-infused microcrystalline tip which delivers skin-healing cosmeceutical benefits.
We recommend this for use in conjunction with our cosmeceuticals as it increases the absorption of skincare, as well as all the exfoliating benefits of a classic in-clinic microdermabrasion treatment. Well, that’s it for this week’s episode of dermatologist talk science of beauty. You can follow Dr. Teo on instagram at @drteowanlin.