J Dermatolog Treat. 2009; 20(2): 82-7Freedman BMBACKGROUND: Microdermabrasion has been accepted as a reliable, non-invasive method for facial rejuvenation. Recently, there has been interest in combining this technique with other modalities to increase its efficacy. The purpose of this study was to determine whether the addition of an antioxidant-based serum enhanced the dermatologic changes seen following microdermabrasion. METHODS: Ten female volunteers, aged 38-52 years, underwent a series of six diamond tip crystal-free 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. Skin biopsies and skin polyphenolic antioxidant levels, determined by Raman spectroscopy, were obtained prior to and after the study period. Investigator ratings for efficacy were analyzed after the study period and compared to baseline. RESULTS: 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). These changes were supported clinically via digital photography. CONCLUSION: The addition of a polyphenolic antioxidant serum to a facial microdermabrasion regimen enhanced the clinical and histological changes seen following microdermabrasion alone. This combination should strengthen the use of microdermabrasion as a non-invasive facial rejuvenation tool and support the role of topical antioxidants as anti-aging factors.

Int J Dermatol. 2008 May; 47(5): 508-13Davari P, Gorouhi F, Jafarian S, Dowlati Y, Firooz ABACKGROUND: Microdermabrasion (MDA) is a safe, simple, and beneficial technique for superficial skin resurfacing. Despite its popular usage, few studies have assessed the efficacy of different MDA protocols applied at the present time. Objectives To assess the effects of MDA generally, as well as to compare the effects of two vs. three passes of MDA in each session for a total number of six therapeutic sessions on skin biophysical characteristics. METHODS: In this randomized, investigator-blind, split-face study, 10 patients underwent a series of six MDA treatments with an interval of 2 weeks. One side of the face was treated with two passes of MDA and the other side was treated with three passes, randomly. Stratum corneum hydration, sebum secretion, and skin pH measurements were obtained before and after the procedure on all sessions and also 1 and 4 weeks after the last treatment. RESULTS: After six sessions of MDA, a decrease in sebum content compared to baseline was shown at the end of treatment sessions, but no statistical difference was observed between two vs. three passes groups (-30.0 [interquartile range, IQR = 50.0] vs. -27.5 [IQR = 125.3], respectively, P = 0.58). Comparison of two treatment groups showed significant higher values of sebum content in the first follow-up after treatment with three passes of MDA. (64.0 [IQR = 52.0] for three passes vs. 45.0 [IQR = 46.0] for two passes, P = 0.04) A significant increase was observed in pH values at the end of treatment series, first and second follow-up after treatment with two passes of MDA. CONCLUSIONS: MDA may have remarkable effects on skin barrier function changes resulting in skin clinical improvements (Cochrane Skin Group identifier: CSG No. 37).

Indian J Dermatol Venereol Leprol. 2008 Jan; 74 Suppl: S28-36Khunger N, Acne surgery is the use of various surgical procedures for the treatment of postacne scarring and also, as adjuvant treatment for active acne. Surgery is indicated both in active acne and post-acne scars. PHYSICIANS' QUALIFICATIONS: Any Dermatologist can perform most acne surgery techniques as these are usually taught during postgraduation. However, certain techniques such as dermabrasion, laser resurfacing, scar revisions need specific "hands-on" training in appropriate training centers. FACILITY: Most acne surgery procedures can be performed in a physician's minor procedure room. However, full-face dermabrasion and laser resurfacing need an operation theatre in a hospital setting. ACTIVE ACNE: Surgical treatment is only an adjunct to medical therapy, which remains the mainstay of treatment. Comedone extraction is a process of applying simple mechanical pressure with a comedone extractor, to extract the contents of the blocked pilosebaceous follicle. Superficial chemical peel is a process of applying a chemical agent to the skin, so as to cause controlled destruction of the epidermis leading to exfoliation. Glycolic acid, salicylic acid and trichloroacetic acid are commonly used peeling agents for the treatment of active acne and superficial acne scars. CRYOTHERAPY: Cryoslush and cryopeel are used for the treatment of nodulocystic acne. Intralesional corticosteroids are indicated for the treatment of nodules, cysts and keloidal acne scars. Nonablative lasers and light therapy using Blue light, non ablative radiofrequency, Nd:YAG laser, IPL (Intense Pulsed Light), PDT (Photodynamic Therapy), pulse dye laser and light and heat energy machines have been used in recent years for the treatment of active inflammatory acne and superficial acne scars. Proper counseling is very important in the treatment of acne scars. Treatment depends on the type of acne scars; a patient may need more than one type of treatment. Subcision is a treatment to break the fibrotic strands that tether the scar to the underlying subcutaneous tissue, and is useful for rolling scars. Punch excision techniques such as punch excision, elevation and replacement are useful for depressed scars such as ice pick and boxcar scars. TCA chemical reconstruction of skin scars (CROSS) (Level C) is useful for ice pick scars. Resurfacing techniques include ablative methods (such as dermabrasion and laser resurfacing), and nonablative methods such as microdermabrasion and nonablative lasers. Ablative methods cause significant postoperative changes in the skin, are associated with significant healing time and should be performed by dermatosurgeons trained and experienced in the procedure. Fillers are useful for depressed scars. Proper case selection is very important in ensuring satisfactory results.