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With Microdermabrasion, Rough Seems to Work Better

Acne scars and wrinkles benefit from more aggressive treatment, study finds

WEDNESDAY, Oct. 21 (HealthDay News) -- Rough buffing of the skin does a better job of removing wrinkles and acne scars and stimulating healing than a gentler rubbing, University of Michigan researchers report.

Known as microdermabrasion, skin buffing has become a popular way to improve the appearance of wrinkles, acne scars, skin discoloration and other signs of aging skin. The procedure involves buffing the skin with grains of diamond or another hard substance such as aluminum oxide crystals, the researchers explain.

Laser resurfacing is considered the "gold standard" for removing wrinkles, acne scars and skin discoloration, but it requires a long healing period after treatment and can sometimes leave the skin damaged, said study leader Dr. Darius J. Karimipour, an assistant professor of dermatology at Michigan.

But with microdermabrasion, he said, the skin heals quickly. Someone could have a treatment at lunchtime and return to work with only a little redness. The researchers' goal was to make microdermabrasion more effective, he said.

"We came up with the idea of a more aggressive approach," Karimipour said. "If we treated the skin more aggressively with microdermabrasion, we could generate more collagen."

The key to improving the appearance of skin is to have the treatment induce the production of collagen, which is an important skin protein, Karimipour explained. Earlier studies had found that aluminum oxide microdermabrasion does not always stimulate collagen production, but he said it was not known if that could be achieved with a more abrasive substance.

To find out, Karimipour's team took skin samples from the arms of 40 people with sun-damaged skin. Samples were taken before and after the participants had microdermabrasion with either a coarse- or medium-grit, diamond-studded wand.

The researchers found that the course-grit diamond increased the production of compounds associated with wound healing and skin remodeling. These included cytokeratin 16, which helps skin heal after injury.

In addition, the coarse-grit buffing produced antimicrobial peptides that fight infection and substances that break down the skin's structural proteins to let the skin rebuild. The researchers also found that skin produced other substances that induce collagen production.

These changes were not seen in skin treated with the medium-grit device, they noted.

Their findings are published in the October issue of Archives of Dermatology.

"This research gives us the basis to believe that aggressive microdermabrasion abrasion could potentially result in beneficial effects like we see in other more aggressive procedures, like laser resurfacing," Karimipour said.

However, he predicted that aggressive microdermabrasion would not replace laser resurfacing. Microdermabrasion is not for the most severe cases but rather for fine-line wrinkles and shallow acne scars, he said.

Dr. Jeffrey Salomon, an assistant clinical professor of plastic surgery at Yale University School of Medicine, said that "the more damage induced to the skin, by whatever mechanism, the stronger the body's repair response."

For microdermabrasion-induced injury, coarseness of the grit is only one part of the picture, Salomon said. "The duration of application, pressure applied during the application and the recipient skin thickness are also parameters, just like different grit of sandpaper are used for different types of wood and different types of applications," he said.

Treating the skin first with chemical peeling agents can reduce the amount of grit needed to get a skin-repair response equivalent to that of a coarser-grit wand, Salomon said.

"So there are a variety of parameters that can be manipulated to achieve equivalent results, independent of the coarseness of the grit," he said. "In the end, you do need to induce an injury to the skin to get objective evidence of skin rejuvenation."

More information

The American Society of Plastic Surgeons has more on dermabrasion.

SOURCES: Darius J. Karimipour, M.D., assistant professor, dermatology, University of Michigan, Ann Arbor, Mich.; Jeffrey Salomon, M.D., assistant clinical professor, plastic surgery, Yale University School of Medicine, New Haven, Conn.; October 2009, Archives of Dermatology

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