MICRODERMABRASION

advanced education

A Buff and Polish

of the Skin

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Course Outline For Microdermabrasion

• What is MD
• Why Learn MD
• Benefits of MD
• History of MD
• Understanding Dermabrasion
• Clinical vs. Medical MD
• How does MD Work
• MD and the Skin
• Crystals used in MD
• Crystals vs. Non-Crystal
• Risk of MD
• Consultation
• Contraindications
• Concerns 2
What is Microdermabrasion (MD) ?

• Known as:
• “Micro-Epidermabrasion”
because the epidermal layer is
the only layer affected by
abrading with tiny grains to buff
and polish the outer layers of
the skin.
• MD uses a hand held wand that
is relatively painless and mild
discomfort and a sensation of
light tingling.

• MD Can be used in conjunction

with other clinical aesthetics
procedures.
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Why Learn Microdermabrasion?
MD was the newest top
aesthetics procedure in
2005 performed in the
United States.
An overall of 150,000 MD
procedures were
performed, which was an
increase of 26% from
2003.
MD is still as popular in
2012 as it was in 2005.
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 Benefits of Microdermabrasion
• Improvement of sun-damaged skin •Immediate results and continued
• Smooth out fine lines and wrinkles improvement
• Evens overall skin texture •Physicians reports optimal results after
• Increased cell turnover 5 – 8 TX
• Improves product penetration
•For all Fitzpatrick skin types
• Improves moisture retention
•Minimal patient discomfort
• Stimulates blood flow for oxygenation
• •Minimal side effects
Improves pigmentation issues
• Minimizes acne scars •No anesthesia or recovery time required
• Minimizes large or oily pores •30 minutes to an hour
• Improvement in comedones, milia and •No downtime
congestion •Affordable
• Overall general exfoliation/rejuvenation •Can be used with chemical peels
• Brightening of uneven skin tone •Adjunctive to cosmetic surgery
• Improves minor stretch marks •Blended post laser skin
•Improves Keratosis Pilaris
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(rough skin bumps)
History of Microdermabrasion

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Before Modern Day Microdermabrasion

• Skin abrading dates

back as far as 1500
BC, when Egyptian
physicians used a
type of sandpaper to
smooth scars and
rejuvenate the skin.
• This was first known
as dermabrasion of
the skin.
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 Understanding Dermabrasion
• 1905, Dr. KROMAYER used
dermabrasion to remove
tattoos, scars and hyper-
pigmentations.
• Rotating wheels and rasps
removed upper layers of the
skin.
• The non-electrical method
proved to be not very
accurate due to human error.

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1907-Dr. BRENKER used a static abrasive disc combined with a
suction to buff and polish the skin. Increased potential of
bacteria across the face required sterilization for procedure.

Manual dermabrasion of a Manual Dermabrasion of a

raised scar depressed scar
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End Results of Dermabrasion
1950's motorized wire brushes replaced the
non-electrical modalities and dermabrasion
became more acceptable.
This new procedure brought on new
challenges such as:
Pain – utilized anesthesia
Long downtime – weeks to
re-epithelize
Scarring – may cause scars
Wound care – meticulous skin care was
lengthy and difficult
Infection – high risk
Danger to practitioner - the abraded
skin particles were aerosolized exposing
the practitioner and staff to possible
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infection
Microdermabrasion Was Born

• By 2000 there were over 100 different MD

machines on the market.
• Currently there are still no manufacturing
performance standards by a government
agency.
• 2 types of MD machines were made;
Aesthetics Version and Medical Version.
• FDA classification as a Class 1 medical device
which has the following implications:
– Machines can be sold without any demonstration
of clinical efficacy.
– Machines can be operated without medical
supervision.
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 Clinical (Aesthetics) Microdermabrasion

• Developed in Italy in 1985 by Drs.

Mattioli and Brutto.
• This first machine was a "closed-
loop" system, meaning the skin was
abraded and returned to a "dirty"
container in the machine instead of
being aerosolized.
• Mattioli was introduced to the
American skin care industry in the
mid 1990‘s.
• Mattioli engineers set the standards
for MD machines of the future.
• MD boom began in 1996
Ultrapeel® Pepita Microdermabraders
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 Medical Microdermabrasion
• Medical MD was available in the US
in 1998 under the Parisian Peel
brand and others.
• In clinical experiences physicians
agree that medical MD adds value
to therapeutic and cosmetic plan of
treatments.
• Medical MD machines provided a
deeper suction level for skin
conditions below the top epidermis.
• Positive end results were achieved.
• Treatment provided by nurse or
clinical aesthetician.

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How Does MD Work?

The Skin and Microdermabrasion

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 The Horny Layer

Two main layers, the epidermis and the dermis. The epidermis is the top layer of skin.
Horny layer is closest to the outside world and sustains the environmental damage. 15
 The Stratum Corneum

The Stratum Corneum is the first layer under the horny layer. It is the most affected
layer under the horny layer. Chemical Acids are needed for transporting and
allowing structural change in the skin. 16
 Clinical MD Verses Medical MD

Clinical Aesthetics affects the epidermal layer of the skin and Medical Aesthetics
affects the dermal layers of the skin. The cosmetology scope of practice lies in
the epidermal layers of the skin.
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MD Action of Exfoliation
•Dead skin cells of the horny layer
continuously shed.
•Skin naturally sheds every 3 to 4 weeks
depending on age of client.
•Corneocyte cohesion develops by the
retention of dead skin cells giving the
appearance of dull, flakiness, dryness, fine
lines and wrinkles.
•Keeping the horny layer properly exfoliated
from dead skin cells provides for a healthy
looking skin, increases blood circulation,
stimulates the production skin cells and
collagen (fibrous protein).
•Once the horny layer is removed, a new
vibrant layer of skin is presented.
•Generally, MD only removes the stratum
corneum, the most superficial layer of skin (5-
10 microns deep).
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MD and Oily-Acneic Skin
MD crystals have proven to
break up sebum from acne
skin types.
Reduces corneocyte
cohesion.
Loosens congestions for
easier extractions.
Smoothes and evens skin
texture.
Assist in the reduction of Post
Inflammatory
Hyperpigmentation. 19
 Microdermabrasion Crystals

Corundum/
Aluminum Crystals
Sodium Bi-Carbonate
Crystals
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 Aluminum/Corundum Crystals
• Natural metal compound found in the earth.
• Variety of different colours including red
and green but the crystals used in MD are
almost always white and sometimes brown.
• Most commonly used in MD.
• Special qualities which make them
particularly good for MD:
– Hard
– Rough
– Cheap
– Light
– Anti-bacteria

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 Properties of
Aluminum Oxide Crystals (AO)
•Hard –AO crystals is hardest known materials,
second to diamonds. This hardness allows
them to be blasted onto the skin without
fragmenting.
•Rough – AO crystals have rough jagged
surfaces. This makes them excellent for
abrading against and exfoliating the top layer
of facial skin.
•Cheap - AO crystals are cheap which makes it
easy to buy them in large quantities.
•Light - AO crystals are much lighter than other
metallic crystals. This means they can be
blasted through MD machines easily without
applying too much air pressure.
•Anti- bacteria- The anti- bacterial properties
of AO crystals make them particularly effective
at treating acne conditions.
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 Risks of Aluminum Oxide Crystals
• Light Crystal Peeling.
• A technology that uses crystal powder (Aluminum
Oxide) to abrade the skin by vacuum pressure.
• Used Crystal powder can remain on the eyes, nose
or mouth after peeling. It is not healthy or sanitary.
• Post Procedure - redness and possible bruising.
• Cost $100-$200 / per treatment.

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 Crystal Purity and Size
• MD crystals should be at least 99.4% pure.
Microdermabrasion crystals usually contain tiny
amounts of other material such as silica which
remain in the crystals despite a lengthy purification
process to make them fit for MD purposes. This
involves melting and re crystallizing the aluminum
oxide up to eight times.
• Size is the other important factor in using MD
crystals. Crystals between 100 (larger) to 120
(smaller) microns are considered good for MD.
• 120 grit equals about 102 microns.
• The larger the size of MD crystal the more harsh the
process will be. A professional who has received MD
training will be able to select the best crystal size to
suit your individual needs based on your condition.

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 How Small Is A Micron?

To put it in perspective, 1 micron = 1/1000 millimeter and

the diameter of human hair is 80 to 100 microns.
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 Microns
• One micron is 1/25,000 of an inch. To understand just how small this is,
consider that human hairs measure between 30 and 120 microns.
• Dust mite allergen measures from .1 to .3 micron and staphylococcus
bacteria measures .7 micron.
• The size of a given particle helps to determine the degree of potential
threat to human health. Particles ranging from .3 to .9 micron present the
greatest health concern.
• While smaller particles (.1 to .3 micron) can be inhaled and exhaled more
easily than mid-range particles, even these minute particles may irritate
breathing passages and lungs.
• Smaller particle filtration is particularly beneficial to people living with
allergies, asthma, other respiratory conditions, or cardiovascular disease.

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 Microdermabrasion Crystals Risks

• Controversy #1- the safety of aluminum oxide; they

are safe because they are non toxic and there is no
possibility of a chemical reaction with skin.
• The main risk associated with aluminum oxide
crystals is the possibility of accidental inhalation
which may cause some temporary respiratory
problems.
• Professional MD machines are designed to be closed
circuit, which means that the MD crystals should
never be let into the air. Human error could be a
challenge by not sealing the mouth of the hand piece
to the skin.
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 Microdermabrasion Crystal Risks
• Controversy #2- practitioner complaints of symptoms such
as itchy eyes and throat, breathing problems or
headaches. While the jury is still out on this one, it’s
important to remember that only people who come into
regular prolonged contact with these MD crystals have
made these complaints.
• Controversy #3-skin abrasion; this can happen if the
practioner is unskilled and untrained in the proper
techniques of MD.
• Choosing the improper grit size of crystals can be
sensitizing to the skin.
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Striping the Skin
Striping shows on the skin for
several reasons;
1. The wand is being pushed
into the skin.
2. The wands grit is too big
3. The skin is sensitive to the
crystals.
4. The suction is too high for
the skin thickness.
5. The wand is moved too slow
across the face and neck.

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Sodium Bicarbonate Crystals

• Sodium bicarbonate is
increasingly seen as an
alternative to traditional
metal based MD crystals.
• Proponents of sodium
bicarbonate MD crystals
point to a number of
benefits:
• Organic
• Water soluble
• Neutral ph balance
• Soothing
• Antiseptic

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 Properties of
Sodium Bicarbonate Crystals
• Organic which means once
it’s disposed of it
decomposes naturally.
• Water Soluble - can be
rinsed off.
• Neutral Ph Balance-no
irritation on the skin and
can soothe the skin.
• Antiseptic qualities-helping
to kill off bacteria that
contribute to acne.
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 Aluminum Vs Bicarbonate Crystals

• No definitive comparative studies have been carried out

between these two MD crystals making it impossible to say
one is better.
• Aluminum and sodium crystals each have their advantages:
– Sodium crystals are lighter. This means it takes less air pressure to
deliver them to the skin. Too much air pressure can contribute to
post treatment redness and soreness.
– Aluminum oxide crystals are harder, which indicates that they may
be more suitable for heavy treatment such as deep scars and
thicker skin types.

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 Side By Side-Crystal & Diamond MD
• Diamond MD (Crystal-Free)
•Utilizes crystals • Diamond system, replaces the MD crystal flow
•The original MD crystal technology uses a special, with a disposable or reusable diamond tip.
hand-held device that propels a high-speed flow of • Closer to eyes and mouth accurately with no
crystals onto the skin. risk of stray crystals damaging or ingested.
•At the same time, the machine's vacuum system • Diamond MD machines have a variety of sizes
sucks away dirt, dead cells and used crystals. and coarseness of tipped wands for different
•Aluminum oxide crystals have been the most skin types and depths of resurfacing.
commonly used abrasive agent for the last 20 years. • The wand tip is made of natural diamond
•The irregular crystal shape makes them a more chips which polish the skin and remove dead
effective abrader. cells, which are then vacuumed back into a
•Aluminum oxide is also an inert (does nothing) waste filter.
material and it causes no allergic or adverse • Natural diamond tips are preferred because
reactions. It is not toxic when ingested and is non- they are easier to control and don't irritate the
carcinogenic. skin (natural minerals are less likely to trigger
adverse reactions).
•Sodium bicarbonate crystals are an organic
• Natural diamond tips do not leave tiny
alternative to aluminum oxide crystals but they are
particles in the eyes, nose or mouth.
a lot softer and less effective in MD. They are used
• Sometimes can be unsanitary when bacteria
on patients with hyperpigmentation and can be
easily washed off after treatment (sodium
from exfoliated skin stays on the tip and
bicarbonate is water-soluble). spread to another areas of the face or body. 33
 Traditional MD Or Diamond Tip

In conclusion; Both the traditional crystal MD and the

Diamond Tip (non-crystal) MD systems have proven to be
equally effective on the skin with proper application.
For the sake of both perceived safety and effectiveness,
crystal micro dermabrasion machines (with aluminum oxide
or sodium bicarbonate crystals) are slowly being phased out
and replaced with diamond micro dermabrasion machines.

YOU DECIDE
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How Does the MD Machine Work

Settings (suction)
Pressure
Passings

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Spray and Suction of Crystals
• Gentle sandblasting the
skin with a high pressure.
• Vacuum suction action that
removes the crystals. While
the crystals are performing
the exfoliation, the vacuum
suction action taking place
is equally important
because it is stimulating the
lower layers of the skin.

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• Crystals are blasted
out of the wand and
onto the skin and at
the same time, the
used crystals, dead
skin cells and debris
are being sucked into
a reserve jar.

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 Consultation
• See Client History Forms
• See Client Microdermabrasion Waiver Form
• See Fitzpatrick Form
• See Aesthetics Assessment Form
• Photos

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 Fitzpatrick Scale and Skin Typing
MD works equally with all Fitzpatrick Skin Types with no
side effects

 I-Skin burns very easy, skin color very pale and

translucent
 II-Skin burns easy, skin color pale in color
 III-Skin burns but then tans, light color skin
 IV-Skin tans easily, olive skin tones
 V-Skin always tans, darker olive skin tones
 VI-Skin tans quickly, African American
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 Microdermabrasion Contraindications
• Client Expectations Active Rosacea
• Fragile Capillaries Vascular lesions
• Widespread acne Herpetic lesions (herpes)
• Warts Open sores
• Skin lesions Anti-coagulants
• Eczema Dermatitis
• Psoriasis Lupus/auto immune
• Erythematosus Diabetes mellitus
• Accutane® (isotretinoin) Certain keratoses
• Evolving dermatosis Weeping Acne (stages 3-4)
•Cancerous lesions Certain Antibiotics
•Malignant Cutaneous tumors
• This is not a method for removing of skin growths 43
 Microdermabrasion Concerns

• Use of sun protection

• Skin hydration
• Inhaling the Aluminum Oxide dust.
• Eye sensitivity from the crystal dust
• Risk of infection
• Hyper pigmentation issues
• Skin sensitivity
• Broken capillaries
• A rehydrating toner, moisturizer and sunscreen
is applied for hydration.
• Some redness may occur for a few hours post
TX similar to a mild sunburn. Apply moisturizer
post TX.

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More Microdermabrasion Contraindications

• Avoid direct sun exposure for 14 days after a treatment. It’s

importance to use a high quality sun block product, along
with minimizing sun exposure. Exposure to UV radiation is
one of the key factors in speeding the skin aging process.
• Avoid Alpha-Hydroxy Acid, Glycolic Acid products and skin
exfoliation scrubs for 72 hours both before and after a
treatment.
• Avoid full face make-up, i.e. liquid foundations or pressed
powder foundations for 24 hours after a treatment. Eye
make-up, lipstick etc. may be applied immediately after a
treatment.

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 After the Treatment
• After vacuuming your skin, special cleansers and moisturizers will
usually be recommended due to a loss of moisture during the
procedure.
• Immediately after your very first MICRODERMABRASION
treatment, your skin will show noticeable improvement.
• Wrinkles, age spots and fine lines diminish as your skin takes on a
more radiant glow.
• Your ACNE and ACNE SCARS will become less noticeable as your
skin begins to look fresher and more radiant with the release of
new collagen.
• You may experience some redness and tightening of your skin after
the procedure. This will only be temporary and will not create any
major discomfort.
• You should suffer no side effects after your MICRODERMABRASION
procedure and healing time is usually just a few hours.
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 Basic Microdermabraion Treatments
Cleanse with steam
Degrease
Lactic 20-50% -5 minutes or enzyme
Neutralize-5 minutes
Pat Dry
Dermabrade-2-5 passings
Rinse
Massage (optional)
Serum
Masque
Rinse (barber wrap)
Moisturizer
Serum
Sunblock
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 Questions?

We create our own destiny

by our failures and success.

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