New approaches document microdermabrasion efficacy, safety

Key Points

National report - Subtle cosmetic improvements are difficult to see in "before" and "after" photographs following minimally invasive cosmetic procedures, yet, although it is challenging, objectively demonstrating these changes is important.

Using novel imaging devices, a recent study shows measurable effects of noninvasive procedures, such as microdermabrasion.

"Physicians often go to lectures and are presented with 'before' and 'after' photographs of minimally invasive cosmetic procedures, but often, the changes are so subtle that the differences cannot really be appreciated. Furthermore, the pictures are not always believable, as slight changes in lighting or camera angle can alter the true or less-than-true results," says James M. Spencer M.D., M.S., department of dermatology, Mount Sinai School of Medicine, New York.

Research particulars

In the study, 16 women underwent microdermabrasion to the face once a week for a total of six weeks.

Patients were treated for photodamage and melasma, and were also given a personal skincare regimen consisting of Purpose cleanser and lotion (Johnson & Johnson), which was also tested for its tolerability and safety. The same physician performed all of the dermabrasions.

"Of all the measurements taken, the most impressive results I saw were that the skin of the patients was actually brighter post-treatment, especially after the third procedure, with significant improvements seen by the end of the study. Fine wrinkles, dullness, pigmentation and pore size improved, verifying that microdermabrasion works," Dr. Spencer tells Dermatology Times.

Novel technology

Dr. Spencer says that Johnson & Johnson developed a device to non-invasively restore skin surface features.

The device uses multiple light sources for photography, emitting visible light, polarized and cross-polarized light, UV light and fluorescent light. A series of photographs were taken using these different sources, giving the physician more information. A similar device is now commercially available from medical imaging companies.

The polarized light shows high-resolution surface detail, the cross-polarized light brings out subsurface blood vessels, the UV light brings out dark and light areas and the fluorescent light shows porphyrins, which are contained in bacteria, hence providing bacterial counts. A colorimetry device to measure color and brightness was used as well.

"When you say something is bright, what that means is (that) light comes from the light source above, hits your skin, bounces off it and then comes to your eye. If someone gets brighter, it actually means that they are a better reflector," Dr. Spencer says.

Colorimeter measurement

The colorimeter objectively measured more light radiating from the skin of the patients.

The device demonstrated that there was a decreased yellowness of targeted skin sites on the face throughout the study. According to Dr. Spencer, this means that the patients have become better reflectors, following a series of microdermabrasion treatments. He says that the moisturizers and cleansers tested were very well-tolerated by the patients.

"What our eye is perceiving more than anything is that patients were really brighter following the treatments, and this is why we find microdermabrasion treatments pleasing," Dr. Spencer says.

He adds that normally, pore size cannot be seen well. The polarized light demonstrated that pore size actually got smaller. The UV light showed that dark areas got lighter, meaning that the evenness of the color in patients' skin improved. According to Dr. Spencer, the fluorescent light showed that the bacterial counts decreased. He explains that because bacteria fluoresce, the decreased fluorescence seen proved that the counts went down.

Subtle changes

"These changes in the skin are very subtle.

"If they were obvious, we would not need these extraordinary devices to measure them. Much of what we do these days in cosmetic dermatology is relatively subtle treatments. I believe it is important to apply objective measurements to them, otherwise it is all subjective interpretation or voodoo," Dr. Spencer says.

Disclosure: Research was funded by Johnson & Johnson.