Treatment and Clinical Management

The technique of microdermabrasion is noninvasive and quite simple. Prior to treatment, the area is cleansed and allowed to dry completely. Vacuum level and crystal pressure may be determined by testing an area of nonfacial skin, but patient tolerance can also dictate an adjustment in the power setting. The first pass is performed by allowing gentle suction of the skin into the hand piece as it is made to glide along the skin surface. The surface area being treated is stretched taut by the clinician’s free hand to avoid excessive suction in any one area, which can cause an abrasion or pinpoint bleeding. A second pass is made at a right angle to the first, and if more passes are required, they should continue to follow this alternating pattern to avoid streaking [81]. Reducing the level of suction and or number of passes may be necessary around the eyes and other delicate areas of the face. The intensity of the treatment, as determined by the number of passes and level of suction, is chosen based on the condition being treated. When the treatment is completed, the residual crystals should be gently brushed off the skin in the direction away from the eyes so as to prevent eye irritation. The skin can then be rinsed with tepid water and a moisturizer with adequate sunscreen applied. Patients are instructed to avoid keratolytic agents, including retinoids, alpha-hydroxy acids, and benzoyl peroxides 3 days before and 3 days following the treatment. They are asked to avoid waxing, electrolysis, and laser hair removal 1 week before treatment, and excessive sun exposure 2 weeks before treatment.All patients are given prophylaxis for HSV 1 day before and 2 days following the treatment using standard oral antiviral therapy.