A 36-year-old patient with moderate facial scarring due to acne does not want to pursue glycol acid or other chemical peels. Is microdermabrasion a good alternative? If so, how frequently can it be performed in a calendar year? Is there any risk of skin cancer over time?
—Lynne Gallison, PA-C, Plymouth, Mich.

Microdermabrasion was introduced in 1985. It is a simple procedure that is safe, widely available, and involves no downtime for the patient. After a vacuum line (suction) pulls the skin into a single hand piece, a second line blows aluminum oxide crystals or other abrasive substances onto the face. The crystals and abraded material are then vacuumed away (Am J Clin Dermatol. 2005;6:89-92). It is speculated that the stimulation of dermal fibroblasts and epidermal renewal are promoted by the physical exfoliation of the stratum corneum. Microdermabrasion has been used to treat photo-aging, dyschromias, stretch marks, and scars (including those from acne) (Dermatol Surg. 2007;33:1005-1026). One study noted that acne scars required a mean of 15.2 microdermabrasion treatments for improvement (Dermatol Surg. 1995;21:531-542). Another study, in which the patients had eight treatments (at 7- to10-day intervals) noted either excellent (38%), good (34%), fair (17%), or poor (12%) results (Dermatol Surg. 2001;27:329-331). A third study evaluated three patients with moderate-to-severe acne scarring. The patients required aggressive treatment (more than 20 passes) every two weeks. After six or seven treatments, the patients were felt to have either good (1), fair (1), or no (1) improvement (Dermatol Surg. 2001;27:524-530). None of these studies mentioned any risk of skin cancer for the acne patients who were treated with microdermabrasion.
—Philip R. Cohen, MD (120-5)