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MICRODERMABRASION AND BEYOND........ by Manuel Octaviano Jr. 

2/17/2016

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Microdermabrasion  is a non- invasive mechanical exfoliation treatment for superficial skin resurfacing. Other skin exfoliation used in today’s cosmetic market are chemical exfoliants like glycolic and tricholoacetic acid peels and laser treatments.The depth of resurfacing achieved with microdermabrasion  is moderately superficial as compared to the more aggressive laser resurfacing procedures. The target depth for most microdermabrasion procedures is removal of the stratum corneum and this is achieved based on the principles of wound healing. By wounding and removing the uppermost layers of the skin in a controlled manner, cell renewal is stimulated with regeneration of a healthier epidermis and dermis. Histological evaluation of facial skin after repeated Microdermabrasion treatments demonstrate a reparative wound-healing process leading to cell regeneration and ultimately a smoother epidermis. Skin hydration increases with improved epidermal barrier function, and fibroblast stimulation increases dermal thickness through production of new collagen and elastin.

Microdermabrasion is commonly used to treat sun damaged skin and is proven to improve skin texture, large pores, blackheads/whiteheads, and hyperpigmentation such as melasma and solar lentigo. It also improves fine lines and superficial acne scarring. Microdermabrasion devices use crystals or diamond tips as the abrasive element . Negative pressure draws the skin to the hand-piece tip then the crystals or diamond tips superficially abrade the skin's surface as they pass across the epidermis. Used crystals and cellular debris are aspirated and collected in a sterile container to be disposed after each treament. Each pass of the hand piece removes approximately 15 μm of skin, and two passes of most microdermabrasion devices fully removed the stratum corneum. The depth of resurfacing achieved with microdermabrasion  is the same as superficial chemical peels however microdermabrasion offers minimal discomfort and has generally no downtime hence it’s usually called “lunch time peel”. 

Recent advances in microdermabrasion technology includes “Hydrafacial” and “Silk Peel” which combines exfoliation with dermal infusion . During this process, topical products like hyaluronic acid or salicylic acid, etc. are delivered into the skin at while doing exfoliation. These systems take advantage of the transient disruption to the epidermal barrier that occurs with removal of the stratum corneum to better deliver medications into the deeper dermal layers. Dermal infusion can enhance results for conditions such as dehydration, hyperpigmentation, acne scars, and rosacea depending on the products  used. 
Microdermabrasion  treatments are most commonly performed on the face, neck and  chest. It is usually done in 6-8 treatments every 2-4 weeks. Single treatment is not enough to see results therefore follow up is normally recommended depending on the skin problem. It is usually combined with other treatments such as IPL skin rejuvenation or lasers for better results. Patients typically experience redness or superficial skin peeling after the procedure. Moisturizer as well as sunscreen protection with SPF 30 or greater is recommended after each procedure. It is best to talk to your skin care practitioner so you will be better informed about this treatment.


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WHAT IS MELASMA? By: Gloria Vergara-Octaviano

2/5/2016

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Have you ever noticed dark brown patches on your cheeks, forehead or chin recently? Well.it could probably be melasma. So, what exactly is Melasma. Melasma sometimes called chloasma or “mask pregnancy” is a skin pigmentation more commonly seen in Asians and Hispanics. The exact cause of melasma is unknown but it could be trigerred by several factors and the most common is sun exposure. Women who are pregnant can also develop melasma that fades after pregnancy thus it is also called “mask of pregnancy”.Other risk factors are oral contraceptives (Progesterone), Hormone Replacement Therapy (HRT),cosmetics or products that makes the skin sensitive to light and hypothyroidism (low level of thyroid hormone). Uncontrolled sunlight exposure is considered the leading cause of melasma, especially in individuals with family history of melasma. Clinical studies have shown that individuals usually develop melasma in the summer months, when the sun is most intense. In the winter, the hyperpigmentation tends to be less noticeable. Melasma presents as symmetrically distributed hyperpigmented macules in areas that receive maximum sun exposure, including the cheeks, the upper lip, the chin, and the forehead, however, melasma can also be seen in other sun-exposed areas of the body. Melasma is more common in women than in men; It generally starts between the age of 20 and 40 years, but it can begin in childhood. Melasma is more common in people that tan well or have naturally brown skin (Asians and Hispanics) compared with those who have fair skin (Caucasians). Melasma is one of the skin pigmentation I find hard to treat especially if it has been present for a longer period and since it responds to treatment gradually there’s always the tendency for patients to resort to other over the counter topical creams that might cause hypersensitivity resulting to more skin damage. Each of us has different skin types so what is effective for your friend might not work for you so it is always better to seek help from experts.  Melasma can improve with microdermabrasion, Intense Pulsed Light (IPL) or laser treatment, a machine that destroys the melanin pigment by means of heat and light. Topical depigmenting agent can also help like Hydroquinone, Azelaic acid and Vit. C. I find the combination of Hydroquinone, Retinoic Acid and Hydrocortisone (Kligman’s formula) more effective than other creams. Oral medications that are currently under investigation includes Tranexamic acid (also used to stop bleeding) and Glutathione but both are not recommended at this time. Melasma can improve in time but there are no overnight treatments. There is no hard and fast rule in treating melasma it is always a case to case basis. Ask your skin practitioner/dermatologist about your options.
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    Author

    Gloria Octaviano  is a Physician-Dermatologist  in the Philippines, she is a  member of the  International Society of Dermatology and a diplomate of The Philippine Academy of Clinical and Cosmetic Dermatology.  

    Manuel Octaviano is a Physician in the Philippines, he is a Fellow of the Anti Ageing Medical Society and a member of Philippine Academy of Clinical and Cosmetic Dermatology. Manny is a Skin and laser consultant/educator. 
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