Microdermabrasion has been a mainstay of non-surgical skin rejuvenation treatments in clinics in the UK for over a decade now, as its minimally invasive technique and skin 'freshening' qualities are an attractive treatment option for many consumers.
In the USA, over 8 million treatments have been performed in the last ten years, reaching a peak of over 1 million in 2004, making it the fourth most popular cosmetic treatment in America, according to the American Society of Aesthetic Plastic Surgery (ASAPS).
Microdermabrasion involves a stream of fine, micro particles or crystals being blasted across the skin, normally treating the face, by a special handpiece as it is moved across the area. Movement of the crystals, usually aluminium oxide or sodium derivatives, at high pressure causes the exfoliation of the outer layers of the skin, similar to a mild sandpapering effect. Loosened dead skin particles, the crystals and other debris are then vacuumed away by the machine.
Microdermabrasion is clinically used to improve the appearance of the skin, increase circulation and provide a 'healthy glow' as the remaining layers of skin increase their production of new skin cells to renew the surface layer. In many cases, specialist skincare products such as those containing antioxidants are also applied to the skin following the microdermabrasion treatment to speed up and increase this dermal renewal.
However, like all non-surgical treatments, there are some minor draw backs. Although the treatment is generally considered to be painless, depending on how aggressively it is targeted, it does leave the individual with a tight feeling to the face and redness of the skin which can last for several hours as the inherent hydration of the skin's surface has been stripped away briefly by the mechanical action.
So scientists have been looking at ways to improve on this technology and not only increase its efficacy in terms of skin rejuvenation, but also remove any associated discomfort and downtime; and now they think they've cracked it with the introduction of hydradermabarasion, the crystal free microdermabrasion.
What is Hydradermabrasion and What Can it Treat?
Hydradermabrasion, marketed by the innovative company behind the first technology, as the Hydrafacial(TM) treatment, is indeed similar in concept to its older cousin; however the primary difference is the lack of any crystals used to assist in the exfoliation process, and the use instead of a specially shaped spiral tip which exfoliates and removes impurities along with delivering pneumatically applied serums that cleanse, hydrate and provide antioxidant infusion during the treatment process.
The HydraFacial(TM) system was first introduced at the American Academy of Dermatology Annual Meeting in 2005. It won the industry's "Best of The Best Award" in 2006 and was nominated for the award again in 2007 and 2008. It became available in the UK in 2009.
Hydradermabrasion takes its name from the word 'hydrate' meaning to 'cause to take up moisture'. This ability to actively moisturise the skin during the treatment process sets it apart from all other skin resurfacing procedures available, such as microdermabrasion, chemical peeling and laser/IPL treatments.
According to the manufacturer the Hydrafacial(TM) treatment is clinically proven to improve the appearance of fine lines, wrinkles, congested and enlarged pores (e.g., blackheads), oily or acne-prone skin and hyperpigmentation (i.e. dark areas of the skin, such as brown age spots).
How Does it Work?
The special tip, which is the unique part of the Hydrafacial(TM) devices, is known as the Hydropeel(TM) Tip. It is passed over the surface of the skin in smooth, stroking movements, whilst proprietary serums are simultaneously directed onto it and then vacuumed away, along with loosened dead skin cells and other debris. All the waste is retained in a separate closed container to avoid any risk of contamination. Treatment is generally considered to be painless and a new treatment tip is used per patient.
The treatment works differently from traditional microdermabrasion due to the spiral shape of the tip, which has multiple abrasive edges, meaning that the skin is exfoliated several times as the tip is moved over it in a planing motion, whilst the serums applied soften the skin and sebum (skin oils) making it much easier to extract away impurities.
Treatment is said to be safe for most skin types and colours, including thinning or ageing skin, dry or oily skin and ethnic coloured skins; however those individuals who have been treated with isotretinoin for severe acne within the last six months, those with active skin infections, such as herpes simplex (cold sores), or with a history of problems associated with skin healing are not suitable candidates for treatment.
The proprietary serums within the Hydrafacial MD(TM) range, which are delivered direct to the skin's surface via the Hydropeel(TM) Tip, include activ-4(TM) which contains glucosamine and lactic acid, as well as active botanicals for cleansing and hydrating all skin types, beta-hd(TM) which contains salicyclic acid for cleansing and hydrating oily and acne prone skin and antiox-6(TM) an antioxidant treatment serum for all skin types containing hyaluronic acid, vitamins A and E and white tea extract designed to combat the damage created by free radicals within the environment, and deeply moisturise the skin.
The manufacturers of the Hydrafacial(TM) device have also teamed up with leading skincare company Skinmedica® to enable them to offer their TNS® (Tissue Nutrient Solution) Serum which contains NouriCel MD(TM), a proprietary mix of human growth factors, cytokines, soluble collagen, antioxidants and matrix proteins, discovered through more than a decade of wound-healing research. Growth factors and cytokines are proteins that the body produces for regular growth and repair of tissue. The proteins are believed to work in concert with each other to produce the desired effects of reducing the appearance of fine lines, wrinkles and sun damage. A home use kit of Skinmedica products is often recommended following the Hydrafacial(TM) TNS® Serum treatment to enhance and maintain the results.
According to Dr Bruce Freedman, who has recently published a study on the use of hydradermabrasion for non-ablative facial rejuvenation looking at the efficacy of applying topical antioxidants on their own or mechanically applying them to post-hydradermabraded skin: "the key step is the pneumatic application of the topical antioxidants; manual application is not as effective"; he said.
Additionally the Hydrafacial(TM) system offers a chemical peeling treatment in conjunction with the hydradermabrasion procedure. There are three Glysal(TM) peel strengths available, ranging from the Mild Glysal(TM) Prep which is suitable for most skin types as a pre-peel or preparation product, the Moderate Glysal(TM) Peel for oily, acne prone skin and to target fine lines and hyperpigmentation and the stronger Aggressive Glysal(TM) Peel.
Finally red and blue LED (Light Emitting Diode) handpieces can be applied to the Hydrafacial(TM) treated skin to aid skin rejuvenation and acne treatment respectively.
The energy delivered by red LED light has been shown to enhance cellular metabolism, accelerate the repair and renewal of damaged skin cells, as well as stimulate the production of collagen leading to improved skin texture and firmness. The Del Sol(TM) red light handpiece emits 615nm red light. Unlike more powerful laser and IPL treatments there is no pain associated with the delivery of the LED light to the skin.
The Del Sol(TM) blue light handpiece emits 420nm blue light. Propionibacterium Acnes or P.Acnes bacteria is known as the cause of acne and porphryin which is a compound generated by P.Acnes is photosensitive and has been proven to react to the wavelength of 405 - 440nm (blue) light which leads to the destruction of the bacteria. The combination of Hydrafacial(TM) as a pre-treatment to the blue LED light means that dead skin and debris is removed first so that the blue light is better targeted at the acne prone skin layers beneath.
Treatment sessions usually take approximately 30 minutes, with most people returning to work or normal activities immediately after treatment with only slight redness to the skin and a possible tight feeling which should resolve in less than 1 - 2 hours. Treatments using the peel products may prolong any redness however. The manufacturers report that many people see visible skin improvement after just one treatment with the results and skin hydration lasting between 5 and 7 days, and sometimes longer, making it an ideal one off treatment for a special occasion or a 'freshen-up'. However, a series of six to ten treatments are usually recommended for improving the appearance of fine lines, wrinkles, acne and oily skin or areas of hyperpigmentation, with ongoing maintenance treatments every 2 to 8 weeks. A treatment programme incorporating the various serums, growth factors, peel products and LED light will be customised on a per patient basis, depending on the individual skin requirements.
The average cost of a basic HydraFacial(TM) treatment is approximately £100, with advanced treatments including LED lights, peels or growth factor serums being in the range of £125+; generally discount packages are available for a course of treatments. As this treatment is currently so new there are only a handful of clinics currently offering it within the UK.
Clinical Results
A number of clinical trials into the use of hydradermabrasion and the associated application of antioxidant serums, both as a stand-alone treatment and in conjunction with other non-surgical skin rejuvenation procedures, such as Intense Pulsed Light (IPL), have been carried out by influential American physicians Dr. Patrick Bitter and Dr. Bruce Freedman.
A study by Dr. Freedman involved 20 volunteers being split into two groups, one group had six hydradermabrasion treatments using the mechanically applied antioxidant serum, spaced 7 - 10 days apart, and the other group simply had the serum applied manually, again for six treatments spaced 7 - 10 days apart. Results gathered two weeks after the final treatment showed that the group treated with hydradermabrasion demonstrated increased thickness in the skin layers, with the deposition of new collagen fibres and increased levels of antioxidants in the skin. Fine lines, pore size and hyperpigmentation were also decreased following treatment. The other group showed no change in skin structure, clinical attributes (such as wrinkling, hyperpigmentation etc.) or antioxidant levels. It was therefore concluded the Hydrafacial(TM) treatment effectively improved skin quality and increased the antioxidant levels present in the skin, whilst the lack of an abrasion element and a manual application of antioxidants did not result in detectable skin changes.
If we are to criticise this study in any way, it would be to note that a third group was not established who were treated with traditional microdermabrasion and topical antioxidant application, so as to establish the exact effect of the differing types of skin abrasion (wet versus dry) and the subsequent take up of the serums by the skin.
In a study by Dr. Bitter, presented at the ASLMS conference in 2009, he looked at how hydradermabrasion worked in conjunction with IPL on facial skin. Two groups of patients were treated with either a series of IPL treatments alone or a combination of IPL and hydradermabrasion. In the combination group, results showed that fine lines, texture, pore size and overall skin appearance were improved. This study showed that hydradermabrasion appeared to enhance the effects of the IPL, which was due to the antioxidant infusion which is part of the Hydrafacial(TM) treatment's uniqueness.
Other Options
Although the Hydrafacial(TM) systems are becoming the most widely known and heavily marketed devices within the hydradermabrasion arena. There are some other systems available which also use the concept of high pressure fluids to exfoliate or hydrate the skin as part of an abrasion treatment.
JetPeel(TM)-3 from Israeli company TavTech Ltd and distributed in the UK by Cross Medical Ltd is also a hydradermabrasion device, in that it uses a pneumatically applied liquid to exfoliate the skin; however the company manufacturing it have chosen a name to market it aligned with a peeling process rather than a microdermabrasion process. Some clinics offering treatment with this device are however choosing to use the term 'hydrodermabrasion' to emphasise the use of water, rather than the implied peeling products.
Each JetPeel(TM) treatment effectively "pressure washes" the skin using microdroplets of water (saline) and pressurised oxygen or air, delivered at supersonic speed - up to 200m/sec. When the jet stream of droplets strikes the skin the kinetic energy of the droplets causes an exfoliation effect. It is claimed that this gentle cleansing unclogs pores and removes any dead skin cells and debris that has built-up on the skin. Unlike other systems, this device doesn't use any kind of vaccum system to remove the resulting waste. The saline can be combined with other topical products containing vitamins and supplements such as hyaluronic acid designed to address different skin conditions, which are said to penetrate better in combination with the superficial exfoliation achieved and barometrically pressure environment caused by the pressurised gas upon the skin.
U.S. company Genesis Biosystems, a long standing producer of microdermabrasion machines, launched the Accelafuze(TM) in 2008; (distributed in the UK by Eden Aesthetics). The device combines traditional microdermabrasion using crystals followed by a rapid 'dermalinfusion' of various topical solutions such as a glycolic acid based cleanser, moisturising, lightening and peptide replacement serums and a lactic acid based peel with LED treatment options using red, blue and yellow light.
Although, like the Hydrafacial(TM) system the Accelafuze(TM) targets the mechanical application of topical products and the use of LED light, the use of traditional crystal based microdermabrasion means that this device cannot truly be classed as a hydradermabrasion option as it still relies on the use of dry crystals for the exfoliation element.
Summary
The popularity of microdermabrasion as a long term treatment programme for maintaining a healthy glow to the skin to reduce the appearance of fine lines, wrinkles and sun damage is well established, along with its versatility as a one-off, special occasion treatment when you want to look your best for a wedding etc.
With the introduction of hydradermabrasion many within the industry are seeing this as the next generation of minimally invasive skin resurfacing which moves on from traditional microdermabrasion by offering a painless treatment with less post treatment redness, along with the pneumatic application of antioxidants directly to the skin during treatment, rather than by topical application post-abrasion.
As with many new technologies, manufacturer claims tend to be somewhat embellished, and we must also offer a small note of caution on their safety and efficacy, as until long-term clinical evidence is gathered, little is known of any potential future complications.
As experience with this technology evolves in the UK you can be sure that we will be here to update you with the facts as they emerge.
Copyright © 2009 The Consulting Room(TM).
