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Darius J. Karimipour, MD; Laure Rittié, MS, PhD; Craig Hammerberg, MS, PhD; Victoria K. Min, BA; John J. Voorhees, MD; Jeffrey S. Orringer, MD; Dana L. Sachs, MD; Ted Hamilton, MS; Gary J. Fisher, PhD

Arch Dermatol. 2009;145(10):1114-1122.

Objective  To investigate dermal remodeling effects of crystal-free microdermabrasion on photodamaged skin.

Design  Biochemical analyses of human skin biopsy specimens following microdermabrasion treatment in vivo.

Setting  Academic referral center.

Participants  Volunteer sample of 40 adults, aged 50 to 83 years, with clinically photodamaged forearms.

Intervention  Focal microdermabrasion treatment with diamond-studded handpieces of varying abrasiveness on photodamaged forearms and serial biopsies at baseline and various times after treatment.

Main Outcome Measures  Quantitative polymerase chain reaction, immunohistochemistry, and enzyme-linked immunosorbent assay were used to quantify changes in inflammatory, proliferative, and remodeling effectors of normal wound healing. Type I and type III procollagen served as the main outcome marker of dermal remodeling.

Results  Coarse-grit microdermabrasion induces a wound healing response characterized by rapid increase in induction of cytokeratin 16 and activation of the AP-1 transcription factor in the epidermis. Early inflammation was demonstrated by induction of inflammatory cytokines, antimicrobial peptides, and neutrophil infiltration in the dermis. AP-1 activation was followed by matrix metalloproteinase–mediated degradation of extracellular matrix. Consistent with this wound-healing response, we observed significant remodeling of the dermal component of the skin, highlighted by induction of type I and type III procollagen and by induction of collagen production enhancers heat shock protein 47 and prolyl 4-hydroxylase. Dermal remodeling was not achieved when microdermabrasion was performed using a medium-grit handpiece.

Conclusions  Microdermabrasion using a coarse diamond-studded handpiece induces a dermal remodeling cascade similar to that seen in incisional wound healing. Optimization of these molecular effects is likely the result of more aggressive treatment with a more abrasive handpiece.

Trial Registration  clinicaltrials.gov Identifier: NCT00111254

Author Affiliations: Department of Dermatology, University of Michigan (Drs Karimipour, Rittié, Hammerberg, Voorhees, Orringer, Sachs, and Fisher and Mr Hamilton), and University of Michigan Medical School (Ms Min), Ann Arbor.

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