Aluminum oxide crystal microdermabrasion was developed in 1995 (41). This process produces superficial epidermal abrasion, and has been used primarily for facial scarring and photodamage. No clinical studies have been done in melasma or any other hyperpigmentation disorder. Although data are lacking in this regard, the effect of microdermabrasion on accelerating the epidermal barrier function makes it a valuable adjuvant therapy (42).
Microdermabrasion is a “feel-good” procedure that can be used to complement topical regimens. We usually alternate the procedure with a series of glycolic acid peels, since their mechanisms of action are different.