The closed, self-contained procedure known as microdermabrasion was first developed in the mid-1980s by researchers in Italy to eliminate the risk of airborne blood generated during conventional dermabrasion treatments (14). Microdermabrasion was approved for use in the United States by the Food and Drug Administration (FDA) in 1997 and has become one of the most […]

Shaving with a razor blade removes hair as well as stratum corneum. As a result, there are many potential detrimental effects to skin including increased risk of irritation from other topically applied products, such as antiperspirants (9). Moreover, while shaving seems at first to make the skin smoother, this process actually generates uplifting scales and […]

Buff puffs, loofahs, mesh poofs, and, to a certain extent, washcloths are used by many people on a daily basis to provide varying degrees of exfoliation to the face and body. The amount of exfoliation is dependent on the force of application, the number of passes over the skin, and abrasiveness of the material being […]

Physical exfoliants involve the use of manual implements to erode away surface skin cells. Presumably, as rubbing is continued and additional force is exerted, skin cells will continue to forcibly desquamate in a non-specific manner. This can continue until the stratum corneum is removed and the “glistening” layer of the live epidermis is reached. A […]

M. Elizabeth Briden Advanced Dermatology and Cosmetic Institute, Edina, Minnesota, U. S.A. Barbara A. Green NeoStrata Company, Inc., Princeton, New Jersey, U. S.A. EXFOLIATION By definition, to exfoliate is to remove the surface in scales or laminae. Therefore, classical exfoliants are those agents that work at the skin’s surface causing the removal of skin in […]

As the pigmentary system yields its secrets, and pathogenic disease mechanisms are more intensely investigated and studied, therapeutic options for pigmentary disorders expand. Once a pigmentary disorder has been diagnosed, the first step is to educate the patient about the condition. This is particularly important if the condition has a chronic nature that will require […]

Pigment dye lasers have been used with success in cafe-au-lait macules, ephelides, lentigines, and orange, red, and yellow tattoos. However, they are no longer recommended due to serious secondary reactions reported, including skin discoloration and purpura (66). When topical 0.05% retinaldehyde is used with the 1540 nm erbium:glass laser, the effects of the increasing dermal […]

Intense pulsed light (IPL) has been successfully used in refractory melasma in Asians, and has been found to be more useful than pigment-specific lasers in severe cases of melasma. It is also an excellent laser for treating lentigenes associated with photoaging (61). In a study of 33 Asian women with refractory dermal or refractory mixed […]

Erbium:YAG lasers have been shown to improve melasma, but the nearly universal appearance of PIH necessitates prophylactic skin preparation with tretinoin, hydro – quinone, and desonide nightly for two to four weeks prior to laser treatment (60).