title: Evaluation of histologic and electron microscopic changes after novel treatment using combined microdermabrasion and ultrasound-induced phonophoresis of human skin.
abstract: BACKGROUND
  Mechanical exfoliation using microdermabrasion has been used as a minimally invasive treatment of photodamage, as well as to improve absorption of topical agents. Phonophoresis, a method of electrically assisted percutaneous delivery of macromolecules, relies on ultrasonic waves producing alterations within the stratum corneum that result in increased absorption.
  
  
  OBJECTIVE
  To determine the effects on photodamaged facial skin that resulted from the ultrasound-enhanced delivery of a combined hyaluronic acid, retinol, and peptide-containing complex following microdermabrasion.
  
  
  METHODS
  Seven individuals, aged 40-65, with Fitzpatrick skin types I-III and class I-III rhytids, underwent eight weekly aluminum oxide crystal microdermabrasion procedures (Parisian Peel; Aesthetic Technologies, Golden, CO, USA), followed by administration of a topical combined hyaluronic acid, retinol, and peptide-containing complex, propelled through ultrasound phonophoresis. The participants continued manual twice-daily application of the topical complex between treatments. Clinical evaluation included digital photography, and patient and investigator assessment of changes in skin dryness, texture, brightness, tone, and rhytids. The 3-month post-treatment histologic evaluation consisted of pre- and post-treatment biopsies evaluated for microscopic and ultrastructural changes.
  
  
  RESULTS
  An overall mild clinical improvement in the skin was noted. A slight increase in vascularity within the papillary dermis, increased reticulin stain (type III collagen), and ultrastuctural evidence of increased type I collagen indicate dermal injury with resulting new collagen formation.
  
  
  CONCLUSIONS
  Microdermabrasion followed by ultrasonic phonophoretic application of topical products represents a novel dermal delivery approach to photorejuvenation.
authors.affiliation: Skin Laser & Surgery Specialists of NY and NJ, New York, New York, USA.
authors.forename: Jacob
authors.initials: J
authors.lastname: Dudelzak
authors.forename: Mussarrat
authors.initials: M
authors.lastname: Hussain
authors.forename: Robert G
authors.initials: RG
authors.lastname: Phelps
authors.forename: Geoffrey J
authors.initials: GJ
authors.lastname: Gottlieb
authors.forename: David J
authors.initials: DJ
authors.lastname: Goldberg
mesh_terms: D000328:Adult; D000368:Aged; D000537:Aluminum Oxide / Q000008:administration & dosage; D003869:Dermabrasion / Q000379:methods*; D005145:Face; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage; D008854:Microscopy, Electron; D008875:Middle Aged; D010455:Peptides / Q000008:administration & dosage; D015612:Phonophoresis / Q000379:methods*; D012060:Rejuvenation; D012867:Skin / Q000166:cytology* / Q000187:drug effects*; D014801:Vitamin A / Q000008:administration & dosage
chemical_list: D010455:Peptides; D014801:Vitamin A; D006820:Hyaluronic Acid; D000537:Aluminum Oxide