Selective removal of stratum corneum by microdermabrasion to increase skin permeability

Abstract

This study sought to determine if microdermabrasion can selectively remove stratum corneum to increase skin permeability. Although, microdermabrasion has been used for cosmetic treatment of skin for decades, no study has assessed the detailed effects of microdermabrasion conditions on the degree of skin tissue removal. Therefore, we histologically characterized the skin of rhesus macaques and human volunteers after microdermabrasion at different conditions. Using mobile tip microdermabrasion, an increase in the number of treatment passes led to greater tissue removal ranging from minimal effects to extensive damage to deeper layers of the skin. Of note, these data showed for the first time that at moderate microdermabrasion conditions selective yet full-thickness removal of stratum corneum could be achieved with little damage to deeper skin tissues. In the stationary mode of microdermabrasion, selective stratum corneum removal was not observed, but micro-blisters could be seen. Similar tissue removal trends were observed in human volunteers. As proof of concept for drug delivery applications, a model fluorescent drug (fluorescein) was delivered through microdermabraded skin and antibodies were generated against vaccinia virus after its topical application in monkeys. In conclusion, microdermabrasion can selectively remove full-thickness stratum corneum with little damage to deeper tissues and thereby increase skin permeability.

Figure 1

Microdermabrasion tip and particles. A microdermabrasion tip with aluminum oxide microparticles flowing inside the tip (a). Scanning electron microscopy image of aluminum oxide microparticles with a small population of very small particles (pointed to by arrows) (b).

Figure 2

Effect of the number of passes on removal of skin layers in monkeys after mobile microdermabrasion. Brightfield images of H&E stained skin sections from biopsies obtained from an untreated control site (a), and sites exposed to mobile-mode microdermabrasion with 50 kPa vacuum pressure for 10 passes (b), 30 passes (c), 50 passes (d), 80 passes (e) and 100 passes (f). Dotted rectangles indicate areas of selective yet full-thickness stratum corneum removal, and arrows point to residual aluminum oxide particles.

Figure 3

Tissue removal scores of skin layers. Quantitative representation of removal scores of stratum corneum and viable epidermis for an untreated control site and sites exposed to different numbers of passes of mobile-mode microdermabrasion at 50 kPa vacuum pressure, displayed as the mean values (a) and the frequency distribution for a total of 180 scores for each site (b). Numbers above the bars represent means (a) and percent frequency (b). Error bars correspond to standard deviations. SC=stratum corneum, VE=viable epidermis.

Figure 4

Effect of exposure time and vacuum pressure on removal of skin layers in monkeys after stationary-mode microdermabrasion. Brightfield images of H&E stained skin sections from biopsies obtained from an untreated control site (a), and sites exposed to stationary-mode microdermabrasion with 30 kPa vacuum pressure and exposure time of 3 s (b) or 6s (c), and 50 kPa vacuum pressure and exposure time of 3 s (d) or 6s (e). Double-lined arrows point to blisters and single-lined arrows point to residual aluminum oxide particles.

Figure 5

Mobile- and stationary-mode microdermabrasion in humans. Brightfield images of H&E stained human skin sections from biopsies obtained from an untreated control site (a), sites exposed to mobile-mode microdermabrasion with 40 kPa vacuum pressure and 7 passes (b and c), and sites exposed to stationary-mode microdermabrasion with an exposure time of 3 s and a vacuum pressure of 30 kPa (d) and 45 kPa (e). Dotted rectangles indicate areas of selective yet full-thickness removal of stratum corneum, double-lined arrows point to blisters and single-lined arrows point to residual aluminum oxide particles.

Figure 6

In vivo delivery through microdermabraded skin. Fluorescence images of skin sections obtained from sites topically exposed to sodium fluorescein solution for 2 h without microdermabrasion treatment (a) and after mobile-mode microdermabrasion at 50 kPa and 50 passes (b).