Before we get into the differences between crystal and crystal free microdermabrasion, it is important to know what it actually does to the skin. Having this knowledge will allow you to intelligently speak and explain to your clients how it is going to help their skin.
New skin cells are created in the stratum germinativum or the basal layer (this is the deepest layer of the epidermis).The new cell growth is stimulated by exfoliation, whether it be natural or with a little help from mechanical or chemical exfoliation treatments. When mitosis occurs in the basal layer, the skin cells migrate towards the top layers of the epidermis, and they begin to die. When it reaches the stratum corneum, they are completely dead and this is where the microdermabrasion comes in handy. Microdermabrasion is a mechanical exfoliation that causes a light resurfacing of the skin, in which a portion of the stratum corneum is removed. You are actually causing damage and wounding the skin, and this is a good thing! When you remove a portion of the stratum corneum, it tells the lower epidermal and dermal cells to get moving! Stimulating new cell growth and having your client's skin look remarkably smooth and luminous.

The Original Microdermabrasion
The idea of using mechanical exfoliation to rejuvenate the skin is nothing new. As early as the 1500s, Egyptians were using sand paper to smooth their skin. In 1987, microdermabrasion was invented by Dr. Mattioli and Dr. Brutto in Italy. In the U.S. microdermabrasion started to explode in the mid 1990s. This crystal machine became a "must have" to aestheticians throughout the United States. The idea was that tiny crystals are sprayed onto the skin and abrade it. At the same exact time, a vacuum is not only pulling the skin closer to the crystals, but also removing the used crystals from the skin.
The effectiveness of your treatment is dependent on four things: the level of the crystals being sprayed, the degree of suction, the number and speed of passes over the skin, and the preparation of the skin. The crystals are typically aluminum oxide crystals and have the molecular structure of beach sand. Aluminum oxide crystals are an inert substance, meaning they have no properties; therefore there is no chance of an allergic reaction. The crystal machine can remove anywhere from 20 to 30 percent of the stratum corneum. The new crystals are abrasive and can cause inflammation to the skin. This inflammation makes it hard to work on certain skin conditions. Anyone with a vascular condition like rosacea and telangiectasia already have inflammation and heat in their skin. The crystal microdermabrasion could exacerbate these conditions and there are other ways to exfoliate the skin without making these conditions worse. The inflammation is caused from the irregular shape of the crystals. Once the crystals have abraded, the skin they are returned to a separate container from the new crystals, with a rounded shape. The downside of this machine is that it can easily clog with the smallest bit of humidity in the air or moisture on the skin. It can also be difficult because you have crystals left on your client's skin that can get everywhere and can be hard to remove at the end of the service.

Diamonds!
The newest form of microdermabrasion is the crystal free or diamond tipped machine. Gaining in popularity in the last 10 years, this machine uses diamonds and suction to exfoliate the skin rather than using crystals. The diamonds are four times harder than the crystals and can remove up to 80 percent of the stratum corneum. The dead skin cells are removed with suction and placed in a filter. When you clean out the filter, you can actually see the dead skin cells build up on the filter. Showing your clients this can reassure them that they are really getting the result that they desire.
The machines usually offer a variety of different wands or tips. Each wand/tip uses crushed diamonds (synthetic or natural) and varies in the amount of coarseness or "grit." Aestheticians can use wands or tips within the range of 75 to 175 microns. The higher the microns indicate that they are coarser and can lead to a more aggressive treatment. Wands and tips can have a long life with proper disinfection and care. While crystals create heat and inflammation on your skin, the diamond machines do not, making it great for use on vascular conditions and inflammatory conditions like acne (grades I and II). Since you can use this on more sensitive skin types it is also great to pair it up with a superficial chemical peel. Removing a portion of the stratum corneum will allow the chemical peel and its properties to better penetrate into the skin. This way the chemicals don't have to fight to get through the stratum corneum and let its properties really do its job!

We've Got the Power!
Crystal and crystal free can be used on the same conditions. Although, keep in mind to use caution on sensitive skin with the crystal machine. It's empowering and satisfying to know that we can truly make a change in the following conditions:

• Hyperpigmention/Photo-damaged skin
• Mild acne
• Reduction of fine lines and wrinkles
• Reduction on some types of scars, including acne scarring
• Helping with the appearance of enlarged pores
• Reduction in the appearance of stretch marks

Contraindications
Having your client fill out a consultation form and reviewing it with them is very important. Microdermabrasion can be used on most all Fitzpatrick skin types. Even though you will start out conservatively, you can still damage a client's skin by not knowing the contraindications for both crystal and crystal free microdermabrasion treatments. If you are concerned with hyperpigmentation, start client on a tyrosinase inhibitor about two weeks prior to treatment. Here are some areas that should be covered on your consultation form and that you should review with your client before each treatment, not just the first one. Contraindications include:

• Use of Accutane within the last year
• Antibiotics either topical or systemic
• Use of topical prescription medication such as Retin A and Renova within the past seven to 10 days
• Broken or bruised skin
• Sunburn
• Diabetes
• Active Herpes

Protocol for Crystal Microdermabrasion

1. Cleansing the client's skin with a cleanser that will not leave a residue behind. Remove cleanser with gauze pads or towels as cotton can clog the machine if left behind on skin.
2. Using a gauze pad, apply acetone or a similar
de-fatting product.
3. Protect eyes from crystals by applying goggles.
4. Start by doing one pass all over the face using linear sweeps. Keep in mind, the quicker the stroke the lighter the exfoliation. During the first treatment use a lower setting.
5. Brush off excess crystals with dry gauze pads.
6. The second pass is dedicated to areas of concern. Prior to treatment, talk with your client about areas that they would like to focus on. You can use a gridding or eraser like techniques on these areas.
7. Brush off excess crystals.
8. The third and final pass will be done with linear sweeps all over the face. Try to go the opposite direction of the
first pass.
9. Brush off crystals and cleanse face using cool water.
10. Apply serums, moisturizer, and sunscreen.

Protocol for Crystal-Free Microdermabrasion

1. As with the crystal machine, you want to cleanse with a cleanser that will not leave a residue behind.
2. Using a gauze pad, apply acetone or a similar
de-fatting product.
3. Avoiding the eye area, begin doing sweeps all over the face. At this time you should be able to see where the skin is coming up. During the first treatment, use a fine or medium wand with a low vacuum setting.
4. Start working in areas where you see the skin starting to slough off. Doing quick strokes over the area in
opposite directions.
5. For a more aggressive treatment, do another pass all over face or increase the vacuum slightly.
6. Turn machine off completely and begin doing light sweeps under the eyes and on the eyes lids.
7. Apply serums, moisturizer, and sunscreen.

Post-Treatment
Since we are resurfacing the skin, you want to explain to your client the importance of using sunscreen after treatments. By not doing this, it can reverse the results you are trying to achieve. For best results, your client can receive treatments once a week for six weeks. After treatment client may experience some erythema. Peeling and dryness may also occur a few days after treatment. These reactions are all normal and clients should use products that calm, soothe, and hydrate. These sessions can be done two times a year. Also, remember that because you are resurfacing the skin you get 100 percent better product penetration. Using nutrient rich serum and ampoules after a microdermabrasion treatment and at home will give your client optimal results.
Whether you decide to use crystal or crystal free microdermabrasion, all professionals would agree that both have amazing results. Start by doing research; Internet, fellow professionals, manufacturers, and distributors are great resources to help you decide on the best system for your practice. Educating yourself will not only help you decide on a machine; now you will be able to explain to your clients the differences in microdermabrasion and what it will do to their skin. With all of the information out there directed to the consumers, we have to stay on top of our game. Believe me if it's out there, they will ask! Staying current will begin to build trust between you and your clients, not to mention a very lucrative business!

Deanna Beaver is a NY licensed aesthetician with 10 years' experience in the spa industry. She has received certifications in paramedical aesthetics and as a laser technician. Deanna is an aesthetics educator at the Aesthetic Science Institute in Latham, NY. In addition to teaching at the Aesthetic Science Institute, Deanna also works as an educator, sales rep, and aesthetician for Dimensions in Aesthetic Advancement in Latham, NY. This email address is being protected from spambots. You need JavaScript enabled to view it., 518-783-4940