Your outermost layer, the stratum corneum, is made of flattened dead cells. It is a functional barrier, but as it thickens and roughens it scatters light, which is what "dull" skin looks like. Microdermabrasion removes some of that layer by physical abrasion.
Two designs do this. The older crystal machines fire fine aluminum oxide or sodium bicarbonate crystals at the skin through a nozzle and immediately vacuum the crystals and dead cells back into a canister. The newer diamond-tip machines skip the crystals: the wand tip is coated in an abrasive surface, and the suction holds skin against it while the provider drags it across. Diamond tips are tidier, more controllable near the eyes, and now far more common.
The suction is doing more than cleanup. Pulling the skin up against the tip is what sets how deeply the abrasion cuts, and it also causes a brief increase in blood flow to the treated area.
The change is genuinely limited to the surface. A single pass takes off a fraction of a layer that renews itself in a few weeks anyway. That is why the result is immediate, pleasant and temporary — and why claims about collagen or scar improvement from microdermabrasion do not hold up. Anything that changes a scar has to reach the dermis, which this deliberately does not.
The machines are registered with the FDA as Class I powered dermabrasion devices, which is a category exempt from premarket review. Nobody assessed the results claims. That is the same status held by Hydrafacial and DiamondGlow.
Stop retinoids for three to five days beforehand. Tretinoin, adapalene or retinol thins the surface layer, and abrading skin that is already peeling is how you end up raw.
No scrubs, acid toners or peels for about a week before.
No waxing or hair-removal cream on the face for a week.
Tell the provider if you get cold sores — abrasion around the mouth can set one off, and a preventive antiviral works if started beforehand.
Avoid a sunburn or a fresh tan. Treating recently sun-exposed skin raises the chance of a pigment mark.
Arrive without makeup if convenient, and mention anything you have applied.
Say if you have sensitive skin or have reacted to exfoliation before. Grit and suction strength are both adjustable, and a good provider will start conservative.
Ask which machine they use. If it is crystal and you wear contact lenses, bring your glasses instead.
Do not schedule it the day before an event. Two or three days out is the sweet spot.
The provider cleanses your face and pulls your hair back. No numbing, no prep beyond that.
Your skin is held taut with one hand while the wand is drawn across in overlapping passes — usually up and down, then side to side, section by section.
It feels like a rough cat's tongue combined with a vacuum. Most people find it strange rather than painful. There is a steady buzzing noise from the pump.
Bonier or thinner areas — around the eyes, the jawline, the upper lip — feel sharper. Say so if it is uncomfortable; the suction can be lowered.
Crystal machines add a fine spraying sensation and a gritty smell. You wear eye protection.
Areas with more buildup, like the nose and chin, may get an extra pass.
Afterwards the provider usually applies a hydrating serum or mask, then sunscreen.
Most sessions run 20 to 30 minutes for the face, longer if the neck and chest are included.
There is no true downtime. You can go straight back to work, though your face may be visibly pink.
Pinkness for one to three hours is normal, sometimes into the evening after a more aggressive pass. It looks like mild windburn.
Skin often feels tight, warm and dry that first evening. A plain moisturizer handles it.
Light flaking on day two or three is common and is just the loosened surface finishing its exit. Do not scrub it.
Skip acids, retinoids, scrubs and exfoliating cleansers for three days.
Sunscreen matters more than usual for the next week. Freshly abraded skin burns faster and pigments more readily.
Some people get a small crop of spots two or three days later where congestion was brought to the surface. It settles without treatment.
By about a week, the skin looks and feels the way it did before.
What you get: smoother skin to the touch, more light reflection, less visible flaking, makeup that sits better, and slightly clearer pores. Most people notice it the next morning and are pleased.
How long: about a week. The layer removed rebuilds. A course of five or six spaced two to four weeks apart can keep skin in a consistently smoother state, and some people see mild improvement in very superficial pigment marks and rough sun-damaged texture over that course. That is the ceiling.
What does not change: indented acne scars, any wrinkle deeper than a fine surface line, skin laxity, pore size, melasma, and stretch marks. Marketing has attached all of these to microdermabrasion at various times. None of them stand up. The abrasion stops above the layer where every one of those problems lives.
Who is disappointed: anyone who bought a package of six for scarring or wrinkles. That is the most common complaint about this treatment and it is entirely a mismatch between what was sold and what the machine does.
On cost: at $100 a session, a six-session course is around $600 for a few months of somewhat smoother skin, after which it reverts. A prescription retinoid costs a fraction of that per month and does more, permanently, if you keep using it. Microdermabrasion is best thought of as an occasional treat or a pre-event tune-up, not a program.
Home microdermabrasion exists in two forms, and one of them is fine.
Handheld battery devices with a diamond-coated tip and a small vacuum, usually $40 to $150. These are genuinely a weaker version of the clinic machine. The suction is much lower and the tip is less abrasive, which limits both the result and the damage you can do. Used once a week with a light hand, they give a modest smoothing effect. Used daily or with pressure, they leave marks and irritation. The circular bruise around the nose from an over-enthusiastic home vacuum is a familiar sight in clinic.
Microdermabrasion scrubs and creams, which are just scrubs with aluminum oxide crystals in them. They exfoliate. They are not microdermabrasion, since there is no suction and no controlled depth. Fine occasionally, though most dermatologists would rather you used an acid.
The honest comparison: a leave-on glycolic acid or lactic acid product a few times a week does more for surface dullness over a month than a home abrasion device, with less risk of overdoing it. On darker skin tones, chemical exfoliation done gently is usually the safer route, because the main hazard here is friction.