Medically reviewed by Franco Cuevas, MD. Last reviewed July 2026.
Microdermabrasion is a mechanical exfoliation that removes the stratum corneum, the outermost layer of dead skin cells. It reliably makes skin feel smoother and look brighter for a short period, with essentially no downtime. What the evidence does not support is most of what it is advertised for. The one study that specifically measured wrinkles found no significant improvement, the American Academy of Dermatology states plainly that it will not treat acne scars, and the devices are not FDA approved or even FDA cleared, because they are exempt from review entirely. Here is an honest account of what it does.
What It Is and What a Session Involves
A handpiece either sprays abrasive crystals, usually aluminium oxide, under vacuum, or uses an embedded diamond tip. Either way it abrades the surface while suction removes the debris.
A session takes 30 to 60 minutes for the face, involves about three passes, and needs no anaesthetic. Afterwards skin looks pink and may swell slightly, resolving within a day.
Courses matter here. The AAD notes that most patients receive between 5 and 16 treatments, weekly to monthly. At roughly $150 to $350 per session, a realistic course runs into four figures.
Hydradermabrasion, sold under brand names like HydraFacial, adds serum infusion. Its published evidence is thinner still, and researchers noted in 2024 that clinical studies validating it are scarce.
The Regulatory Status, Which Is Widely Misstated
This is where promotional pages mislead most often.
Powered dermabrasion brushes are Class I devices that are exempt from 510(k) premarket notification. Manufacturers need only register their establishment. There is no FDA review of safety or effectiveness for these devices at all.
That means microdermabrasion devices are neither “FDA approved” nor, in the typical case, “FDA cleared.” Approved is reserved for a much more rigorous pathway. Cleared applies to devices that went through 510(k) review, which exempt devices did not. Any clinic advertising an “FDA-approved microdermabrasion treatment for wrinkles” is making a claim that does not correspond to anything in the regulatory system.
What the Evidence Actually Shows
The standard evidence appraisal, published in Plastic and Reconstructive Surgery in 2010, concluded that microdermabrasion can produce changes in the dermal matrix and improve skin contour irregularities, may help deliver medication through the skin, and that “its role in the treatment of dyschromias and acne vulgaris is limited.”
The underlying studies are small. Note the sample sizes.
| Indication | Evidence | Verdict |
|---|---|---|
| Skin roughness and brightness | Patient-rated improvement, uncontrolled studies | Modest and temporary |
| Fine lines and wrinkles | 14-patient study found no significant improvement in wrinkles; 10-patient study found only mild change | Weak |
| Acne | One pilot study | Limited, per the evidence review |
| Acne scarring | Not included in the Cochrane review of acne scar treatments at all | AAD says it will not treat them |
| Melasma and pigmentation | Not included in the Cochrane melasma review; small uncontrolled series only | Weak, and carries pigmentation risk |
| Stretch marks | One uncontrolled subgroup | Very weak |
| Enlarged pores | Patient-reported only | Subjective and transient |
| Enhancing absorption of topical products | Demonstrated for several drugs | The best-supported effect |
Two details are worth pulling out. In the 10-patient photodamage study, the measurable changes were interpreted as consistent with mild abrasion, increased blood flow, and persistent swelling. Some of the apparent improvement is oedema, not remodelling. And the Cochrane review of acne scar treatments assessed 24 randomised trials covering seven interventions. Microdermabrasion was not among them.
The AAD is direct about durability: results “tend to be temporary” and follow-up treatments are usually necessary.
How It Compares to the Alternatives
For most of the goals microdermabrasion is sold for, something else has substantially better evidence.
For fine lines and photoaging: topical tretinoin has a systematic review and meta-analysis behind it covering 8 trials and 1,361 patients, with significant improvement in both fine and coarse wrinkles. Compare that to 14 patients and a null result on wrinkles. A prescription retinoid also costs far less than a course of facials.
For acne scars: Cochrane found moderate-quality evidence only for injectable fillers, with everything else at very low quality. This needs a dermatologist and a deeper modality.
For melasma: hydroquinone and triple-combination cream are the interventions with review-level evidence.
Microdermabrasion’s genuine advantage is not efficacy. It is safety and the absence of downtime. It sits at the gentlest end of the resurfacing ladder, and gentleness is exactly why its effects are limited.
Who Should Not Have It
Avoid entirely with an active skin infection in the treatment area, including cold sores, shingles, warts, or impetigo, and with a known allergy to the abrasive crystal.
Use caution with rosacea, visible broken capillaries, a history of keloid or thickened scarring, psoriasis, lupus, or uncontrolled diabetes. The American Society for Dermatologic Surgery also lists active acne among reasons a patient may not be a good candidate, which is worth knowing if you were offered it as an acne treatment.
Cold sores. Beyond avoiding active lesions, the procedure can reactivate dormant herpes simplex. Tell your provider if you get cold sores, because antiviral cover may be appropriate.
Isotretinoin. Genuinely contested. The AAD tells patients that taking it within the past six months raises the risk of complications including scarring. A 2017 ASDS expert consensus reviewed the evidence and found little support for delaying superficial procedures. Disclose it and let the clinician decide rather than assuming either position.
Darker skin tones. The procedure is generally considered suitable for all skin types, but the AAD adds a useful caveat: if your skin tends to develop dark marks after acne or injury, you may be at greater risk of more dark spots. That risk is lower with a dermatologist.
Blood thinners. Not a formal contraindication in the guidelines, but bruising and petechiae are recognised side effects of the vacuum component, so mention anticoagulants to your provider as a precaution.
Afterwards: skin is more vulnerable to sun for several days, so use sunscreen for at least a week. Avoid glycolic acid, retinol, and benzoyl peroxide for a day or two afterwards, and prescription retinoids for three to seven days. Do not schedule a treatment within two weeks of an important event, given the redness and possible petechiae.
Who Can Perform It
There is no federal standard. State boards control this and rules vary.
The recurring legal distinction is depth. Treatment limited to the outermost layer is generally within an esthetician’s or cosmetologist’s scope, often under physician supervision. Treatment reaching deeper epidermal levels is typically restricted to physicians or to nurses and physician assistants under supervision.
There is a wrinkle worth noticing. In some states, treatment intended to remove scarring, blemishes, or wrinkles is characterised as medical treatment. In other words, the specific outcomes these treatments are advertised for are the ones that push the procedure into medical scope. Check your own state’s cosmetology and medical boards rather than relying on a clinic’s description.
The AAD’s safety endorsement is explicitly conditional: the excellent safety record it describes is for microdermabrasion performed by a dermatologist.
Insurance
Microdermabrasion is cosmetic and is essentially never covered. Where coverage exists in this family of procedures, it attaches to true dermabrasion, a much deeper procedure, for a documented medical indication such as actinic keratoses that failed topical therapy. Claims that microdermabrasion itself may be covered for acne or rosacea come from industry marketing, not payer policy.
Microdermabrasion FAQs
Does microdermabrasion get rid of wrinkles?
There is little evidence that it does. The one study that specifically measured wrinkles found no significant improvement, though patients did report smoother, less mottled skin. Topical tretinoin has far stronger evidence for wrinkles.
Does microdermabrasion treat acne scars?
No. The AAD states directly that it will not treat acne scars. Dermatologists sometimes use it to even skin tone alongside an actual scar treatment. It was not included in the Cochrane review of acne scar interventions.
Is microdermabrasion FDA approved?
No. These devices are Class I and exempt from FDA premarket review, so they are neither approved nor, typically, cleared. The FDA has not assessed them for effectiveness.
How many sessions will I need and what will it cost?
The AAD says most patients have between 5 and 16 treatments. At roughly $150 to $350 per session, a full course commonly runs well into four figures.
How long do the results last?
The AAD states results tend to be temporary and follow-up treatments are usually necessary. Some of the immediate improvement is mild swelling rather than lasting change.
Is it safe for darker skin?
Generally yes, but if your skin tends to darken after acne or injury you have a higher risk of developing more dark spots. Having it done by a dermatologist reduces that risk.
