The Vibraderm™

Introduction

The Vibraderm™ attachment for the Procell Therapies Multi-Tool is a newly patented technology to assist you to easily perform a Procell Micro-Channeling .

Using a vibrating stainless steel abrasion surface, the Vibraderm™ exfoliates the epidermis in a massage-like manner to gently remove the outer layers of the stratum corneum, allowing the skin to become smoother and softer. Treatments can be administered over the entire body, including the face, neck, decollet and back.

The Vibraderm™ Tip is also an excellent method for pre-treatment of the skin prior to performing conventional aesthetic procedures such as IPL/LASER skin rejuvenation, and removal of age and brown spots.

By treating a patient with Vibraderm™ you can assist penetration of any type of topical medication or product to enhance their performance. Microchanneling treatments are performed quickly and comfortably. Each paddle may be patient specific so there is no risk of cross contamination.

Exfoliation: Microdermabrasion v Procell Microchanneling

Microdermabrasion is a popular skin rejuvenation treatment that involves mechanical exfoliation and vacuum assisted removal of the Stratum Corneum, (SC). Depending on how aggressive the technician is in executing such exfoliation, it can be expected that the entire structure of the SC is removed, along with possible removal of significant portions of the Stratum Granulosum (SG) and Stratum Spinosum (SS), and/or exposure of these layers to the environment from which they are typically shielded by the SC.

Procell Microchanneling is a mechanical exfoliation of a portion of the SC, with compaction of underlying SC cells and preservation of the SG & SS.

Recent illumination of the sophisticated nature of the skin’s barrier function, product penetration and cytokine/receptor activity in the skin cycle may shed light on why it is that traditional microdermabrasion is favored by some, yet not by others based upon the reality of widely varying outcomes and side effects observed by patients and physicians alike.

Let’s take a brief look at some important observations regarding structural formation of the SC and the skin’s natural barrier function:

Cytokines and the Skin Barrier

Kai H. Hänel,¹ Christian Cornelissen,^1,2 Bernhard Luscher,^1, and Jens Malte Baron² Concluding Remarks

“The terminal differentiation events, which result in the cornified envelop, are difficult to study at the cellular level beyond documenting protein expression, because the cells no longer proliferate and cannot easily be separated from earlier differentiation stages.

As a consequence, in most situations it is not clear how a specific cytokine controls the expression of genes relevant for the differentiation process.”

“Together, the studies that are presently available do not allow precise conclusions about how certain cytokines affect barrier formation. In particular, it is typically not known whether a cytokine controls the expression of a relevant gene directly, or whether these are secondary effects.”

Because these processes are highly balanced, it is not surprising that many cytokines provoke a weakening of the barrier, albeit that their effects are mediated by different components. These contribute to efficient barrier formation, beginning with effects on early differentiation processes to the disturbance of terminal events that define the barrier proper.

Stratum corneum cytokines, structural proteins, and transepidermal water loss: effect of hand hygiene.

Visscher MO¹, Said D, Wickett R. CONCLUSION:

“This preliminary study showed significantly lower Stratum Corneum biomarker levels in Health Care Workers compared with controls and regional differences between the hand and forearm. Exposure to repetitive hand hygiene results in substantial chronic skin irritation without time for barrier recovery between work periods. The impact on SC structural proteins and cytokines has many commonalities with chronic inflammation, although mechanistic questions remain.”

This is all to say that for many patients, wholesale removal of the SC, SG & SS via vacuum assisted microdermabrasion may too aggressive to predictable facilitate improvement of barrier function, product penetration and skin rejuvenation.

Alternatively, light exfoliation & compaction of the cornified layer, while leaving its structure relatively intact is a more desirable option for delivering ingredients that enhance barrier function and cytokines that augment the patients natural skin cycle.

Even vacuum assisted removal of the SC only via traditional microdermabrasion, may lead to premature environmental exposure of the SG and SS to the harsh environment.

Without functionality all layer’s cytokine/receptor infrastructure from the bottom all the way to the top, this exposure may result in more harm than the eventual benefit of redevelopment.

And to put it even more simply: Scraping and vacuuming the entire SC (and possibly SG & SS layers) may not be the best exfoliation method for skin rejuvenation and improvement & maintenance of barrier function.

Hence the evident improvement in skin structure produced by Zelickson’s Vibraderm.

Histologic examination revealed an even and adequate removal of 75% of the stratum corneum, with the remainder being compacted. Epidermal thickening was also observed compared to pre-treatment samples and the Grenz zone was thickened. There is a reactive epidermal hyperplasia noted after treatment.

“Seventy five percent (of treated patients) felt they had improvement in the tone and texture of their skin on the Vibraderm treated side compared to only 55% of patients who observed improvement on the microdermabrasion side.” Dr. Zelickson said.

This 20% differential in perceived improvement may be attributable to the absence (or presence of) precise & harmonic interactions of cytokines and receptors between all layers of the epidermis, including the SC.

While further study is warranted, the sophistication of cytokine/receptor interaction on barrier function and skin rejuvenation must be taken into account when considering how aggressive one might be in SC removal via exfoliation.

With recent advancements in the identification of cytokine/receptor interaction, and their apparent harmonic function, Procell Therapies is recommending a “less is more”  approach when it comes to exfoliation of the SC for the improvement of barrier function and overall skin rejuvenation.

The creation of Microchanneling for light dermabrasion as a stand alone service, or prior to other skin rejuvenation treatments is in direct response to the growing body of data describing the interactions of cytokines in all layers of the epidermis in the regulation of overall skin health and appearance.

Operation of the Vibraderm™ Tip

1. Clean both the skin to be treated and the Vibraderm™ Tip with an appropriate antiseptic.

1. Turn the knurled nut on the Vibraderm™ Tip in a counterclockwise direction to move it away from the ball joint end and insert the paddle into the hand piece.
2. Turn the knurled nut in a clockwise direction until SNUG contact is made with the device tip. Be careful not to overtighten as this will loosen the connection.
3. Turn the “on/off” switch to the appropriate speed The low speed is for initially allowing the patient to become comfortable with the a “feel” of the paddle, or for those patients with very sensitive skin.
4. Hold the device like a pen. Gently apply the steel exfoliation surface of the paddle to the skin.
5. The treatment is performed with very light pressure on the hand piece. As a safety feature, if the paddle is pressed too firmly on the skin it will pop off, preventing excessive abrasion.
6. The paddle should be moved slowly over the treated area, generating a massage-like sensation
7. Perform 1-3 passes over the treatment area.

Cleaning the DermaPaddle™

1. Bend theVibraderm™ Tip to the side to pop it off the Multi-Tool.
2. Soak the Tip in a dilute Enzymatic solution like ENDOZYME for 10 minutes or more
3. Using a toothbrush or similar brush, brush the Exfoliating Surface under HOT running water.
4. Soak in Disinfectant Solution (Cidex, Barbicide).
5. Rinse under HOT running water and lay out to dry.
6. TheVibraderm™ Tip will typicelly last between 3-6 treatments.
7. The Tip is intended for treatment only upon a single client’s skin, for a series of treatments.

Vibraderm™ Tip NOTES

• Anesthetics are not required
• No downtime.
• Treatment as often as daily is recommended
• After the initial series of treatments, ongoing monthly maintenance regimen is suggested.
• All skin types I-VI may be treated using the Vibraderm™ Tip.
• Patients may experience a mild erythema immediately following a Vibraderm™treatment which typically resolves within 30-45 minutes.
• Application of the X-Taz Mask or similar moisturizing prepararion Immediately after treatment is recommended.
• Moisturizers and sunscreens should be applied daily between treatments.

Vibraderm™ Safety

It is recommended that individuals with the following conditions consult with a physician prior to undergoing Vibraderm™ treatment:

• Active herpes simplex
• Tattoos
• Eczema
• Active acne
• Dermatitis
• Diabetes