Microdermabrasion and chemical peels are exfoliation procedures used to treat various cosmetic and medical skin conditions. Microdermabrasion involves mechanical abrasion of the skin with a handheld motorized device. Chemical peels involve applying acids directly to the skin. After partial destruction of the skin, these modalities rejuvenate the skin by stimulating production of new skin as well as inducing changes such as increasing production of collagen. Patients planning to undergo one of these procedures should be screened for absolute or relative contraindications, including recent use of retinoids, active skin infection, and immunosuppression. In addition, patients with histories of herpes simplex virus infection in or near the area to be treated should receive antiviral prophylaxis. Microdermabrasion is performed by passing a handheld abrasion device over the skin. Chemical peels are performed by applying liquid acid to the skin. After a chemical peel, patients treated with strong acids may require acid neutralization to protect the skin from sun exposure and reduce pain. Patients should receive aftercare instructions about application of topical agents to reduce pain, erythema, and itching. Patients undergoing chemical peels should be instructed specifically not to remove peeling skin but to let it shed spontaneously.
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