Microdermabrasion as a Novel Tool to Enhance Drug Delivery via the Skin: An Animal Study WOAN-RUOH LEE, MD, DSC, Ãy REN-YEU TSAI, MD, z CHIA-LANG FANG, MD, MS, y CHING-JU LIU, MS, J CHUNG-HONG HU, MD, zz AND JIA-YOU FANG, PhD J BACKGROUND Microdermabrasion is a widely performed skin rejuvenation procedure. It can partly ablate and homogenize the stratum corneum (SC) layers. OBJECTIVE The effect of microdermabrasion treatment on the skin permeation of hy- drophilic and lipophilic drugs was examined in this study. METHODS 5-Fluorouracil (5-FU) and clobetasol 17-propionate were used as the hydro- philic and lipophilic permeants, respectively. In vitro skin delivery using porcine skin and in vivo topical application employing nude mouse as the animal model were both used to examine the effect of microdermabrasion. The vacuum pressures used in this study (15–25 cmHg) were much lower than those used for therapeutic purposes. RESULTS The 5-FU permeation across microdermabrasion-treated skin was 8- to 24-fold higher than that across intact skin and depended on differences in treatment pressure and duration. An intensity of 15 cmHg for 10 seconds showed the greatest enhancement of 5-FU delivery via the skin. In contrast to the results for 5-FU, microdermabrasion reduced the skin permeation and deposition of topically applied clobetasol. The partitioning effect of clobetasol from the vehicle to the SC may have predominated this result. Microderm- abrasion also enhanced the skin delivery of the hydrophilic 5-aminolevulinic acid (ALA). Confocal laser scanning microscopy (CLSM) of microdermabrasion-treated skin revealed intense red fluorescence of ALA-transformed protoporphyrin (PpIX) within the epidermis and upper dermis. CONCLUSIONS Microdermabrasion can improve the skin permeation of hydrophilic mol- ecules. The authors have indicated no significant interest with commercial supporters. T he delivery of drugs via the dermal route has been ex- tensively investigated. Neverthe- less, clinical applications are limited due to the stratum corn- eum (SC), the predominant bar- rier of the skin. This barrier prop- erty can be partially overcome by removal of the SC such as with tape stripping. The area and depth of SC treated by tape stripping, however, cannot be precisely con- trolled. Its safety and the ability of the skin to recover are also ques- tionable. The authors recently suggested that an erbium:YAG laser can effectively enhance and control drug delivery via the skin. 1–3 The erbium:YAG laser can ablate the SC with minimal residual thermal damage to the skin. The large size of the device and high price of the laser, how- ever, may limit its applicability. Microdermabrasion is a process that uses Al 2 O 3 crystals and neg- ative pressure to simply peel off the outer surface of the SC. 4 Pro- posed uses for microdermabrasion include the management & 2006 by the American Society for Dermatologic Surgery, Inc.  Published by Blackwell Publishing  ISSN: 1076-0512  Dermatol Surg 2006;32:1013–1022  DOI: 10.1111/j.1524-4725.2006.32224.x 1013 Ã Department of Dermatology, Taipei Medical University Hospital, Taipei, Taiwan; y Graduate Institute of Medical Sciences, Taipei Medical University, Taipei, Taiwan; z Department of Dermatology, Taipei Municipal Wan Fang Hospital, Taipei, Taiwan; y Department of Pathology, Taipei Medical University, Taipei, Taiwan; J Pharmaceutics Laboratory, Graduate Institute of Natural Products, Chang Gung University, Taoyuan, Taiwan; z Department of Dermatology, School of Medicine, Taipei Medical University, Taipei, Taiwan