Hydrafacial vs Aquapeel vs microdermabrasion:
suction, water or abrasion

What is the difference between Hydrafacial, Aquapeel and microdermabrasion?

All three are ways of cleaning and lightly resurfacing the outermost layer of the skin, and they differ in what the handpiece does when it touches the face. Hydrafacial is a patented hydradermabrasion platform. Its spiral tip creates a vortex that applies a mild glycolic and salicylic solution, loosens and extracts debris from pores by suction, and infuses a serum of hyaluronic acid, antioxidants and peptides in the same movement, with the solution applied and evacuated continuously so that contact time is controlled. A 2008 paper in the Journal of Cosmetic Dermatology describing hydradermabrasion with an antioxidant serum reported changes in epidermal thickness and in measures of antioxidant level after a course of treatments, which is the origin of the claim that the infusion matters and not only the exfoliation.

Aquapeel, also written aqua peel or water peel, is the generic Korean-style version of the same idea. A suction handpiece delivers a stream of water and a peeling solution, usually an alpha or beta hydroxy acid in low concentration, across the skin and draws the loosened debris away; several devices are sold under the name, and the serums and tips vary with the clinic rather than being a fixed protocol. Microdermabrasion is the oldest of the three and the most purely mechanical: a wand either blasts aluminium oxide crystals against the skin and vacuums them away, or abrades the surface directly with a diamond-tipped head, removing the outermost cells of the stratum corneum. A 2001 clinical and histopathological study in Dermatologic Surgery found the changes it produced were confined to the surface, and later molecular work in the Journal of the American Academy of Dermatology described a mild wound-healing response in the epidermis, with and without the crystals.

What does each of them change, and what does none of them do?

All three change the surface: they remove dead cells and debris, clear congested pores, and leave the skin smoother, more hydrated and brighter for a time. That is a real effect and a useful one, for congestion, dullness, dehydration, flaky skin and the run-up to an event, and as maintenance between treatments that do go deeper. Hydrafacial's distinction is the infusion and the control over the acid step; Aquapeel's is that it is widely available and gentle; microdermabrasion's is that it is the most abrasive, which makes it the one most likely to leave the skin pink and sensitive and the least suitable for reactive or darker skin.

What none of them does is reach the dermis. Acne scars are dermal and need RF microneedling or fractional resurfacing at the depth the scar sits; established pigment is a deposit in the epidermis or dermis and needs a pico laser chosen for its depth; melasma is a chronic condition that heat and friction can worsen; laxity belongs to a lifting protocol. A facial can brighten the skin over a pigmented patch and make it look cleaner for a short time; it does not remove the deposit, and the Hydrafacial page says so. The glass skin page draws the same line between what a facial polishes and what a treatment changes.

“A facial polishes the surface. If what bothers you is a scar, a deposit of pigment or skin that has slackened, no amount of polishing reaches it, and I will say so.”

Dr Sin YongOn what a mechanical facial can and cannot do

Which skin suits Hydrafacial, which suits Aquapeel, and which suits microdermabrasion?

Hydrafacial suits the widest range because its three variables, acid strength, suction and serum, are adjusted for the skin on the day. Oily, congested skin takes a stronger acid step and the extraction; dehydrated or sensitive skin takes a gentler pass and the hydration; skin between laser or injectable treatments takes it as maintenance, timed so that it does not disturb a healing surface. Darker phototypes are treated with the settings turned down, because any surface irritation can darken Fitzpatrick IV to VI skin, and anyone on a retinoid or recently peeled is assessed before the acid step is used.

Aquapeel suits mild congestion and dullness in someone who wants a gentle, inexpensive facial and is not expecting more than a cleaner surface; what it delivers depends on the device and the solution in the particular clinic, so the question to ask is what is in the stream. Microdermabrasion suits thicker, oily, non-reactive and lighter skin with surface roughness, and is the one most often turned down here: the abrasion is less controllable than an acid, it leaves the skin pink and sensitised, and in the skin types that predominate in Singapore the inflammation it causes can leave the face darker than it found it. None of the three suits active inflamed acne, rosacea in a flare, open wounds, a cold sore, a sunburn, or the period just after a laser or a peel.

Sorted at assessment

• Is the concern at the surface, congestion, dullness, dehydration, or in the dermis, scars, pigment, laxity?
• Skin type, and how it has reacted to acids, suction or abrasion before.
• What is active on the skin: acne, rosacea, eczema, a retinoid, a recent treatment.
• Whether the facial is the treatment, or maintenance around another one.

How is Hydrafacial used here, and what happens when the concern is deeper?

Hydrafacial is the mechanical facial used here, assessed by Dr Sin Yong, who selects the serums and boosters and sets the acid strength and suction for the skin in front of him; Aquapeel and microdermabrasion are not used here. Its role is maintenance and preparation: congested or dull skin, skin that is dehydrated by air-conditioning, and skin that sits between laser, RF microneedling or injectable treatments and needs looking after without being disturbed. Where the assessment finds a dermal problem, a facial is not substituted for the treatment that problem needs. Scars go to Secret RF or the S3 Resurfacing Lift by depth, pigment to the pico laser after it has been identified, dull tone driven by inflammation to R2 Glow, and hydration that sits below the surface to a skin booster.

What decides the plan is the examination: what the concern is and where it sits, the skin type, what is active on the skin, and what else is scheduled so that the facial is timed around it. Aftercare after any of the three is simple and similar: sunscreen, no exfoliating acids or retinoids until the skin has settled, no picking at any flaking, and a note of anything that stung or darkened so the next settings are adjusted. Fees follow the plan and are set out in writing after assessment, as explained on how fees are quoted. Someone who has been having Aquapeel or microdermabrasion elsewhere and feels the result has plateaued is usually describing the limit of a surface treatment rather than a failure of technique, and the consultation looks at what sits underneath.