Background. Microdermabrasion has become a popular method of skin rejuvenation for treating dyschromia, fine wrinkles, and mild scarring. Objective. To analyze the onset and extent of the dermatologic changes associated with microdermabrasion. Methods. Ten volunteers, ages 31-62 years, underwent a series of six aluminum oxide micro dermabrasion facial treatments 7-10 days apart. Skin biopsy specimens were obtained prior to the study, after three treatments, and after six treatments. Results. Compared to the controls, the treated areas demonstrated the following histologic changes: thickening of the epidermis and dermis, flattening of the rete pegs, vascular ectasia and perivascular inflammation, and hyalinization of the papillary dermis with newly deposited collagen and elastic fibers. Conclusion. This study suggests that micro dermabrasion produces clinical improvement by a mechanism resembling a reparative process at the dermal and epidermal levels.