Dermabrasion

What is dermabrasion?

Dermabrasion, or surgical skin planing, is a procedure where a dermatologist or plastic surgeon uses a specialized instrument to "sand" the skin. This abrasive or planing action improves skin contour as it scrapes away top layers of skin to unveil smooth new skin.

Dermabrasion is an option if you want smoother skin. Many people who suffer from skin irregularities such as fine lines from sun damage, wrinkles, melasma, acne scars (and more) see great improvement. But, it’s important to understand the risks as well as the rewards before you decide if dermabrasion is right for you.

Dermabrasion offers good results if you have fair skin. Darker skin tones are more prone to scarring or discoloration. If your skin is darker, you may achieve better results with alternative skin resurfacing procedures.

The word “dermabrasion” is straightforward. “Derm” means “skin” and “abrasion” means “the process of scraping or wearing something away.” The word itself means “scraping of the skin.”

When is dermabrasion used? What kinds of conditions get treated with dermabrasion?

Dermabrasion was first developed to lessen acne scars and pox marks. Today, it’s also used to reduce wrinkles and fine lines, remove tattoos and reverse sun damage. Not every skin condition can benefit from dermabrasion, but many can.

Dermabrasion can improve:

• Age (liver) spots.
• Crow’s feet and fine lines.
• Melasma and other patches of dark skin.
• Pox marks and tattoos.
• Red, thick skin on the nose (rhinophyma).
• Scars from acne, accidents, or surgery.
• Skin growths that are benign (noncancerous).
• Precancerous skin patches.
• Sun damage and wrinkles.
• Stretch marks.

Dermabrasion can’t improve:

• Birthmarks.
• Burns.
• Moles.

Who is dermabrasion right for?

People of all ages, including children, can get dermabrasion. However, if you’re on the older side, keep in mind that you might heal slower than expected.

Two factors may keep you from eligibility: skin type and medical history. If you are Asian, Black, or have a dark complexion in general, this treatment could permanently discolor your skin. You might not want to risk dermabrasion.

If you have medical conditions like allergic rashes, skin reactions, fever blisters or cold sores, you could risk a flare-up. Also, if your acne is ongoing, dermabrasion isn’t an option because there’s a risk of infection. Infection is also a risk if you’ve had a bad burn, chemical peel, or if you’ve had radiation treatments.

One last risk is that your freckles might go away when your skin gets scraped.

Is dermabrasion an outpatient or inpatient procedure?

Dermabrasion is an outpatient procedure. That means that you’ll be in the office, surgery center or hospital for the procedure, but that you won’t stay overnight. In rare cases, if there is extensive work that needs monitored, you may be admitted into the hospital.

Can I do dermabrasion on myself at home?

Only a trained dermatologist or plastic surgeon should perform a dermabrasion. Make sure you find a qualified professional.

What’s the difference between dermabrasion and other skin resurfacing options like microdermabrasion?

Depending upon your skin type, condition and goals, you may want to consider other skin resurfacing options. Work with your dermatologist to figure out which option will work best for you.

Consider the following skin resurfacing alternatives:

• Chemical peels use chemicals to dissolve top layers of skin of all skin types.
• Laser skin resurfacing utilizes a laser to reduce wrinkles or scars on fair skin types only.
• Microneedlinguses a physical device to reduce wrinkles or scars on all skin types.
• Microdermabrasionuses a spray of tiny abrasive crystals to soften all skin types. It’s a lighter procedure than dermabrasion and won’t work for deep skin issues, such as stretch marks, scars or wrinkles. It doesn’t require anesthesia and your skin recovers in 24 hours.

What happens before the dermabrasion procedure?

You’ll meet with your dermatologic or plastic surgeon before the procedure to discuss your goals and expectations. During the consultation, your plastic surgeon or dermatologic surgeon will describe the type of anesthesia, the procedure and what realistic results you can expect. A 50% improvement in your skin’s condition is considered a good result.

To be considered a good candidate for dermabrasion, you need to prepare yourself for how you’ll look while your skin is healing. Your skin will be very pink and raw; without proper post-procedural care, a scab-like crust will form, potentially delaying healing and worsening the outcome. Your skin may ooze and it will have a moist dressing on it for the day immediately following surgery, prior to starting wound care at home. It’s critical to stay out of the sun during the healing period so that the new skin heals evenly and doesn’t become discolored. You may want to take at least two weeks off from work for your skin to heal properly. It may take several months for the full results to emerge.

Dermabrasion is typically an outpatient procedure performed in your healthcare provider’s office where your skin is numbed with a local anesthetic. But, if you’re having other cosmetic procedures at the same time (such as a facelift), you may have your procedure done at an inpatient surgery center and receive general anesthesia. Your healthcare provider will also explain the risks and complications that may occur and will take photographs before and after the procedure to evaluate your results.

Be prepared at the consultation to discuss the following with your healthcare provider:

• Your medical conditions.
• Drug allergies.
• Past medical treatments, including surgeries.
• Current medications.
• Current vitamins and other supplements.
• Tobacco, drug and alcohol use.

What will my dermabrasion pre-procedure self-care routine look like?

Once you’ve scheduled your dermabrasion procedure, your healthcare provider will give you preoperative instructions. To prepare for your procedure, your healthcare provider may instruct you to:

• Stay out of the sun. Your healthcare provider will likely speak to you about how recent sun exposure before your procedure can cause your skin to permanently discolor after dermabrasion.
• Stop certain drugs you take. Ask your healthcare provider how long you should stop blood thinners or other medications you take that have skin discoloration side effects (hyperpigmentation).
• Don’t smoke. Stop for at least two weeks leading up to your procedure because it decreases blood flow and slows the healing process.

What happens during the procedure?

Your skin will be cleansed with an antiseptic and your healthcare provider will give you any or a combination of the following to make you comfortable during the dermabrasion procedure:

• Numbing spray.
• Topical anesthetic gel.
• Local anesthetic injection.

Once the numbing medication has taken effect, your healthcare provider will use a high-speed rotary instrument with an abrasive diamond wheel or wire brush to scrape away the outer layers of skin and reveal the fresh layers underneath. Once the procedure is complete, your healthcare provider will apply a moist dressing to your skin to keep it protected while it heals.

How long does the procedure last?

The length of the procedure depends on how much of the skin will go through dermabrasion. It may take a few minutes, or it may take more than 90 minutes.

Will I be asleep during the procedure?

You will be awake during the procedure but the area will be numbed. Sometimes general anesthesia is necessary.

What should I expect after the procedure?

Be sure to arrange for someone to drive you home after surgery. You won’t be able to operate a vehicle.

Before you leave the healthcare provider’s office, you’ll receive instructions about when to return for a follow-up visit and how to change the dressing. Your healthcare provider will prescribe an antiviral and an antibiotic to help you avoid infections. They also may suggest you use a retinoid ointment (Retin-A®). This vitamin A treatment can boost skin rejuvenation.

After dermabrasion you’ll have to do the following to avoid any problems:

• Cleanse your skin several times a day. This will remove the crusting caused by the normal healing process, and help avoid infection.
• Keep the area moist and help the healing process by changing the ointment or dressing regularly.
• Avoid sun exposure. (And use sunscreen every day after you heal.)

You’ll attend one or more follow-up visits so that your healthcare provider can monitor your condition. They will want to double-check that you’re healing that there are no signs of infection.

Is dermabrasion permanent?

Dermabrasion will permanently remove tattoos.

What are the risks of dermabrasion?

Some medical conditions and medications you have may mean you’re not a good candidate for dermabrasion. Dermabrasion is not ideal if you have:

• Rosacea, as it puts you at risk of infection.
• Blood, immune or skin disorders that slow the healing process.
• Browlift or facelift procedures done recently.
• Burn scars as they won’t respond to dermabrasion.
• Dark skin as it increases the chances of permanent discoloration or scarring.
• Herpes simplex can complicate healing with infection and cold sores which may scar.
• Keloid conditions which cause scarring.
• Medications for acne in previous months such as isotretinoin (Absorica®, Claravis®) or any other medications that may thin your skin, or blood thinners that put you at an increased bleeding risk.
• Skin that is cold-sensitive.

Are there side effects and complications with dermabrasion?

Side effects of dermabrasion are uncommon but can occur. The most common complications include:

• Acne flare-ups. Sometimes people with acne rosacea experience tiny white spots (milia) which will eventually go away as the skin heals.
• Temporary or permanent uneven changes in skin color.
• Temporary or permanent darkening of the skin, usually caused by sun exposure in the days and months following surgery.
• Enlarged pores (usually temporary).
• Scarring.
• Swelling.
• Infection.

Is dermabrasion painful?

Your skin will be numbed using local anesthesia or a freezing spray during the procedure so that you won’t feel any pain. After the procedure, you may feel like you had a bad sunburn. If there is a severe stinging sensation, your healthcare provider may prescribe pain medications.

What are the benefits of dermabrasion vs. chemical peels?

There are benefits you may get from dermabrasion that you may not get from a chemical peel. Benefits of dermabrasion vs. chemical peels include:

• Boosts collagen: Studies show that dermabrasion stimulates collagen production in your skin, which boosts rejuvenation effects and means you’ll have younger-looking skin. Collagen production from a chemical peel isn’t as effective.
• Better for medium skin tones: Dermatologists report less discoloration risk in medium skin tones with dermabrasion versus chemical peels.
• Deep scar reduction: Studies also show that dermabrasion is more effective at reducing deeper acne scars than chemical peels.

What will my dermabrasion post-procedure self-care routine look like?

After the procedure, your skin may feel as though you have a bad sunburn for a few days. You’ll have a follow-up appointment with your healthcare provider to check your skin and re-apply a dressing to keep your skin moist and protected. Your healthcare provider may prescribe medications to help reduce the sting you may feel. Healing usually occurs within 10 to 14 days. The newly formed skin, which will be very pink and tender at first, will gradually develop a normal color over the course of about three months. Makeup can be used as a cover-up as soon as the skin is healed. Most people can resume most of their normal activities seven to 14 days after dermabrasion.

Your dermatologist or plastic surgeon will give you an after-care leaflet so that you know how to take care of your newly-exposed skin while it’s in the delicate stages of healing. Here’s what to expect in your post-procedure after-care routine.

For your post-procedure routine you will need to:

• Stay away from alcohol for the first 48 hours after the procedure.
• Avoid aspirin and ibuprofen for a week following dermabrasion.
• Avoid swimming in chlorinated pools for a month.
• Avoid vigorous sports for four to six weeks.
• Change the dressing on the abrasion as directed by your healthcare provider. Typically, instructions will say to cleanse the skin several times per day to prevent crusting. Then, reapply a moist dressing of a petroleum jelly product designed to help skin heal.
• Don’t smoke because smoking reduces blood flow and can delay healing.
• Stay out of direct sunlight for three to six months and wear SPF 30 sunscreen every day.
• Take any antiviral or antibacterial medications your healthcare provider has prescribed.
• Go to all follow-up visits with your healthcare providers.

What is the recovery time from dermabrasion?

It will likely take at least two weeks for your skin to heal. Several weeks (or even months) might pass by before you’ll see the full, complete results.

Be sure to follow your healthcare provider’s instructions closely as some people may receive specific instructions intended to keep certain health conditions they have in check while they heal.

Dermabrasion is a terrific tool to improve your skin’s appearance and may give you the added benefit of increased confidence.

When should I contact my healthcare provider?

Contact your dermatologist as soon as possible after you notice the wrinkles, sun damage, melasma, scars and more.