Dermabrasion is a cosmetic medical procedure in which the surface of the epidermis of the skin (the stratum corneum) is removed by abrasion (sanding). It is used to remove sun-damaged skin and to remove or lessen scars and dark spots on the skin. The procedure is very painful and usually requires a general anaesthetic or twilight anaesthesia, in which the patient is still partly conscious. Afterward, the skin is very red and raw-looking, and it takes several months for the skin to regrow and heal. Dermabrasion is useful for scar removal when the scar is raised above the surrounding skin, but is less effective with sunken scars.

In the past, dermabrasion was done using a small, sterilized, electric sander. In the past decade, it has become more common to use a CO2 or Erbium:YAG laser. Laser dermabrasion is much easier to control, much easier to gauge, and is practically bloodless compared to classic dermabrasion.

The Best Candidates For Dermabrasion

Dermabrasion and dermaplaning can enhance your appearance and your self-confidence, but neither treatment will remove all scars and flaws or prevent aging. Before you decide to have a skin-refinishing treatment, think carefully about your expectations and discuss them with your surgeon.

Men and women of all ages, from young people to older adults, can benefit from dermabrasion and dermaplaning. Although older people heal more slowly, more important factors are your skin type, coloring, and medical history. For example, black skin, Asian skin, and other dark complexions may become permanently discolored or blotchy after a skin-refinishing treatment. People who develop allergic rashes or other skin reactions, or who get frequent fever blisters or cold sores, may experience a flare-up. If you have freckles, they may disappear in the treated area.

In addition, most surgeons won’t perform treatment during the active stages of acne because of a greater risk of infection. The same may be true if you’ve had radiation treatments, a bad skin burn, or a previous chemical peel.

In general, the best candidates for dermabrasion are people:

  • In good physical health
  • Psychologically stable
  • Aware of the processes involved
  • Accepting of the physical limitations involved in the healing process
  • Free of active acne
  • Who have not had a previous chemical peel, severe sunburn, or radiation treatment
  • Without unidentified skin sensitivities
  • Who have not taken Accutane any time in the past year and a half
  • Can realistically avoid exposure to direct sunlight for several weeks following the procedure
  • Well informed about variations in the procedure’s outcome, especially as it pertains to different skin tones and skin types (Patients with fair skin tones generally have better results from dermabrasion than patients with darker skin.)
  • With realistic expectations for the procedure’s outcome

The above is only a partial list of the criteria that your doctor will consider in determining whether or not this procedure is appropriate for you. Be sure to ask your doctor if he / she considers you an ideal candidate for dermabrasion

Alternative Procedures

If you’re planning “surface repairs” on your face, you may also be considering chemical peel, an alternative method of surgically removing the top layer of skin. However, dermabrasion and dermaplaning use surgical instruments to remove the affected skin layers, while chemical peel uses a caustic solution.

Many plastic surgeons perform all three procedures, selecting one or a combination of procedures to suit the individual patient and the problem. Others prefer one technique for all surface repairs. In general, chemical peel is used more often to treat fine wrinkles, and dermabrasion and dermaplaning for deeper imperfections such as acne scars. A non-chemical approach may also be preferred for individuals with slightly darker skin, especially when treating limited areas of the face, since dermabrasion and dermaplaning are less likely to produce extreme changes and contrasts in skin color.

Risks and limitations:

Infection and scarring is rare, but can occur. If too much scar tissue forms, it may be softened with steroid injections. Occasionally hyperpigmentation (darkening of the skin) occurs, but this may be treated with bleaching cream. Skin lightening or patchiness can also occur, especially on people with darker natural skin tones.

After the procedure, some patients get small whiteheads called milia. These usually disappear after washing, but some may require the doctor’s help to remove them. You should tell your doctor if you have this problem. You can help minimize certain risks by following the advice and instructions of your doctor, both before and after a chemical peel.

Pre-existing conditions may also put you at risk. To reduce your risks, let your doctor know if you have a history of fever blisters of cold sores, such as herpes or shingles. Taking an anti-viral medicine before the procedure may help prevent the flare-ups afterwards.

Also tell your doctor if you have taken Accutane in the last 18 months. This medication can impede healing and increase the risk of scarring.

What Happens After Dermabrasion?

After the procedure, your skin will feel as though it has been severely “brush-burned” for a few days. Your doctor can prescribe or recommend medications to help reduce any discomfort you may have, such as an over-the-counter pain reliever. Healing usually occurs within seven to ten days.

The newly formed skin, which is pink at first, gradually develops a normal color. In most cases, the pinkness largely fades by six to eight weeks. Makeup can be used as a cover-up as soon as the skin is healed.

Generally, most people can resume their normal activities in seven to 14 days after dermabrasion. Patients are instructed to avoid unnecessary direct and indirect sunlight for three to six months after the procedure, and to use sunscreen on a regular basis when outdoors.

Effects and Complications

The most common side effects include:

  • Uneven changes in skin color (temporary or permanent)
  • Darkening of the skin (temporary or permanent)
  • Formation of a scar
  • Infection

Darkening of the skin usually occurs because of sun exposure in the days and months following surgery.

Care After Surgery

Do not drink alcohol for 48 hours after the surgery. Do not take aspirin or any products that contain aspirin or ibuprofen for one week after the surgery. Avoid smoking, as advised by your doctor. You will have a mandatory appointment the day after your surgery and your doctor will provide more details.

Expectations

Dermabrasion wounds and destroys the skin. You need to prepare yourself for how your skin will look immediately after treatment and throughout the healing process. It is also extremely important for you to follow your doctor’s instructions on caring for your skin after the treatment so you can avoid infection and help your skin heal properly.

Be sure that your doctor understands what you hope to achieve and that you understand what results you can realistically expect. Do not expect a 100% improvement. In general, a 50% improvement in the skin condition is considered a good result. Even with realistic expectations, you may not see results for several weeks or months after dermabrasion.

Sun protection

After dermabrasion, you will need to wear sunscreen every day and avoid sun exposure as much as possible. New skin is more susceptible to damage and discoloration from sunlight.

Options for resurfacing

Dermabrasion, chemical peel, and laser resurfacing are the most commonly used techniques for improving the texture and appearance of the skin. Although these techniques use different methods, they have basically the same effect on the skin-they destroy and remove the upper layers of skin to allow for skin regrowth.

No one technique is necessarily better than the others. When performed by an experienced surgeon, laser resurfacing may be slightly more precise than dermabrasion or chemical peels. Laser treatment also tends to be more expensive than dermabrasion or chemical peeling. In general, the choice of technique is based on the site you want to treat, your skin type and condition, the doctor’s experience, your preferences, and other factors. Some people may get the best results by using a combination of techniques.

Sources: Plastic Surgery, Ienhance

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