Dermabrasion is a treatment to improve the look of the skin. It uses a wire brush or a diamond wheel with rough edges (called a burr or fraise) to remove the upper layers of the skin. The brush or burr spins quickly, taking off and levelling (abrading or planing) the top layers of the skin. This process injures or wounds the skin and causes it to bleed. As the wound heals, new skin grows to replace the damaged skin.
Things that affect the depth of the skin removal include:
- How coarse the burr or brush is, and how fast it spins.
- How much pressure is applied, and for how long.
- The condition and features of your skin.
The face is the most common site for this treatment. But other areas of the skin can be treated this way too. Dermabrasion is used most often to improve the look of acne scars and fine lines around the mouth. It also may be used to treat an enlarged nose (rhinophyma) caused by rosacea, a skin condition.
How it is done
The areas to be treated are cleaned and marked. A local anesthetic (such as lidocaine) is used to numb the skin. Ice packs are placed on the skin for up to 30 minutes. A freezing (cryogenic) spray may be used to harden the skin for deeper abrasions if the anesthetic and ice packs don't make the skin firm enough. For deep abrasions, or if the entire face is going to be treated, you may need stronger anesthesia, pain killers, sedation, or general anesthesia.
One small area at a time is treated. The freezing spray (if needed) is applied for a few seconds. Then the rotating burr or brush is used to take off the top layers of skin. Gauze is used to stop any bleeding. Then the area is covered with a clean dressing or ointment.
Dermabrasion is almost always done in your doctor's office or on an outpatient basis.
What To Expect After Surgery
The time it takes to heal after dermabrasion depends on the size and depth of the area that was treated. Someone who has a full-face treatment will take longer to heal than someone who has just a small area of skin treated. Deeper abrasions take longer to heal.
In most cases, the skin grows back in 5 to 8 days. This new skin is pink or red. The colour most often fades in 6 to 12 weeks. Until then, your normal skin tones can be matched using makeup.
Many people have little or no pain and can get back to their regular activities soon after the treatment. Some people need pain relievers. If swelling occurs, a corticosteroid such as prednisone may be used.
Proper care of the treated area while the skin is healing is very important. You will need to:
- Clean the skin several times a day. This helps to avoid infection. It also gets rid of the crusting that may occur.
- Change the ointment or dressing on the wound. This keeps the area moist and helps healing.
- Avoid sun exposure and, after peeling has stopped, use sunscreen every day. New skin is more likely to get sun damage.
If you are getting treatment around your mouth, you may get an antiviral drug called acyclovir to prevent infection. Tell your doctor if you have had cold sores in the past.
You will need several follow-up visits to your doctor. The doctor will keep track of how well the skin heals and regrows. He or she will also watch for and treat early signs of infection or other problems.
Why It Is Done
Dermabrasion may be used to treat:
- Fine lines and wrinkles around the mouth.
- Scars on the face, such as from acne.
- Skin growths, such as rhinophyma.
You may not be a good candidate for dermabrasion if you:
- Have used isotretinoin (a drug used to treat acne) within the last 6 to 12 months.
- Have recently had a face-lift or brow-lift. Skin areas that were not affected by the lift can be treated.
- Have a history of abnormal scarring (keloid or hypertrophic scars).
- Have an active herpes infection or other skin infection.
- Are overly sensitive to cold. (This could be a problem if freezing spray needs to be used.)
- Have a skin, blood flow, or immune problem that could make healing harder.
How Well It Works
Your skin type, the condition of the skin, how much experience your doctor has, the type of brush or burr used, and your lifestyle after the treatment can all affect the short-term and long-term results. Some types of skin problems or defects respond better to dermabrasion than others. People with lighter skin who limit their time in the sun after treatment tend to have better results. People with darker skin and those who keep spending lots of time in the sun may not have good results.
In general, dermabrasion results in a smooth, even skin texture. It also gives scarred skin a more uniform look.
- Dermabrasion works well to improve surface or nearly flat acne scars. Deeper, pitted acne scars may need another type of treatment along with or instead of dermabrasion. (Other treatments include punch grafting, elevation, and excision.)
- Scars from surgery or injury may be improved when dermabrasion is done 8 to 12 weeks after the surgery or injury. But most new scars will heal and fade some on their own for the first 6 months or so.
- Some surface growths on the skin can be removed. But they are rarely treated using dermabrasion.
- Colour changes in the skin can be improved, especially when dermabrasion is used with a bleaching agent and tretinoin (Retin-A). This can enhance the bleaching agent's effects.
- Dermabrasion does not have a big effect on deeper wrinkles. But it may improve fine wrinkles around the mouth and eyes.
The removal of scars, growths on the skin, and tattoos using dermabrasion is permanent. But changes in the colour and texture of the skin caused by aging and the sun may continue. Dermabrasion is not a lasting fix for these problems.
Common short-term side effects of dermabrasion include:
- Redness. This usually fades in 6 to 12 weeks.
- Flare-ups of acne or tiny cysts (milia). These can often be treated successfully with tretinoin. Antibiotics are sometimes needed.
- Increased colour in the skin. The skin in the area that was treated may turn darker than the surrounding skin several weeks after dermabrasion.
- Increased sensitivity to sunlight.
Less common problems may include:
- Scarring. The risk of scarring is higher with deeper abrasions and is more likely to occur in bony areas. People who have taken isotretinoin to treat acne are also more likely to have scarring after dermabrasion.
- Lasting redness.
- Long-term loss of colour in the skin. This is more of a problem in darker-skinned people.
- Tissue damage caused by excessive freezing (when a freezing spray is used).
- Infection. This is rare. An antiviral drug may be given before the procedure if the area around the mouth or the entire face is going to be treated.
What To Think About
Dermabrasion wounds and destroys the skin. You need to prepare yourself for how your skin will look right after treatment and throughout the healing process. It is also very important for you to follow your doctor's advice on caring for your skin after the treatment. This will help you avoid infection and help your skin heal.
Be sure that your doctor knows what you hope to achieve. And make sure that you know what results you can 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.
After dermabrasion, you will need to wear sunscreen every day and avoid sun exposure as much as possible. New skin is more likely to be damaged and change colour from sunlight.
Options for resurfacing
Dermabrasion, chemical peel, and laser resurfacing are all methods used to improve the texture and appearance of the skin. They destroy and remove the upper layers of skin to allow the skin to regrow. But lasers have largely replaced the use of dermabrasion, except to treat small specific areas, such as a scar.
Your doctor will suggest treatment based on your skin type and condition, his or her experience, your preferences, and other things. Some people may get the best results by using more than one technique.
Other Works Consulted
- Tanzi EL, Alster TS (2012). Ablative lasers, chemical peels, and dermabrasion. In LA Goldman et al., eds., Fitzpatrick's Dermatology in General Medicine, 8th ed., vol. 2, pp. 3021-3031. New York: McGraw-Hill.
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