Dermabrasion

Overview

Dermabrasion is a skin-resurfacing procedure that uses a rapidly rotating device to sand the outer layers of skin. After dermabrasion, the skin that grows back is usually smoother and younger looking.

Dermabrasion can decrease the appearance of fine facial lines and improve the look of scars, such as those caused by acne. Dermabrasion can be done alone or in combination with other cosmetic procedures.

During dermabrasion, doctors will numb your skin with anesthetics. You might also have the option of taking a sedative or receiving general anesthesia, depending on the extent of your treatment.

Skin treated with dermabrasion will be sensitive and bright pink for several weeks. The pinkness will take about three months to fade.

Why it’s done

Dermabrasion can be used to treat or remove:

• Scars caused by acne, surgery or injuries
• Fine wrinkles, especially those around the mouth
• Sun-damaged skin, including age spots
• Tattoos
• Uneven skin tone
• Swelling and redness of the nose (rhinophyma)
• Potentially precancerous skin patches (actinic keratoses)

Risks

Dermabrasion can cause side effects, including:

• Redness and swelling. After dermabrasion, treated skin will be red and swollen. Swelling will begin to decrease within a few days to one week, but might last for weeks or even months.

  Your new skin will be sensitive and bright pink for several weeks. The pinkness will likely take about three months to fade.

• Acne. You might notice tiny white bumps (milia) on treated skin. These bumps usually disappear on their own or with the use of soap or an abrasive pad.
• Enlarged pores. Dermabrasion might cause your pores to grow larger. Typically, pores shrink to near-normal size after any swelling decreases.
• Changes in skin color. Dermabrasion often causes treated skin to temporarily become darker than normal (hyperpigmentation), lighter than normal (hypopigmentation) or blotchy. These problems are more common in people who have darker skin and can sometimes be permanent.
• Infection. Rarely, dermabrasion can lead to a bacterial, fungal or viral infection, such as a flare-up of the herpes virus — the virus that causes cold sores.
• Scarring. Rarely, dermabrasion that’s done too deeply can cause scarring. Steroid medications can be used to soften the appearance of these scars.
• Other skin reactions. If you often develop allergic skin rashes or other skin reactions, dermabrasion might cause your skin to flare up.

Dermabrasion isn’t for everyone. Your doctor might caution against dermabrasion if you:

• Have taken the oral acne medication isotretinoin (Amnesteem, Claravis, others) during the past year
• Have a personal or family history of ridged areas caused by an overgrowth of scar tissue (keloids)
• Have acne or other pus-filled skin condition
• Have recurrent herpes simplex infections
• Have burn scars or skin that’s been damaged by radiation treatments

How you prepare

Before you have dermabrasion, your doctor will likely:

• Review your medical history. Be prepared to answer questions about current and past medical conditions and any medications you’re taking or have taken recently, as well as any cosmetic procedures you’ve had in the past.
• Do a physical exam. Your doctor will inspect your skin and the area to be treated. This will help him or her determine what changes can be made and how your physical features — for example, the tone and thickness of your skin — might affect your results.
• Discuss your expectations. Talk with your doctor about your motivations and expectations, as well as the potential risks. Make sure you understand how long it’ll take to heal and what your results might be.

Before dermabrasion, you might also need to:

• Stop using certain medications. Before having dermabrasion, your doctor might recommend stopping blood thinners and any medications that cause skin to become darker than normal (hyperpigmentation).
• Stop smoking. If you smoke, your doctor might ask you to stop smoking for a week or two before and after dermabrasion. Smoking decreases blood flow in the skin and can slow the healing process.
• Take an antiviral medication. Your doctor will likely prescribe an antiviral medication before and after treatment to help prevent a viral infection.
• Take an oral antibiotic. If you have acne, your doctor might recommend taking an oral antibiotic around the time of the procedure to help prevent a bacterial infection.
• Have botulinum toxin (Botox) injections. These are usually given at least three days before the procedure, and help most people achieve better results.
• Use a retinoid cream. Your doctor might recommend using a retinoid cream such as tretinoin (Renova, Retin-A) for a few weeks before treatment to promote healing.
• Avoid unprotected sun exposure. Too much sun exposure before the procedure can cause permanent irregular pigmentation in treated areas. Discuss sun protection and acceptable sun exposure with your doctor.
• Arrange for a ride home. If you’re sedated or receive a general anesthetic during dermabrasion, you’ll need help getting home after the procedure.

What you can expect

Dermabrasion is typically done in an office-based procedure room or outpatient surgical facility. However, if you’re having extensive work done, dermabrasion might be done in a hospital.

Before the procedure, a member of your health care team will clean your face, cover your eyes and mark the area to be treated. A topical anesthetic might be rubbed on your skin to decrease sensation. Then your skin will be numbed with local anesthetics.

You might have the option of taking a sedative or receiving general anesthesia, depending on the extent of your treatment.

During the procedure

During dermabrasion, a member of your health care team will hold your skin taut. Your doctor will move the dermabrader — a small motorized device with an abrasive wheel or brush for a tip — across your skin with constant, gentle pressure. He or she will carefully remove the outer layers of skin to reveal new, smoother skin.

Dermabrasion can take a few minutes to more than an hour, depending on how much skin is being treated. If you have deep scarring or you’re having a large amount of skin treated, you might have dermabrasion done more than once or in stages.

After the procedure

After dermabrasion, treated skin will be covered with a moist, nonstick dressing. You’ll likely need to schedule a checkup soon after treatment so that your doctor can examine your skin and change your dressing.

At home, change your dressing as directed by your doctor. Your doctor will also let you know when you can begin regularly cleaning the treated area and applying protective ointments. Your self-care instructions will vary depending on the extent of your procedure.

While you’re healing:

• Treated skin will be red and swollen
• You’ll likely feel some burning, tingling or aching
• A scab or crust will form over treated skin as it begins to heal
• The growth of new skin might be itchy

To relieve pain after the procedure, your doctor might prescribe pain medication or recommend over-the-counter pain relief, such as aspirin, ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others). Your doctor will recommend an over-the-counter medication that is best for you.

You might prefer to remain at home while you’re healing from dermabrasion, though you can usually return to work after two weeks. Keep treated areas away from chlorinated swimming pool water for at least four weeks. Your doctor might recommend avoiding active sports — especially those involving a ball — for four to six weeks.

Once new skin completely covers the treated area, you can use cosmetics to conceal any redness.

If your treated skin appears to be getting worse — becomes increasingly red, raised and itchy after it has started to heal — contact your doctor. These might be signs of scarring.

Results

After dermabrasion, your new skin will be sensitive and red. Swelling will begin to decrease within a few days to a week, but can last for weeks or even months. The pinkness of your skin will likely take about three months to fade.

Once the treated area begins to heal, you’ll notice that your skin looks smoother. Protect your skin from the sun for at least six to 12 months to prevent permanent changes in skin color.

If dark skin coloring is a concern after healing is complete, your doctor might prescribe hydroquinone — a bleaching agent — to help even out your skin tone.

Keep in mind that dermabrasion results might not be permanent. As you age, you’ll continue to acquire lines by squinting and smiling. New sun damage also can reverse your results.