Dermabrasion

Overview

Dermabrasion is a skin-resurfacing procedure that uses a rapidly rotating device to gently abrade the outer layers of skin. The skin that grows back after dermabrasion is typically smoother and more youthful in appearance.

Dermabrasion is effective in reducing the appearance of fine facial lines and improving the look of scars, such as those caused by acne. It can be performed alone or in combination with other cosmetic procedures.

During dermabrasion, your skin will be numbed with local anesthetics. Depending on the extent of treatment, you might also have the option of taking a sedative or receiving general anesthesia.

Skin treated with dermabrasion will be sensitive and appear bright pink for several weeks. The pinkness generally fades within about three months.

Why it’s done

Dermabrasion is used to treat or improve:

Scars caused by acne, surgery, or injuries
Fine wrinkles, especially 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, such as:

Redness and swelling: Treated skin will initially appear red and swollen. Swelling typically diminishes within a few days to a week but may persist for weeks or even months. Skin will be sensitive and bright pink for several weeks, with the pinkness taking about three months to fade.
Acne: Temporary tiny white bumps (milia) may appear on treated skin, usually resolving on their own or with gentle cleansing.
Enlarged pores: Dermabrasion might temporarily enlarge pores, which usually return to near-normal size once swelling subsides.
Changes in skin color: Treated skin may temporarily become darker (hyperpigmentation), lighter (hypopigmentation), or blotchy. These changes are more common in individuals with darker skin tones and can sometimes be permanent.
Infection: Rarely, dermabrasion can lead to bacterial, fungal, or viral infections, including flare-ups of the herpes virus (cold sores).
Scarring: Deep dermabrasion can rarely cause scarring. Steroid medications can help minimize the appearance of scars.
Other skin reactions: Individuals prone to allergic skin rashes or other reactions may experience flare-ups after dermabrasion.
Dermabrasion isn’t suitable for everyone. Your doctor may advise against it if you:

Have taken oral acne medication isotretinoin (Amnesteem, Claravis, others) within the past year
Have a personal or family history of keloids (ridged scar tissue)
Currently have acne or other pus-filled skin conditions
Experience recurrent herpes simplex infections
Have burn scars or skin damaged by radiation therapy

How you prepare

Before undergoing dermabrasion, your doctor will likely:

Review your medical history: Be prepared to discuss current and past medical conditions, medications, and previous cosmetic procedures.
Perform a physical exam: Your doctor will examine your skin and the treatment area to determine the most suitable approach based on your skin’s tone, thickness, and desired outcomes.
Discuss expectations: Talk with your doctor about your goals, motivations, and potential risks. Make sure you understand the expected healing time and potential outcomes.

Additionally, before dermabrasion, you may need to:

Discontinue certain medications: Your doctor may recommend stopping blood thinners and medications that increase skin pigmentation (hyperpigmentation) before treatment.
Quit smoking: If you smoke, your doctor may advise quitting for a week or two before and after dermabrasion to promote better healing.
Take antiviral medication: To prevent viral infections, such as cold sores, your doctor will likely prescribe antiviral medication before and after treatment.
Take oral antibiotics: If you have acne, your doctor may suggest taking antibiotics around the time of the procedure to prevent bacterial infection.
Receive botulinum toxin (Botox) injections: These are typically administered at least three days before dermabrasion to enhance results.
Use a retinoid cream: Your doctor may recommend applying a retinoid cream, such as tretinoin (Renova, Retin-A), for several weeks before treatment to aid in healing.
Avoid sun exposure: Excessive sun exposure before dermabrasion can cause permanent irregular pigmentation in treated areas. Discuss sun protection measures with your doctor.
Arrange transportation: If sedation or general anesthesia is used during dermabrasion, you’ll need assistance getting home afterward.

What to expect

Dermabrasion is usually performed in an office-based procedure room or outpatient surgical facility. However, extensive procedures may be conducted in a hospital setting.

Before the procedure, your face will be cleansed, your eyes protected, and the treatment area marked. Topical anesthetic may be applied to reduce sensation, followed by local anesthetic to numb the skin.

Depending on the extent of treatment, you may receive a sedative or general anesthesia.

During the procedure

During dermabrasion, a healthcare professional will hold your skin taut while your doctor uses a small motorized device with an abrasive wheel or brush to gently remove the outer layers of skin. This reveals smoother, newer skin underneath.

Dermabrasion can take from a few minutes to over an hour, depending on the area being treated. For deep scarring or extensive treatment, dermabrasion may be performed in stages or multiple sessions.

After the procedure

After dermabrasion, the treated skin will be covered with a moist, nonstick dressing. You’ll likely need a follow-up appointment soon after treatment for your doctor to examine your skin and change the dressing.

At home, follow your doctor’s instructions for dressing changes, skin cleansing, and application of protective ointments. Your specific care regimen will depend on the extent of your treatment.

During healing:

Treated skin will be red and swollen.
You may experience burning, tingling, or aching sensations.
A scab or crust will form as the skin heals.
New skin growth may cause itching.
To manage discomfort, your doctor may prescribe pain medication or recommend over-the-counter pain relievers like aspirin, ibuprofen (Advil, Motrin IB), or naproxen sodium (Aleve).

While healing from dermabrasion, you may prefer to stay at home. Typically, you can return to work within two weeks. Avoid chlorinated pool water for at least four weeks, and refrain from active sports, especially those involving a ball, for four to six weeks.

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

If your treated skin appears to worsen—becoming increasingly red, raised, or itchy—after initial healing, contact your doctor. These could be signs of scarring.

Results

After dermabrasion, your new skin will initially be sensitive and red. Swelling will decrease within days to a week but may persist for weeks or months. The pink coloration usually fades within about three months.

As the treated area heals, you’ll notice smoother skin texture. Protect your skin from sun exposure for at least six to 12 months to prevent permanent changes in skin color.

If concerns about darkened skin persist after healing, your doctor may prescribe hydroquinone, a bleaching agent, to help even out skin tone.

Remember, results from dermabrasion may not be permanent. Continued aging, facial movements (such as squinting and smiling), and new sun damage can affect your skin’s appearance over time.