Surgery Overview
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
leveling (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 color 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.
- Color 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 color and texture of
the skin caused by aging and the sun may continue. Dermabrasion
is not a lasting fix for these problems.
Risks
Common short-term side effects of dermabrasion
include:
- Scarring.
- Redness. This usually
fades in 6 to 12 weeks.
- Swelling.
- Flare-ups of acne
or tiny cysts (milia). These can often be treated successfully with tretinoin.
Antibiotics are sometimes needed.
- Increased color 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 color
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
Expectations
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.
Sun protection
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 color 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.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
References
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.
Credits
ByHealthwise Staff
Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Specialist Medical ReviewerKeith A. Denkler, MD - Plastic Surgery
Current as ofOctober 13, 2016