Surgery Overview
Dermabrasion is a technique that 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 rotates rapidly, 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 that was removed during dermabrasion.
Things that affect the depth of the resurfacing include how coarse the
burr or brush is, how quickly it rotates, how much pressure is applied and for
how long, and the condition and features of your skin.
The face is
the most common site for treatment, but other areas of the skin can be treated this way. Dermabrasion is used most often to improve the appearance of
acne scars and fine lines around the mouth. It also
may be used to treat an enlarged nose (rhinophyma)
caused by
rosacea, an inflammatory skin condition.
How it is done
The areas to be treated are cleaned
and marked. A local anesthetic (such as lidocaine) is usually used to numb the
skin before treatment, and ice packs are applied to the skin for up to 30
minutes. A freezing (cryogenic) spray may sometimes be used to harden the skin
for deeper abrasions if the anesthetic and ice packs do not 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
and then the rotating burr or brush is used to take off the top layers of skin.
Gauze is used to stop any bleeding, and 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
Your recovery and healing time after
dermabrasion depends on the size and depth of the area that was treated.
Someone who has a full-face dermabrasion, for example, will have a longer
recovery time than someone who has just a small area of skin treated. Deeper
abrasions take longer to heal.
In general, regrowth of skin occurs
in 5 to 8 days. This new skin is a pink or red color, which usually fades
in 6 to 12 weeks. Until then, your normal skin tones can be achieved using
makeup.
Many people have little or no pain and can get back to
their regular activities soon after the procedure. Some people need pain
relievers. If swelling occurs, a corticosteroid such as prednisone may be used
to reduce the swelling.
Proper care of the treated area while the
skin is healing is extremely important. This involves:
- Cleansing the skin several times a day to avoid
infection and to get rid of the crusting that sometimes
occurs.
- Changing the ointment or dressing on the wound to keep
the area moist and to promote healing.
- Avoiding sun exposure and,
after peeling has stopped, using sunscreen every day. New skin is more
susceptible to sun damage.
You may be given an antiviral drug called acyclovir to
prevent infection if you have a history of infection with the herpes simplex
virus.
Several follow-up visits to your doctor may be needed to
monitor the skin's healing and regrowth and to identify and treat early signs
of infection or other complications.
Why It Is Done
Dermabrasion is used to treat damage
and defects in the upper layers of the skin, such as:1
- Acne scars. Removing and improving the
appearance of acne scars are the most common uses for
dermabrasion.
- Scars caused by surgery or trauma, if they are not
deep.
- Superficial skin growths, such as
rhinophyma. In rare cases, dermabrasion may be
used to treat small
cysts, epidermal nevi, some
basal cell skin cancers, or
Bowen's disease.
- Tattoos (rarely). There
are better ways to remove tattoos (such as with laser
resurfacing).
- Color changes in the skin (solar lentigines or
melasma). Chemical peels or laser resurfacing are used more commonly than
dermabrasion for these problems.
- Fine lines and wrinkles around the
mouth.
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, although 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 (if freezing spray needs to
be used).
- Have a skin, blood flow, or immune disorder that could
make healing more difficult.
How Well It Works
Your skin type, the condition of the
skin, your doctor's level of experience, the type of brush or burr used, and
your lifestyle following the procedure 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 sun exposure
after the procedure tend to have better results than those with darker skin and
those who continue to spend lots of time in the sun.
In general,
dermabrasion results in a smooth, even skin texture and gives scarred skin a
more uniform appearance.
- Dermabrasion is effective in improving
superficial or nearly flat acne scars. Deeper, pitted acne scars may require
another form of treatment (such as punch grafting, elevation, or excision) in
addition to or instead of dermabrasion.
- Scars from surgery or
injury may be improved when dermabrasion is done 8 to 12 weeks after the
surgery or injury (although most new scars will heal and fade somewhat on their
own for the first 6 months or so).
- Some superficial growths on the
skin can be completely 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), which can enhance the bleaching
agent's effects.
- Dermabrasion does not have a dramatic 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 sun exposure may continue to develop. Dermabrasion
is not a lasting fix for these problems.
Risks
Common temporary side effects of dermabrasion
include:
- Scarring.
- Redness. This usually
fades within 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 (hyperpigmentation) than the
surrounding skin several weeks after dermabrasion.
- Increased
sensitivity to sunlight.
Less common complications 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.
- Prolonged 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 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 all methods used to improve
the texture and appearance of the skin by destroying and removing the upper layers of skin to allow for skin regrowth. But lasers have largely replaced the use of dermabrasion, except for the use of dermabrasion to treat small specific areas, such as a scar.
Your doctor will recommend 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 a combination of techniques.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
References
Citations
- Tanzi EL, Alster TS (2008). Skin resurfacing: Ablative
lasers, chemical peels, and dermabrasion. In K Wolff et al., eds.,
Fitzpatrick's Dermatology in General Medicine, 7th ed.,
vol. 2, pp. 2364–2371. New York: McGraw-Hill Medical.
Credits
| By | Healthwise Staff |
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| Primary Medical Reviewer | Anne C. Poinier, MD - Internal Medicine |
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| Specialist Medical Reviewer | Keith A. Denkler, MD - Plastic Surgery |
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| Last Revised | July 31, 2012 |
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