What Is Dermabrasion?
Dermabrasion is a surgical procedure where damaged skin is removed by a medical professional using a handheld instrument rotating at a high speed. Tiny abrasions, or cuts, are made in the skin that trigger a wound-healing response, resulting in new collagen and elastic fibers, gradually improving the texture of the skin.
What Is Dermabrasion Used For?
Dermabrasion can be used to treat a variety of skin conditions including:
- Rhinophyma (bulky nodules from chronic inflammation that distort the shape of the nose in some people with rosacea).
- Acne scars.
- Scars resulting from surgery or trauma.
- Severely sun-damaged skin.
- Deep wrinkles.
- Noncancerous skin growths.
- Melasma.
Who Should Avoid Dermabrasion?
You should not have dermabrasion if you have:
- Used isotretinoin within the previous 6-12 months because this has been reported to increase the risk of scarring.
- An active skin infection.
- Skin conditions where lesions can be triggered at sites of trauma (eg, psoriasis, lichen planus), in which case a test spot is advised prior to proceeding with full dermabrasion.
- Immunosuppression or a bleeding disorder that may delay wound healing.
- A history of keloid formation after trauma or procedures.
- A history of radiation therapy in the treatment area.
What Do I Need to Do to Prepare for Dermabrasion?
To prepare for dermabrasion:
- You may need to undergo basic laboratory testing, including a hepatitis panel and screening for HIV infection.
- Daily application of tretinoin 0.05% cream for 2-3 weeks prior to dermabrasion to help accelerate skin resurfacing.
- You may receive antiviral prophylaxis starting one day prior and continued 1 week after the procedure to help prevent viral infection (such as reactivating a herpesvirus infection [eg, cold sores]).
- Patients may also be given a strong oral anti-inflammatory medication known as prednisone to help decrease the swelling and inflammation seen after dermabrasion.
Because bruising after treatment is common, you may be advised to stop any nonessential medications or dietary supplements up to 2 weeks prior to the procedure, such as:
- Aspirin.
- Nonsteroidal anti-inflammatory medications (eg, ibuprofen or naproxen).
- Vitamin E.
- Fish oil supplements.
- Other blood thinning agents (eg, warfarin or heparin).
However, you should first check with your medical professional before stopping any medication.
What Should I Expect During the Dermabrasion Treatment?
First, the skin is cleansed. Then, the medical professional will inject local anesthetic into the skin or the nerves supplying the skin to numb the area. Full-face dermabrasion may require sedation prior to the procedure to make you more comfortable and less anxious.
The medical professional will then use a rotating instrument, likened to a small power sander, to remove layers of skin.
What Can I Expect Following Dermabrasion Treatment?
Immediately following dermabrasion, there may be minor pinpoint bleeding and stinging. Swelling and redness will be prominent the few hours and days after the procedure, which will gradually improve with the use of oral anti-inflammatory medications. A dressing is placed over the treated area for the first 48-72 hours.
You should plan to take 1-2 weeks off from work while you initially heal. In approximately 2-3 months, the skin color will appear normal again, but the greatest improvement in texture will be noticed 6 months later.
Following dermabrasion, you can expect a significant improvement to the appearance of the skin, but the skin will not be completely smooth.
What Follow-up Care Measures Should I Take after Dermabrasion?
Your medical professional will determine follow-up care specific to your case, but generally, you will return for dressing changes daily for the first 3-4 days, and then you will need to be seen by your medical professional weekly for 1 month, then at 3 months, and again at 6 months for final evaluation.
At home, you should cleanse the area daily with gentle soap and water followed by application of petroleum jelly (eg, Vaseline) to protect the skin. If you were using a retinoid cream, you can typically restart that 1-2 weeks following dermabrasion.
Be sure to wear sunscreen protection daily, especially in the first 3-6 months following dermabrasion. It is important to wear sun-protective clothing and a board-spectrum sunblock (one that protects against UVA and UVB rays) of SPF 30 or higher.
What Are the Risks and Potential Side Effects Associated with Dermabrasion?
Side effects of dermabrasion include:
- Redness and swelling that may last up to a month. Strong anti-inflammatory medications (eg, prednisone by mouth) can be prescribed to treat these effects.
- Skin discoloration, either lightening or darkening from surrounding skin colors.
- Small superficial cysts, known as milia, can occur a few weeks after the procedure.
- If dermabrasion penetrates to a level deeper than the dermis, there is risk of scar formation.
What Else Should I know about Dermabrasion?
Be sure to return to your medical professional for all follow-up visits to monitor your healing following dermabrasion.
Your skin will likely first appear worse before it starts to heal and improve. However, if your skin becomes increasingly irritated after it starts to heal or there are signs of infection (such as pain, spreading redness, or fever), contact your medical professional.