If you are exploring ways to rejuvenate your skin, you may have come across dermabrasion—a technique that sands away the outer layers of skin to minimize scars, wrinkles, and pigmentation differences. This guide delves into what dermabrasion entails, who it is best for, and what considerations you should take into account to achieve smoother skin.

Dermabrasion is a mechanical exfoliating technique that removes the outer layers of skin to improve its appearance and treat various skin conditions. This procedure is carried out using a rotating instrument, traditionally a wire brush or diamond fraise mounted on a rotary hand engine. It is a highly controlled surgical scraping technique that, when performed by a skilled dermatologic surgeon, can yield significant cosmetic improvements.

Over the years, this cosmetic procedure has been used to treat:

• deep acne scars
• facial scars
• fine facial wrinkles and fine wrinkles
• sun damage
• other skin irregularities

It’s a powerful tool in the armamentarium of a dermatologic surgeon, and when performed effectively, the results can be transformative, providing a newfound sense of confidence and self-esteem to those who have been dealing with skin issues.

The art of skin resurfacing has a long history, tracing its roots back to ancient times. Early civilizations used various abrasive substances like sandpaper, salt crystals, and alabaster to enhance skin appearance. However, these methods were rudimentary and did not meet today’s standards of safety and effectiveness.

The true birth of dermabrasion as a medical procedure began to take shape in the 20th century. In the 1950s, dermatologists started using motorized devices with rotating wheels or brushes to sand down the skin’s surface to treat acne scars and pox marks, marking the formal introduction of mechanical dermabrasion in clinical settings.

Over the subsequent decades, the equipment and techniques for dermabrasion were refined. Surgeons began using more precise instruments, allowing better control over the depth and extent of skin removal. The transition from coarse abrasives to finer, diamond-encrusted wheels and fraises led to more predictable and aesthetically pleasing results.

Despite this, dermabrasion has some drawbacks:

• It is relatively invasive
• Clinical outcomes are highly operator-dependent
• It requires significant knowledge of the skin and hands-on learning experience
• If done incorrectly, adverse consequences such as scarring, dyspigmentation, and infection are likely complications.

Nevertheless, dermabrasion is a safe procedure when done properly.

Dermabrasion has a wide range of applications, making it a versatile tool for skin enhancement. It is a preferred method for treating deep skin imperfections like acne scars. These are often challenging to address with other cosmetic procedures, but dermabrasion can significantly decrease their appearance.

Additionally, dermabrasion is effective in addressing the following age-related skin concerns:

• Wrinkles
• Age spots
• Sun damage
• Stretch marks
• Dyschromias (conditions that affect the texture and appearance of the skin)

In addition to cosmetic improvements, dermabrasion is also utilized for the removal of precancerous skin patches, known as keratoses. This makes dermabrasion not only a tool for aesthetic enhancement but also a proactive measure in skin health maintenance.

The precision and effectiveness of CROSS make it an attractive option for individuals seeking to diminish these types of acne scars and regain smooth, clear skin.

Before deciding to undergo dermabrasion, it’s important to consider several factors:

• Dermabrasion is an invasive procedure that carries substantial risks of adverse consequences.
• Therefore, a consultation with an experienced dermatologist is crucial.
• The treatment parameters and selection vary depending on your skin type, the area to be treated, and your medical history.

Certain medical conditions can also influence the suitability of dermabrasion. For example, patients with a history of impetigo require additional prophylactic antibiotics, and those with a history of cold sores should notify their physician as the condition can flare up after dermabrasion. Dermabrasion may not be suitable for individuals who have:

• taken isotretinoin for acne in the past year
• a personal history of keloids or burn scars
• active acne
• frequent cold sores
• radiation-damaged skin

When it comes to the suitability of dermabrasion, not all skin types are created equal. Individuals with fair skin can achieve good results with dermabrasion. This treatment is known for its effectiveness in addressing various skin concerns. This is because fair skin tends to heal more evenly, reducing the risk of color changes that can occur after dermabrasion.

On the other hand, individuals with darker skin are more likely to experience undesirable changes and contrasts in skin color post-dermabrasion. Furthermore, individuals with a personal or family history of keloids may not be suitable candidates for dermabrasion. The same applies to people with active acne or pus-filled skin conditions, and those who tend to develop allergic skin rashes or other skin reactions.

Therefore, a thorough evaluation of your skin type and medical history is essential in determining whether dermabrasion is the right choice for you.

Before dermabrasion, patients are advised to:

• Stop taking certain medications, such as aspirin and blood thinners, which may affect the healing process
• Quit smoking for 2 weeks before and after the procedure to improve blood flow and healing
• Take an antiviral medication before and after treatment to prevent viral infections
• Take an oral antibiotic if there is a risk of bacterial infection

Use of a retinoid cream, such as tretinoin, for a few weeks before the procedure may also be suggested to help with healing. Moreover, patients should avoid unprotected sun exposure before the procedure to prevent permanent irregular pigmentation in treated areas. All these preparations are designed to enhance the effectiveness of the procedure and minimize potential complications.

Knowing what to expect can help alleviate any anxiety and prepare you for the journey ahead. Dermabrasion, being an aggressive skin resurfacing procedure, requires anesthesia. The duration of the procedure can range from a few minutes to several hours, depending on the surface area of the treatment site.

Before Your Appointment

Before the dermabrasion procedure, patients should take an antibiotic and stop using all retinols or harsh chemicals three days beforehand. Removal of makeup and shaving (if necessary) a day before the procedure also helps ensure clarity in the treatment areas.

Day of Your Appointment

On the day of your appointment, we will take professional photos to monitor your progress.

Anesthesia plays a crucial role in ensuring your comfort during the dermabrasion procedure. To ensure patient comfort, local anesthesia is administered to numb the treatment area. This could involve infiltrative and/or a large volume of tumescent anesthesia to make the tissue turgid, enhancing the procedure’s safety. Depending on the extent of the treatment, it may also be accompanied by a sedative, receive intravenous sedation, or undergo regional nerve block injections for enhanced comfort during the procedure. The most appropriate anesthesia or sedation method for you will be determined based on individual factors and the specifics of the treatment plan.

It’s important to note that patients who are administered sedation or general anesthesia will need to arrange for a ride home after the procedure, as they will not be able to drive themselves.

Step-by-Step Procedure

Once the anesthesia has taken effect, the dermabrasion procedure begins. The skin is first thoroughly cleansed with an antiseptic cleansing agent to minimize the risk of infection. The area to be abraded is then carefully marked with a surgical marker.

A motorized device equipped with an abrasive wheel is meticulously moved across the skin to uniformly remove the outer layers or manually sculpt away regions of undesirable scar texture. The duration of the procedure can vary significantly, from a few minutes to over an hour, depending on the size of the treated area, with some cases requiring multiple sessions to address deep scars or extensive areas. The surgeon continues the dermabrasion technique until a depth is reached where scars and wrinkles are sufficiently minimized without compromising skin safety.

The procedure concludes with the surgeon applying ointments and sterile dressings to assist with the post-procedure skin recovery process.

Following dermabrasion, keeping the treated area clean and moisturized will be essential to optimal recovery. Vinegar soaks can be used to remove crusting and scabbing in a gentle, sterile manner. This is usually followed by an occlusive ointment or post-procedure cream to maintain a moist healing environment.

Using cool compresses wisely can help manage discomfort and swelling. It is also recommended to:

• Sleep with the head elevated to aid the recovery process
• Maintain a healthy diet
• Avoid smoking and alcohol
• Ensure sufficient physical activity to prevent blood clot formation

These measures are critical during the recovery period.

In the long term, protective cosmetics may be used after the initial crusting has healed. Patience is key during the healing process. It typically takes up to 3 months for the pinkness in the skin to fade post-dermabrasion.

Short-Term Recovery

In the immediate aftermath of the procedure, patients may experience slight swelling and redness, which typically fade within a few hours. As the skin heals, there will be a formation of a scab or crust, and the new skin may feel itchy, with sensitivity and blotchiness lasting several weeks.

Care involves:

• Keeping the treated area protected with a moist dressing
• Cleansing gently and regularly to prevent bleeding
• Performing regular vinegar soaks
• Applying prescribed ointment to maintain the skin moist and support healing

Pain medication may be prescribed for discomfort, but NSAIDs such as Advil are not recommended during the first week, to prevent aggravation of bleeding and bruising.

Sun protection is absolutely essential during the initial healing process, especially for individuals with darker skin tones, as it helps prevent skin discoloration.

Long-Term Recovery

Long-term skin care after dermabrasion includes vigilant sun protection and adherence to any additional skin care instructions to prevent pigmentation irregularities. Using sunscreen is an essential part of the skin care routine after dermabrasion to aid in healing and protect from sun exposure.

After dermabrasion, patients are advised to:

• Avoid chlorinated swimming pools for at least four weeks
• Refrain from active sports, particularly those involving a ball, for four to six weeks
• Resuming exercise routines should include measures to protect the skin from sunlight and avoidance of strenuous activities, bending, or lifting during the initial recovery weeks.

Patients may experience facial flushing when consuming alcohol, and this can persist for 3-4 weeks following the dermabrasion procedure. It’s important to note that it can take 6-12 months for skin pigmentation to completely return after undergoing dermabrasion.

As with any cosmetic procedure, dermabrasion carries certain risks and potential complications. Some of these include:

• Permanent hyperpigmentation (darkening) or hypopigmentation (lightening) of the skin, particularly common in individuals with brown or black skin tones
• Delayed re-epithelialization
• Hypertrophic scarring, which has been reported in patients undergoing dermabrasion during or after isotretinoin therapy

It is important to discuss these risks with your dermatologist before undergoing the procedure.

Some patients with a history of keloids or koebernizing conditions such as psoriasis, lichen planus, or pyoderma gangrenosum may need a test spot of dermabrasion before undergoing the full procedure. Immunosuppressed individuals, patients with viral hepatitis or HIV infections may experience delayed wound healing and an increased risk of postoperative infection. Individuals who experience frequent or severe outbreaks of cold sores or have burn scars or skin damaged by radiation treatments should consider the increased risks of complications from dermabrasion.

Dermabrasion may also cause pores to appear larger, which could be an aesthetic concern for some patients.

Preventing Complications

Preventing complications from dermabrasion involves taking several proactive steps. Consulting with a knowledgeable expert who can thoroughly consider your medical history prior to recommending dermabrasion is the best way to prevent complications. Avoiding the acne medication isotretinoin for at least a year before undergoing dermabrasion can prevent potential complications.

To ensure proper healing and prevent complications after dermabrasion, it is important to follow these guidelines:

1. Protect your skin from direct sun exposure.
2. Use at least SPF 30 sunscreen daily for a minimum of one year post-dermabrasion.
3. Quit smoking to promote healing and avoid poorly healed skin or irregular scarring.
4. Schedule and attend a follow-up appointment for professional examination of the skin and appropriate dressing changes.

Following these guidelines will help prevent pigmentation irregularities, skin injury, and other complications.

Managing Side Effects

After undergoing dermabrasion, patients may experience some side effects that can be effectively managed with the right approach. Slight swelling and redness post-treatment are common, but these typically fade within a few hours. Small white bumps known as milia might appear on treated skin. These usually resolve on their own without intervention, or they can be managed with medical-grade extraction.

While dermabrasion is a powerful tool for skin resurfacing, it’s not the only option available. There are several alternative procedures, each with their own benefits and drawbacks.

Dermabrasion offers the advantage of a shorter recovery period, as well as being a more cost-effective option when compared to other skin resurfacing treatments. This makes it a popular choice for those seeking efficient and affordable skin rejuvenation. The choice between dermabrasion and other skin resurfacing options should be based on individual factors such as skin type, condition, and personal aesthetic goals.

Microdermabrasion

Microdermabrasion is a minimally invasive skin rejuvenation procedure that gently sands the skin, using tools like a specialized instrument with an abrasive surface or a fine stream of abrasive particles. The treatment targets the reduction of sun damage, wrinkles, fine lines, and other skin concerns by stimulating collagen production for improved texture and elasticity.

Unlike dermabrasion, recovery from microdermabrasion typically involves no downtime, allowing most individuals to resume their normal activities immediately. However, to sustain the appearance of the skin, regular microdermabrasion sessions are often recommended, with many patients opting for monthly treatments.

Dermabrasion vs. Dermaplaning

Dermaplaning is another skin resurfacing technique that shares some similarities with dermabrasion. Both procedures involve the surgical removal of skin layers but differ in their specific purposes. Dermaplaning is also aimed at removing vellus hair, or “peach fuzz,” from the skin.

While both procedures use surgical instruments, dermaplaning employs a type of blade that is distinct from those used in dermabrasion. Dermaplaning utilizes a dermatome, similar to an electric razor, to carefully remove the surface layers of skin.

Chemical Dermabrasion: Chemical Peels

Chemical peels, such as CROSS or microneedling with acid, is another alternative to dermabrasion. This procedure, which involves a chemical peel, includes:

1. Cleansing the skin
2. Applying a chemical solution
3. Allowing time for it to work
4. Removing it to reveal new skin beneath.

Chemical peels can treat a variety of skin concerns such as:

• Fine lines
• Wrinkles
• Sun damage
• Enlarged pores
• Acne
• Pigmentation

These peels vary in ingredients and intensity, from light to deep, with deeper peels producing more dramatic results but requiring a longer recovery time.

Laser Dermabrasion: Ablative Laser Resurfacing

Laser resurfacing, uses laser energy to resurface the skin, as opposed to the mechanical resurfacing in traditional skin resurfacing dermabrasion. This technique is effective for treating a variety of skin conditions, including:

• wrinkles
• fine lines
• acne scars
• age spots
• sun damage
• uneven skin tone
• certain types of skin lesions

During the procedure, the laser is passed over the skin, sending short, concentrated pulsating beams of light that selectively vaporize tissue at the target area. The precision of lasers can reduce the risk of certain side effects compared to mechanical methods, but does not allow for the same level of manual control over abrasion depth. Lasers can also be quite expensive, and typically require several sessions for optimal results.