Dermabrasion

Overview

Dermabrasion is a skin-resurfacing procedure that uses a rapidly rotating device to remove the outer layer of skin. The skin that grows back is usually smoother.

Dermabrasion can decrease the appearance of fine facial lines and improve the look of many skin flaws, including acne scars, scars from surgery, age spots and wrinkles. Dermabrasion can be done alone or in combination with other cosmetic procedures.

During dermabrasion, your doctor numbs your skin with anesthetics. You might also have the option of taking a sedative or receiving general anesthesia, depending on the extent of your treatment.

Skin treated with dermabrasion will be sensitive and blotchy for several weeks. It might take about three months for your skin tone to return to normal.

Why it's done

Dermabrasion can be used to treat or remove:

• Scars caused by acne, surgery or injuries
• Fine wrinkles, especially those around the mouth
• Sun-damaged skin, including age spots
• Tattoos
• Swelling and redness of the nose (rhinophyma)
• Potentially precancerous skin patches

Risks

Dermabrasion can cause side effects, including:

• Redness and swelling. After dermabrasion, treated skin will be red and swollen. Swelling will begin to decrease within a few days to one week, but might last for weeks or even months.

  Your new skin will be sensitive and blotchy for several weeks. It might take about three months for your skin tone to return to normal.

• Acne. You might notice tiny white bumps (milia) on treated skin. These bumps usually disappear on their own or with the use of soap or an abrasive pad.
• Enlarged pores. Dermabrasion might cause your pores to grow larger.
• Changes in skin color. Dermabrasion often causes treated skin to temporarily become darker than normal (hyperpigmentation), lighter than normal (hypopigmentation) or blotchy. These problems are more common in people with brown or black skin and can sometimes be permanent.
• Infection. Rarely, dermabrasion can lead to a bacterial, fungal or viral infection, such as a flare-up of the herpes virus, the virus that causes cold sores.
• Scarring. Dermabrasion that's done too deeply can cause scarring. Steroid medications can be used to soften the appearance of these scars.
• Other skin reactions. If you often develop allergic skin rashes or other skin reactions, dermabrasion might cause these reactions to flare up.

Dermabrasion isn't for everyone. Your doctor might caution against dermabrasion if you:

• Have taken the oral acne medication isotretinoin (Myorisan, Claravis, others) during the past year
• Have a personal or family history of ridged areas caused by an overgrowth of scar tissue (keloids)
• Have acne or another pus-filled skin condition
• Have frequent or severe outbreaks of cold sores
• Have burn scars or skin that's been damaged by radiation treatments

How you prepare

Before you have dermabrasion, your doctor will likely:

• Review your medical history. Be prepared to answer questions about current and past medical conditions and any medications you're taking or have taken recently, as well as any cosmetic procedures you've had.
• Do a physical exam. Your doctor will inspect your skin and the area to be treated to determine what changes can be made and how your physical features — for example, the tone and thickness of your skin — might affect your results.
• Discuss your expectations. Talk with your doctor about your motivations, expectations and potential risks. Make sure you understand how long your skin will take to heal and what your results might be.

Before dermabrasion, you might also need to:

• Stop using certain medications. Before having dermabrasion, your doctor might recommend not taking aspirin, blood thinners and certain other medications.
• Stop smoking. If you smoke, your doctor might ask you to stop smoking for a week or two before and after dermabrasion. Smoking decreases blood flow in the skin and can slow the healing process.
• Take an antiviral medication. Your doctor will likely prescribe an antiviral medication before and after treatment to help prevent a viral infection.
• Take an oral antibiotic. If you have acne, your doctor might recommend taking an oral antibiotic around the time of the procedure to help prevent a bacterial infection.
• Have onabotulinumtoxinA (Botox) injections. These are usually given at least three days before the procedure and help most people achieve better results.
• Use a retinoid cream. Your doctor might recommend using a retinoid cream such as tretinoin (Renova, Retin-A, others) for a few weeks before treatment to help with healing.
• Avoid unprotected sun exposure. Too much sun exposure before the procedure can cause permanent irregular pigmentation in treated areas. Discuss sun protection and acceptable sun exposure with your doctor.
• Arrange for a ride home. If you'll be sedated or receive a general anesthetic during the procedure, arrange for a ride home.

What you can expect

Dermabrasion is typically done in an office procedure room or outpatient facility. If you're having extensive work done, you might be admitted to a hospital.

On the day of your procedure, wash your face. Do not apply any makeup or facial creams. Wear clothes that you don't have to pull over your head because you'll have a facial dressing after your procedure.

Your care team will give you anesthesia or sedation to decrease sensation. If you have questions about this, ask a member of your care team.

During the procedure

During the procedure, the doctor moves a small motorized device across the skin with constant, gentle pressure. The device has an abrasive wheel or brush for a tip that removes the outer skin layers.

Dermabrasion can take a few minutes to more than an hour, depending on how much skin is being treated. If you have deep scarring or you're having a large amount of skin treated, you might have dermabrasion done more than once or in stages.

After the procedure

After dermabrasion, treated skin will be covered with a moist, nonstick dressing. You will receive self-care instructions to follow at home and you might be given prescription pain medication.

You'll likely need to schedule a checkup soon after treatment so that your doctor can examine your skin and change your dressing.

At home, change your dressing as directed by your doctor. Your doctor will also let you know when you can begin regularly cleaning the treated area and applying protective ointments. Your self-care instructions will vary depending on the extent of your procedure.

While you're healing:

• Treated skin will be red and swollen
• You'll likely feel some burning, tingling or aching
• A scab or crust will form over treated skin as it begins to heal
• The growth of new skin might be itchy

To relieve pain after the procedure, take prescribed pain medication or an over-the-counter pain reliever, such as aspirin, ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, Anaprox DS, others). Ask your doctor which pain reliever is best for you.

You might prefer to remain at home while you're healing from dermabrasion, though you can usually return to work after two weeks. Keep treated areas away from chlorinated swimming pool water for at least four weeks. Your doctor might recommend avoiding active sports — especially those involving a ball — for four to six weeks.

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

If your treated skin appears to be getting worse — becomes increasingly red, raised and itchy after it has started to heal — contact your doctor. This might be a sign of scarring.

Results

After dermabrasion, your new skin will be sensitive and red. Swelling will begin to decrease within a few days to a week, but can last for weeks or even months. It might take about three months for your skin tone to return to normal.

Once the treated area begins to heal, you'll notice that your skin looks smoother. Protect your skin from the sun for six to 12 months to prevent permanent skin color changes.

If your skin tone is blotchy after healing, ask your doctor about prescription hydroquinone — a bleaching agent — to help even out your skin tone.

Keep in mind that dermabrasion results might not be permanent. As you age, you'll continue to get lines from squinting and smiling. New sun damage also can reverse the results of dermabrasion.