Dermabrasion is a procedure in which damaged skin is removed by a surgeon using a high-speed rotating brush. The brush removes the top layer of skin, and a new layer of skin replaces the old layer during healing. The new skin will have an improved contour and a smoother appearance compared to the old skin.

Dermabrasion has long been used to improve the appearance of scars resulting from acne, chicken pox, accidents and previous surgeries. It also is used to remove tattoos, and to treat age spots, wrinkles and precancerous changes caused by chronic sun damage.

Following dermabrasion, the skin initially feels as though it has been severely sunburned and may appear red, sensitive and swollen. Medications can be prescribed to help alleviate this discomfort. Gradually, the skin takes on a more normal appearance over a period of eight to 12 weeks.

Once the skin is healed, patients will be required to wear sunscreen with a sun protection factor (SPF) of at least 15 daily for between three and six months.

Dermabrasion is a surgical procedure in which damaged skin is removed or “sanded” using a high-speed rotating brush. Also known as skin planing or skin-smoothing surgery, this procedure improves skin contour and gives it a smoother appearance. It is especially effective in treating deep facial scars and defects, including acne and chickenpox scars, removing tattoos, and treating age spots, deep wrinkles and precancerous changes caused by chronic sun damage.

The skin is the largest body organ. It protects the internal organs from exposure to temperature extremes, damage, bacteria and other external forces. Skin is composed of three layers: the epidermis, dermis and subcutaneous tissue. The epidermis contains no blood vessels and depends on the dermis to deliver nutrients and remove wastes.

During dermabrasion, the upper layer (epidermis) of a person’s skin is removed through a method of controlled scraping and a new layer of skin replaces the old layer during healing. Although dermabrasion can improve the appearance of a scar, it cannot eliminate the scar. Scars that are particularly deep or extensive may require multiple dermabrasion treatments.

Dermabrasion may be used in combination with other therapies, such as a facelift or chemical peel. Significant scars may be treated with a combination of dermabrasion, soft tissue fillers, scar revision and laser treatment.

A variation of dermabrasion called dermaplaning can also used to treat deep acne scars. In dermaplaning, a hand-held instrument called a dermatome – which resembles an electric razor and has an oscillating blade that moves back and forth – is used to “skim” off the surface layers of skin that surround craters and other defects.

Dermabrasion is used to improve the appearance of scars resulting from acne, chickenpox and other diseases, accidents and previous surgeries. It is also used to remove tattoos, and to treat age spots, wrinkles and precancerous changes caused by chronic sun damage.

Dermabrasion is most effective when the area to be treated is small and localized. It may not be recommended for people with dark skin due to an increased risk for discoloration and blotchiness.

In recent years, laser resurfacing treatments and a variation of dermabrasion known as microdermabrasion have largely replaced dermabrasion in treating superficial facial lesions and defects. However, dermabrasion remains the best treatment available for treating deeper scars (especially those related to acne) or for patients who do not respond well to other techniques.

Dermabrasion is also used to treat rhinophyma, an advanced case of the skin condition rosacea. This disorder occurs when oil glands enlarge in the face, resulting in a bulbous, red nose and swollen cheeks. Rhinophyma tends to affect men age 40 and older. Dermabrasion can be used to sculpt the nose down to normal size and shape.

Finally, dermabrasion can be used to treat prominent perioral dermatitis, a condition in which deep wrinkles form around the mouth. These wrinkles may result from smoking, heredity, age or sun exposure.

Dermabrasion is not effective in treating certain types of pigmented birthmarks, burns resulting from scars or congenital skin defects. It is also unable to prevent the natural aging process of the skin.

Patients typically consult with a dermatologist or other physician about their skin condition to determine whether dermabrasion is the best treatment for their condition. A medical history will be compiled and the patient’s skin will be evaluated. Patients should alert their physician if they have a history of clotting disorders, bleeding or scarring with keloids (red, raised formation of fibrous scar tissue).

Patients are encouraged to inform the physician of all medications or supplements (e.g., vitamins) being taken. Some ingredients in medications such as aspirin can interfere with the healing process. Therefore certain medications should not be used before or immediately after surgery. Smoking also delays healing by decreasing blood circulation. Patients will be advised to avoid smoking for a specific period of time before the procedure.

If it is determined that dermabrasion is an appropriate therapy for the condition, photographs may be taken to help evaluate the level of improvement after the procedure. Patients prone to herpes simplex virus (cold sores) outbreaks may be asked to take a medication that can prevent the activation of the virus, and therefore lesion breakouts. These antiviral medications are taken before, during and after the procedure.

Dermabrasion is usually performed in a dermatologist's office or an outpatient surgical facility. Just prior to surgery, the patient may receive a relaxation medication. The area to be treated is cleansed with an antiseptic agent and a spray is applied that freezes and numbs the skin. In other cases, the skin instead may be swollen or "tumesced" with an anesthetic solution. If extensive dermabrasion is planned, the patient may be placed under general anesthesia.

During the procedure, the physician will use a high-speed, rotating instrument with an abrasive wheel or brush to remove the upper layers of the skin. In some cases, abrasive paper may also be used.

The surgery itself may take anywhere from a few minutes to an hour or more, depending on the size and location of the skin to be treated. The procedure will continue until the physician reaches the safest level of skin that will make the scar or wrinkle less visible. In some cases, multiple sessions may be necessary to achieve the desired effect on the skin.

Following dermabrasion, the skin often feels as though it has been severely sunburned and may appear red, sensitive and swollen. As the skin heals, a scab will begin to form. Aching, tingling or burning sensations may appear in the treated area, and eating and talking may be difficult. In addition, the new skin will probably itch as the cells grow. Special emollients and dressings may help speed the skin’s recovery.

A physician may prescribe medications to help alleviate any discomfort the patient feels, although significant pain is rare. Antibiotic medications are prescribed in some cases to help ward off potential infections. For most patients, healing is complete within 10 days.

The new skin that emerges as a result of dermabrasion is often pink. Initially, the treated skin may develop whiteheads that eventually disappear, or enlarged pores that usually shrink to normal size over time. Gradually, the skin will take on a more normal appearance over a period of eight to 12 weeks. Once the skin is healed, hypoallergenic makeup may be used to cover up the skin. Most patients can resume normal activities in seven to 10 days.

Patients who have undergone dermabrasion are instructed to use sunscreen with a sun protection factor (SPF) of at least 15 daily for between three and six months. During this time, they are also urged to avoid unnecessary direct and indirect exposure to sunlight.

Physicians may also ask their patients to avoid sports and other activities that may cause a bump to the face for two weeks following the procedure. Intense sports, such as basketball, should be avoided for four to six weeks. Patients should also avoid placing their face in chlorinated water for at least a month.

Male patients may also be advised to delay shaving for a recommended period of time. Following all physician guidelines is essential for proper healing.

For most patients, dermabrasion is a safe and effective procedure. However, some patients may experience complications. Some individuals may develop light or dark areas of skin following treatment, and this may be permanent. In such cases, increased pigmentation can be treated with bleaching creams. Dermabrasion can result in thickened skin in some areas. Cortisone creams and injections can be used to help the skin return to normal. Fever blisters (cold sores) may appear in patients prone to frequent outbreaks of herpes infections. Antiviral medications can often treat this symptom. Patients with facial skin conditions such as acne, rosacea and dermatitis may also experience flare-ups after the procedure.

The risks associated with any surgery (e.g., bleeding, infection) or use of anesthetic (e.g., allergic reaction, breathing difficulties) may occur during dermabrasion.

A physician should be alerted if skin remains red, elevated or itchy even after it has healed. Patients should also alert their physician if the treated area appears to get worse during the healing period. A physician should be contacted if the area becomes increasingly red, raised or itchy after a period of improvement. Such developments may indicate that abnormal scars are beginning to form.

Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions related to dermabrasion:

1. Is dermabrasion a good treatment option for my skin condition?
   
   
2. Are there other treatments I should consider before dermabrasion?
   
   
3. How does the procedure unfold? Will I need to stay in the hospital?
   
   
4. How many sessions will I require?
   
   
5. Will I require anesthesia?
   
   
6. What type of results can I expect?
   
   
7. How long does recovery take? Will I have to miss work?
   
   
8. Will I feel any discomfort during the procedure? What about during recovery?
   
   
9. Will I need to take any precautions during recovery?
   
   
10. What complications may I develop from undergoing dermabrasion?
    
    
11. How soon after the procedure can I begin wearing makeup again?