Dermabrasion is a procedure in which the superficial layers of the skin are removed. This uses rough-edged tools like a diamond fraise or burr, or a wire brush, to gently peel off the topmost layers of the epidermis and thus allow new smooth skin to grow back over the deeper layers.
This procedure requires a sufficient degree of skill, as abrasion which is too deep or too extensive may cause long-term scarring and other complications. Also, risk and benefits should be considered individually, as skin types and health history may differ.
Dermabrasion is painful and, therefore, it is performed under local anesthesia. Sedation or even general anesthesia may be necessary if a more complicated surgery is planned, and especially if the patient is nervous or a large area is to be treated.
Diamond microdermabrasion peeling on the forehead. Image Credit: Serko1982 / Shutterstock
Indications, Risk and Side Effects
Dermabrasion is performed in patients with any of the following indications, though the list is not exhaustive:
- Skin growths or tags as a result of aging skin
- Fine wrinkles and lines on the face
- Premalignant tumors
- Acne scars
- Facial scarring following trauma or surgery
- Actinic elastosis and photoaging
Dermabrasion is a surgical procedure and the complications of anesthesia may occur, as in any other patient. These include breathing difficulties and hypersensitivity to medications, bleeding from the surgical site, or infection entering through the abraded skin.
Dermabrasion During Pregnancy
In pregnancy, profound hormonal changes take place which affect the functioning of many body systems. Some of the most important with relation to dermabrasion concern the increased sensitivity of the skin and the presence of fluid retention. These are almost universal phenomena during pregnancy.
Increased sensitivity to trauma has led most dermatologists to avoid performing dermabrasion during gestation. This could potentially result in acne flares, skin irritation with scarring or hyperpigmentation, and a blotchy appearance after healing.
Melasma is a condition occurring during pregnancy in which the pregnant woman develops reddish-brown splotches over certain parts of the body, including the face. It is also called the pregnancy mask. The occurrence of this type of pigmentary condition during the gestational period has led to concerns about increased risks of scarring and hyperpigmentation following the dermabrasion procedure if done at this time.
Furthermore, anesthetic effects may be drastic and catastrophic, even if the risk is low. Since most indications for dermabrasion are purely cosmetic, even if necessary, they are best delayed until the baby is safely delivered and no longer subject to the effects of anesthesia or related adverse effects as detailed above.
Infection of the raw treated area is another potential threat to the intrauterine fetus, though very small if the woman is under regular follow up. However, with increased immune activity during pregnancy, the risk of infection with the need for antibiotic therapy is to be avoided as far as possible during this sensitive time.
With the numerous physiological changes directed towards the preservation and growth of the fetus, wound healing is often delayed. This may result in suboptimal recovery or prolonged healing time after dermabrasion in pregnancy. This is due to longer duration taken for skin cells to mature at this time.
Finally, hypersensitivity to the chemicals used is another factor to be kept in mind. Some of them, such as the alphahydroxy acids, may even be unsuitable for pregnant women.