Dermabrasion is a cosmetic procedure intended to improve the smoothness of the most superficial layers of the skin. It uses a fine wire brush or a diamond fraise (a rough-edged wheel) or burr which rotates rapidly to take off the top skin layers which come into contact with it.
This is, of course, associated with injury to the skin which will therefore take time to heal. The new skin will be of better quality than the injured skin that was removed. The procedure is usually less costly than chemical peeling or laser resurfacing.
The depth of skin that is removed by the procedure depends upon the speed at which the device spins, the coarseness of the abrading surface, the pressure applied on the spinning tool and the duration of application. The fineness and fragility of the skin will also play an important role.
Dermabrasion is most commonly performed on the face but not always confined to this area. It is most useful to remove acne scars, fine wrinkles or lines around the mouth, surgical scars older than about three or four months, and solar elastosis.
Diamond microdermabrasion peeling on the forehead. Image Credit: Serko1982 / Shutterstock
Dermabrasion is performed in an outpatient clinic or the doctor’s office. The area of skin which is to be treated is first cleaned meticulously and the boundaries are marked. The skin is then numbed using a local anesthetic such as lidocaine.
The skin may be hardened temporarily for the tool to have sufficient grip, using a freezing or cryogenic spray, or ice packs placed on it for up to 30 minutes. Sedation or even general anesthesia is indicated if extensive areas are to be treated, or if the patient is very nervous.
Once the skin is prepared and anesthesia has been induced, the rotating burr or fraise is applied to the skin and layers are removed very gently, a few at a time. The bleeding is controlled by gauze application, following which the raw area is immediately covered with ointment or a clean dressing.
The latter step is essential to prevent scab formation which could disfigure the wound, and it also encourages healing without scarring. Small areas are treated one at a time.
Skin healing will always depend on how much of the face was treated. Large areas will take more time, as will skin that has been abraded deeper. Healing with skin regrowth takes about a week to start, and is marked by a pinkish or reddish appearance which fades in about 6-12 weeks. It may be advisable to wear hypoallergenic make up to match skin tones until this time. Sunscreen should be worn for about a year.
Pain fades quickly in most cases, allowing the downtime to be minimized. However, pan relievers may be prescribed if needed. Corticosteroids are often given if there is excessive swelling of the treated site.
Post-operative care is crucial in obtaining a good result. It includes the following and any additional steps advised by the treatment specialist:
- Frequent skin cleaning using warm water, which will remove any scabs, slough, and bacterial film
- Changing the ointment or wound dressing regularly to keep the raw area moist; this will promote proper healing and prevent scabbing
- Keep out of the sun until the peeling stops from the treated area; even after this, the patient should use sunscreen whenever exposed to the sunlight because healing skin is especially susceptible to photodamage
- Keep follow up appointments regularly to let the doctor appraise the rate and quality of healing; this will help to detect infection or scarring early enough to control them