Reviewed by Steven H. Dayan, MD
While you are probably hearing a lot about high-tech lasers and the latest injectables for facial rejuvenation, dermabrasion still has an important role in banishing fine wrinkles, treating sun damage, acne scars, freckles and vertical wrinkles around your mouth, as well as tattoo removal. Dermabrasion is also known as surgical skin planing.
During dermabrasion, the surgeon sands away the outermost layer of your skin using a rough wire brush or a burr containing diamond particles. The brush is attached to a motorized handle. The scraping continues until the surgeon reaches the safest level that will make the scar or wrinkle less visible. This depth depends on what needs to be corrected. To put this into context, dermabrasion often goes deeper for acne scars than wrinkles.
Dermabrasion does involve significant downtime. The top layer of your skin is removed and you will be left with pink or red skin. The deeper the treatment, the more substantial the downtime. Microdermabrasion is a less-invasive alternative to dermabrasion. It blasts the skin using tiny crystals to exfoliate the skin's outer layer.
Dermabrasion: Is it Right for You?
Not everyone is a candidate for dermabrasion. For example, if you are prone to raised red keloid scars or other forms of excessive scarring, or if you tend to form pale or dark spots after skin injuries (hypopigmentation and hyperpigmentation, respectively), dermabrasion is probably not a good idea.
If you have extremely thin skin, dermabrasion may also not be recommended. Moreover, if you have a history of certain viral diseases such as oral herpes, you may not be a good candidate for dermabrasion. Why? If you have an outbreak during your healing, the infection can spread and result in severe and permanent scarring. Taking an antiviral drug can significantly decrease your chances of this happening.
You should not have dermabrasion on the affected area if you have:
- Undiagnosed skin lesions
- Active acne. If you have taken Accutane (isotretinoin) in the past 12 to 18 months to treat your acne, dermabrasion is ill-advised. Accutane can lead to increased scarring post-dermabrasion.
- Active rosacea (a chronic skin condition marked by inflammation on the cheeks, nose, chin forehead or eyelids)
- Uncontrolled diabetes
- Autoimmune diseases such as lupus
- Pigment disorders
To find out if you are a candidate for dermabrasion, schedule a consultation with a plastic surgeon who has experience performing a range of facial procedures. There are many facial cosmetic surgeons to choose from, and it can be difficult to know whom to trust for compassionate care and effective treatments. To take some of the unknowns out of the process, All About Facial Rejuvenation offers a directory of highly trained and experienced surgeons who have received many positive reviews from their patients.
A consultation appointment is your time to talk about skin treatment options, including dermabrasion. You and your doctor will discuss whether dermabrasion is right for you, how much skin can be safely removed, and the amount of improvement you can expect as a result. Part of this frank conversation should involve potential risks and complications of dermabrasion.
At the consultation, you should tell your doctor everything about your health. Make sure the doctor knows if you smoke and has a complete list of any and all medications or vitamins you take on a regular basis. Don't leave anything out. Smoking impairs wound healing and certain medications can increase risks associated with dermabrasion and impede your recovery.
You will also discuss what type of anesthesia will be used for your procedure. Dermabrasion is usually done under light sleep sedation, regional anesthesia, or sometimes local anesthesia with oral sedation. This decision is based on how large of an area is being treated. Some physicians may use intravenous sedation for larger areas.
Dermabrasion: What to Expect
Dermabrasion normally takes anywhere from 15 minutes to two hours to perform, depending upon the size of the area being treated. Your surgeon will carefully sand or abrade your skin to the depth agreed upon during your consultation. If you have severe acne scarring, dermabrasion may be combined with additional procedures such as injectable fillers, but not at the same time. This will have been decided upon in advance as well.
Your surgeon will cover your face with a thin film of antibiotic ointment or a burn cream after the dermabrasion procedure. Some surgeons may apply a thin layer of synthetic sheeting to protect the newly surfaced tissue as it heals.
Your doctor will tell you how to take proper care of your treatment area, including washing your hands carefully before you touch the treatment areas or change your dressings or bandages. Do not put anything on the treated area without checking with your doctor first. Your surgeon may also tell you to use cold packs, ice packs, gel packs, or vinegar soaks on your face for the first 48 hours after your treatment. Healing time depends upon the depth of your dermabrasion. Several follow-up visits to your doctor may be needed to monitor the process. Taking your pain medication as well as any antibiotic and antiviral drugs on time will help ensure that you have a complication-free recovery.
After your dermabrasion, you will essentially have brand new skin and you must protect it carefully. Use sunscreen with a high sun protection factor (SPF) faithfully! You should not use skin products containing alpha hydroxy acids, vitamin A (Retin A) or exfoliants until you get the OK from your surgeon. Ask your doctor when you can start applying cosmetics again.
Dermabrasion does have its share of risks, including:
- Swelling. Steroids may be necessary to reduce swelling
- Acne flare-ups or tiny cysts (milia)
- Pigment changes
- Sun sensitivity
- Allergic reactions
Choosing a board-certified plastic surgeon or facial plastic surgeon with extensive experience performing dermabrasion will help ensure your safety and satisfaction.
Dermabrasion costs around $100 for a spot treatment and as much as $4,000 for a more in-depth procedure. These prices usually include anesthesia and the surgeon's fee. Prices will also vary significantly in different areas of the country. If the cost is prohibitive, ask your doctor about financing options.
About the Reviewer of this Article
Steven H. Dayan, MD, is a facial plastic surgeon based in Chicago, where he founded and serves as a medical director for a skin care center (True Skin Care), a state-accredited educational center for estheticians. He also is founder and medical director for a DeNova Research. Dr. Dayan is board certified in otolaryngology and a member of the American Academy of Facial Plastic and Reconstructive Surgery. He is also a clinical assistant professor at the University of Illinois, and participates in laboratory and clinical research in minimally invasive medical procedures and plastic surgery. He serves on the editorial board of the Facial Plastic Surgery Journal and has written and published extensively in the field. A graduate of Washington University in St. Louis, Dr. Dayan attended the University of Illinois Medical School. He completed a residency at the University of Illinois and a facial plastic surgery fellowship.
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