Dermabrasion: The Facts

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Dermabrasion, or skin sanding, uses one of several devices to remove the surface layer of your skin to remove wrinkles, correct scarring, either from acne or surgery, or to remove actinic keratoses – growths that result when fair-skinned people get too much sun in their younger years.

Dermabrasion These keratoses are usually reddish and have a white scale on top and need to be removed before they become cancerous. They are generally rough to the touch, and may feel sore when you rub them, or when they come in contact with clothing. Seborrheic keratoses, on the other hand, are commonly non-cancerous but can be quite disfiguring as age brings on more and more of these dark brown spots.

Dermabrasion involves the use of diamond fraises, ultra-fine wire brushes or serrated wheels. The fraises look remarkably like buffing attachments for the Dremel rotary tool, and contain miniscule chips of diamond. The wire brushes and serrated tools are also micro-fine versions of similar tools used with a Dremel or sander, to sand, buff or clean wood, and the hand tool into which dermabrasion heads are inserted achieve speeds similar to a Dremel - that is, about 18,000 to 35,000 revolutions per minute.

At that speed, it’s possible to remove too much surface skin and create additional scarring, so it is important to choose a doctor or technician with a lot of experience using the tool. In addition, those with very fine, or thin, skin should consider laser procedures instead, as these have potentially less risk for scarring.

If you choose dermabrasion to remove just a few wrinkles or a small scar you will be awake but under a local anesthesia. If the procedure is more extensive, your doctor may choose either sedation to calm you or general anesthesia, which will keep you from experiencing pain or anxiety. With modern anesthesia techniques, the risks are minimal but they still exist, so make sure you are comfortable with being put under.

The length of the procedure varies depending on the extent of wrinkling or scarring. A simple scar will take less than an hour, including surgical prep time. More complex procedures can take several hours. If there is a great deal of scarring, or many keratoses, your surgeon may choose to treat you in several sessions.

Once the dermabrasion is complete, petroleum jelly or antibiotic ointments will be smeared over the sanded surface to reduce scab formation and scarring. Your doctor may also give you pain medication, and will likely give you antibiotics. Take the first as needed and the second as directed; infections can cause horrendous scarring.

After surgery, your skin will be quite red, hot and swollen. The swelling can last up to three weeks, and may make it painful to talk or eat, depending on how much of your face has been treated. Plan ahead by buying straws, liquid food supplements like Ensure, and advising your family and friends that talking, smiling and laughing will hurt you physically and may stretch skin beyond its capacity to heal.

After the burning comes itching, as the skin starts to heal. This can be very intense and uncomfortable, but resist putting ointments on your face unless your doctor approves them. You may also use hypoallergenic foundation to hide the redness, but again only with a doctor’s approval. Dermabrasion can also cause enlarged pores, or whiteheads, as oil is trapped beneath the healing skin, and any kind of substance applied to the skin will exacerbate them, but they will go away in time.

You will need to avoid strong sunlight for up to 12 months, until you skin tone returns to normal. You should definitely avoid the chlorinated water of swimming pools, and extremely hot water for bathing or showering, for at least a month, and alcoholic drinks will make your skin flush even darker in the initial days after a procedure.

Unlike microdermabrasion, which peels a maximum of 15 microns from the skin’s surface, dermabrasion goes quite deeply into the skin. This makes it both more effective in removing scars but more invasive, and the dangers of scarring or hyperpigmentation (dark or light spots or areas) are greater.

Dermabrasion is not an instant fix; that is, each treatment improves skin by up to 50 percent, but no more, and additional treatments may be needed after a year. Dermabrasion also can’t be used on the throat area.

I had a friend who had dermabrasion for acne scarring, and she was less than pleased with the results. Of course, this may have been due to her skin type, the skill of the operator or the fact that dermabrasion techniques were more primitive ten years ago. I personally think that laser resurfacing is a kinder and more effective method than dermabrasion for removing scars and keratoses, but consult your doctor to make a final decision.