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Family Health

Dermabrasion - Part 1

Dermabrasion is a skin-resurfacing procedure that uses a rapidly rotating device to sand the outer layers of skin. After dermabrasion, the skin that grows back is usually smoother and younger looking.

Dermabrasion can decrease the appearance of fine facial lines and improve the look of scars, such as those caused by acne. Dermabrasion can be done alone or in combination with other cosmetic procedures.

During dermabrasion, your skin will be numbed with anesthetics. You might also have the option of taking a sedative or using general anesthesia, depending on the extent of your treatment.

Skin treated with dermabrasion will be sensitive and bright pink for several weeks. The pinkness will likely take about three months to fade.

Why it's done

Dermabrasion can be used to treat or remove:

  • Scars caused by acne, surgery or injuries
  • Fine wrinkles, especially those around the mouth
  • Sun-damaged skin, including age spots
  • Tattoos
  • Uneven skin tone
  • Swelling and redness of the nose (rhinophyma)
  • Potentially precancerous skin patches (actinic keratoses)

Risks

Dermabrasion can cause various side effects, including:

  • Redness and swelling. After dermabrasion, treated skin will be red and swollen. Swelling will begin to decrease within a few days to one week, but might last for weeks or even months. Your new skin will be sensitive and bright pink for several weeks. The pinkness will likely take about three months to fade.
  • Bleeding. After dermabrasion, treated skin might bleed a little. With proper skin care, bleeding will stop on its own.
  • Acne. You might notice tiny white bumps (milia) on treated skin. These bumps usually disappear on their own or with the use of soap or an abrasive pad.
  • Enlarged pores. Dermabrasion might cause your pores to grow larger. Typically, pores shrink to near normal size after any swelling decreases.
  • Changes in skin color. Dermabrasion often causes treated skin to temporarily become darker than normal (hyperpigmentation), lighter than normal (hypopigmentation) or blotchy. These problems are more common in people who have darker skin and can sometimes be permanent.
  • Infection. Rarely, dermabrasion can lead to a bacterial, fungal or viral infection, such as a flare-up of the herpes virus — the virus that causes cold sores.
  • Scarring. Rarely, dermabrasion that's done too deeply can cause scarring. Steroid medications can be used to soften the appearance of these scars.
  • Other skin reactions. If you often develop allergic skin rashes or other skin reactions, dermabrasion might cause your skin to flare up.

Also, keep in mind that dermabrasion might cause freckles to disappear from treated areas.

Dermabrasion isn't for everyone. Your doctor might caution against dermabrasion if you:

  • Have taken the acne medication isotretinoin (Amnesteem, others) in the past year
  • Have a personal or family history of ridged areas caused by an overgrowth of scar tissue (keloids)
  • Have acne or another pus-containing skin condition (pyoderma)
  • Have recurrent herpes simplex infections
  • Have burn scars or skin that's been damaged by radiation treatments

How you prepare

Before you have dermabrasion, your doctor will likely:

  • Review your medical history. Be prepared to answer questions about current and past medical conditions and any medications you're taking or have taken recently, as well as any cosmetic procedures you've had in the past.
  • Do a physical exam. Your doctor will inspect your skin and the area to be treated. This will help him or her determine what changes can be made and how your physical features — for example, the tone and thickness of your skin — might affect your results.
  • Discuss your expectations. Talk with your doctor about your motivations and expectations, as well as the potential risks. Make sure you understand how long it'll take to heal and what your results might be.

Before dermabrasion, you might also need to:

  • Stop using certain medications. Before having dermabrasion, your doctor might recommend stopping blood thinners and any medications that cause skin to become darker than normal (hyperpigmentation).
  • Stop smoking. If you smoke, your doctor might ask you to stop smoking for a week or two before and after dermabrasion. Smoking decreases blood flow in the skin and can slow the healing process.
  • Take an antiviral medication. Your doctor will likely prescribe an antiviral medication before and after treatment to help prevent a viral infection.
  • Take an oral antibiotic. If you have acne, your doctor might recommend taking an oral antibiotic around the time of the procedure to help prevent a bacterial infection.
  • Use a retinoid cream. Your doctor might recommend using a retinoid cream (tretinoin) for a few weeks before treatment to promote healing.
  • Avoid unprotected sun exposure. Too much sun up to two months before the procedure can cause permanent irregular pigmentation in treated areas. Discuss sun protection and acceptable sun exposure with your doctor.
  • Arrange for a ride home. If you'll be sedated or have general anesthesia during dermabrasion, you'll need help getting home after the procedure.