Dermabrasion

Overview

Dermabrasion, sometimes called microdermabrasion, is a skin treatment that uses a fast-spinning device to remove the top layer of skin. When new skin grows back, it usually is smoother.

This treatment can help make fine lines, acne scars, surgery scars, age spots and wrinkles less noticeable. Dermabrasion can be done by itself or with other cosmetic treatments.

Before the procedure, your healthcare professional will numb the skin so you don't feel pain. You also may get medicine to help you relax or even sleep through the treatment, depending on how much skin is being treated.

After the procedure, your skin will be discolored and very sensitive for a few weeks. Your skin usually returns to its typical color in about three months.

Why it's done

Dermabrasion can improve:

• Scars caused by acne, surgery or injuries.
• Fine wrinkles, especially those around the mouth.
• Sun-damaged skin, including age spots.
• Tattoos.
• Swelling and discoloration of the nose, also called rhinophyma.
• Precancerous skin patches.

Risks

Dermabrasion can cause side effects, including:

• Discoloration and swelling. After the procedure, your skin will look swollen and red, purple or brown, depending on your skin color. The swelling usually starts to go down in a few days to a week. But it can last for weeks or even months.

  Your new skin may be sensitive and uneven in color for several weeks. It may take three months for your skin to return to its typical color.

• Acne. Small white bumps, called milia, may appear on the treated skin. These usually go away on their own or with gentle washing.
• Enlarged pores. Your pores may look bigger after dermabrasion.
• Changes in skin color. Your skin may look darker, lighter or blotchy. This happens more often in people with brown or Black skin. It sometimes can be permanent.
• Infection. Rarely, dermabrasion can cause an infection. The procedure also may trigger cold sores if you've had them before.
• Scarring. If the surgeon removes too much skin in the procedure, it can cause scars. Scarring is more common in people with brown or Black skin. Steroid medicine can make these scars softer and less noticeable.
• Other skin reactions. If you often get allergic skin rashes or other skin irritation, dermabrasion could make them worse.

Dermabrasion may not be right for everyone. Your healthcare professional may caution against it if you:

• Have taken the acne medicine isotretinoin (Myorisan, Claravis, others) in the past year.
• Have a personal or family history of thick, raised scars, called keloids.
• Have acne.
• Get serious cold sores or get cold sores often.
• Have burn scars or skin damaged by radiation treatments.

How you prepare

Before you get dermabrasion, your care team likely will:

• Review your medical history. Be ready to answer questions about your health now and in the past. You also will need to tell them what medicines you take or have taken recently and about any cosmetic treatments you've had.
• Examine your skin. Your healthcare professional will look at your skin and the area you want to treat. This helps determine what changes can be made and how your skin type and color may affect the results.
• Ask about your expectations. Share why you want dermabrasion and what results you're hoping for. Ask about the risks, how long it will take your skin to heal and what kind of results you might see.

To prepare for the procedure, you also may need to:

• Stop taking certain medicines. Your healthcare team may ask you to avoid taking aspirin, blood thinners and other medicines.
• Stop smoking. If you smoke, your care team may ask you to quit for 1 to 2 weeks before and after the procedure. Smoking slows healing by cutting blood flow in your skin.
• Take an antiviral medicine. Your healthcare professional likely will prescribe an antiviral medicine to take before and after dermabrasion to prevent an infection caused by a virus.
• Get Botox injections. OnabotulinumtoxinA (Botox) injections are usually given three days before the procedure to improve results.
• Use a retinoid cream. Your healthcare professional may prescribe a cream such as tretinoin (Renova, Retin-A, others) for a few weeks before the procedure to help your skin heal.
• Stay out of the sun. Too much sun before and after the procedure can make your skin color look uneven or blotchy in treated areas. Use a broad-spectrum sunscreen every day to protect your skin.
• Arrange a ride home. If you will get medicine to help you relax or sleep during the procedure, make sure someone can drive you home afterward.

What you can expect

Dermabrasion usually is done in a medical office or an outpatient clinic. If you're having a large area treated, you may stay in the hospital.

On the day of your procedure, wash your face. Do not apply any makeup or facial creams. You'll have a bandage on your face after the procedure. So wear clothes that you don't have to pull over your head.

You will be given a local anesthetic, which numbs the skin. You also may have the option of getting medicine to help you relax. Or you may be given general anesthesia to help you sleep through the procedure. If you have questions, ask your care team.

During the procedure

Your healthcare professional moves a small, motorized device across the skin with steady, gentle pressure. The device has an abrasive wheel or wire brush that scrapes away the top layer of skin.

Dermabrasion can take a few minutes to over an hour, depending on how much skin is treated. If you have deep scars or need a large area of skin treated, you may need more than one session.

After the procedure

Once the dermabrasion is done, your healthcare professional will cover the treated skin with a moist, nonstick bandage. You'll get instructions on how to care for your skin at home. Your healthcare professional may prescribe pain medicine.

You'll likely need to schedule a checkup soon after treatment so your healthcare professional can check your skin.

At home, follow the instructions for changing your bandage. Your care team will tell you when you can start washing the treated area and applying ointments. Your care plan will depend on how much skin was treated.

While you're healing:

• Your skin will be discolored and swollen.
• You may feel burning, tingling or aching.
• A scab or crust will form as your skin heals.
• New skin may feel itchy as it grows.

To ease pain, take prescribed pain medicine or a pain reliever you can buy without a prescription, such as aspirin, ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve). Ask your healthcare professional which choice is best for you.

You may want to stay home while you're healing. Most people can return to work after two weeks. Avoid swimming in chlorinated pools for at least four weeks. Your healthcare professional may recommend avoiding active sports — especially those that may involve contact with the treated skin — for 4 to 6 weeks.

Once new skin covers the treated area, you can use makeup to hide any color changes to the skin.

If you notice your treated skin getting more discolored, swollen, and itchy after it starts healing, contact your healthcare professional. This may be a sign of scarring.

Results

After dermabrasion, your new skin will be sensitive and red, purple or brown, depending on your skin color. Swelling should start to go down within a few days to a week, but it may last for weeks or months. It can take about three months for your skin to return to its usual color.

As your skin heals, you should see smoother skin. Protect your skin from the sun for 6 to 12 months to prevent long-term or permanent skin color changes.

If your skin is blotchy after healing, ask your healthcare professional about hydroquinone, a prescription skin-lightening cream that may help.

Keep in mind that dermabrasion results may not last forever. As you age, you will still get wrinkles from smiling and squinting. Sun exposure also can undo the improvements from dermabrasion.