Dermabrasion is an old procedure used before lasers to treat superficial small acne scars. The top layers of the skin are removed during dermabrasion. When this technique was first introduced, sandpaper was used to remove blemished skin. This resulted in new skin growing to replace old dead skin. These days of course, there are gadgets to perform the procedure. These have a wire brush called a fraise or a burr with diamond particles, attached to rotating wheels, to which a motorized handle is attached.
Procedure and Cost of Dermabrasion
Dermabrasion is done to smooth skin surfaces 6-8 weeks after surgical scar removal has been done. This procedure must be done only by a plastic surgeon or qualified dermatologist. The treatment area is first marked out and cleaned. It will then be anesthetized usually with a numbing spray. A sedative to make the patient drowsy can also be given.
Ice packs can be applied or a freezing spray administered to numb and harden the area. This is required for deeper abrasions or if the whole face has to be treated. The treatment areas are divided and one area at a time is treated.
The burr or brush rotates swiftly on the skin’s surface, abrading and leveling top layers. The treated areas will bleed due to the skin being scraped off. New skin grows to replace the wounded skin. The depth of resurfacing depends on the coarseness of the brush, the speed with which it rotates, the quantum of pressure applied and the time taken during each rotation of the brush. It also depends on how blemished the skin is and other features of the skin like tone and texture. The bleeding is controlled by using gauze. An ointment will be applied and clean dressing used to cover the skin.
Dermabrasion is usually limited to the face to treat acne, rhinophyma caused by acne rosacea, wrinkles, and fine lines. However, if required, it can be done on other parts of the body too.
A crust will form on treated areas and this will dry and fall-off within 2 weeks after treatment. A wind burnt appearance and redness can remain for up to 9 months. If the treated areas are small, the healing is quicker than if the full face is treated. New skin will re-grow within a few days (maximum 8 days).
Dermabrasion costs around $1500 per treatment and for the full face the cost is around $2500-$4500.
Benefits of Dermabrasion
Dermabrasion is very useful for soft, superficial scars. An advantage of dermabrasion is that it usually requires a single sitting, although in some cases, repeated treatment maybe required.
Redness usually disappears within 12 weeks and even before that, normal skin tones can be got by using makeup. Most people suffer very little pain and can return to regular activities immediately after dermabrasion. Sometimes painkillers and a corticosteroid injection for swelling will help manage pain and reduce inflammation. Dermabrasion works very well for those with light skin who can limit exposure to sun. A successful procedure can turn out smooth textured, even skin tone. Using dermabrasion with tretinoin and a bleaching agent can improve the color of skin.
Qualified plastic surgeons recommend dermabrasion as a first-rate resurfacing treatment for acne scars. It must be part of a set of various treatments like laser resurfacing, chemical peels or acne surgery to be truly effective. It can help treat wide and mildly depresses facial scars. It is very important to choose a board-certified plastic surgeon to perform the procedure.
Limitations of Dermabrasion
Some side effects of dermabrasion:
- Swelling and redness of the treated skin will remain from a few days to a few months. The skin will be sensitive and bright pink.
- Bleeding will happen after the procedure. This is stopped with bandages and ointments.
- Acne-type white bumps called milia may appear on the treated areas. These bumps disappear either on their own or by using a coarse pad or soap.
- Enlarged pores will appear after dermabrasion and these shrink when swelling reduces.
- Skin tone can change and become dark (hyperpigmentation),light (hypopigmentation) or blotchy. Dark-skinned people are more susceptible to these changes, which can be permanent in rare cases.
- Infection from fungus, viruses or bacteria is possible if the area is not cleaned and dressed properly.
- Scarring is a rare side effect and this can be reduced by using steroid medications.
- Allergic rashes can develop rarely.
- Other side effects are eczema, pain, dilated blood vessels and lines demarcating treated areas could be prominent.
Hyperpigmentation can be prevented if hydroquinone (4%) is used a month prior to the procedure being performed.
If used on deep ice pick or depressed fibrotic scars, dermabrasion can make the scars more visible. This is because these scars are wider beneath the skin’s surface – which is revealed during dermabrasion. Hence, dermabrasion is limited only to softer, superficial scars. This technique is not so widely used these days after the introduction of easier-to-use and newer methods for scar treatment. The appearance of keloidal scars, hypertrophic scars can worsen and there can be a dramatic change in pigmentation of dark-skinned people after dermabrasion. Another drawback of dermabrasion is that it is as costly as newer techniques like laser resurfacing.
No one can get 100% results and it is suggested that if your skin looks even 50% better than it did before dermabrasion, it is a good result. These are realistic expectations and patients must not look for changes for a few weeks or even months after treatment.
Precautions while Dermabrasion
Be sure to find experienced and qualified dermatologists or plastic surgeons to perform dermabrasion. Make sure after-care treatment is done properly. The treated area will have to be cleansed several times to prevent infection and remove crusts as they form. Vaseline can be applied and dressing changed frequently. Patients must avoid the sun and even after healing must always use a sunscreen before going out. This is because new skin can easily get damaged by the sun. Make sure you keep all doctor’s appointments to monitor the healing of the skin. This also helps doctors check for signs of complications like infections and control it before it spreads.
Dermabrasion cannot be done for those who have been using isotretinoin recently (6-12 months), who have had a recent brow-lift or face lift, have herpes or other skin diseases, are sensitive to cold, or have immune or blood disorders. Your doctor will recommend the best course of action to follow depending on the extent of scarring, skin tone, texture and so on. A combination of techniques often produces the best results.
What users say about Dermabrasion
Based on the comments and reviews of several patients, one limitation is that they felt there was not much improvement in their scars. The downtime and very high cost is also a limiting factor to some of them.
Other users commented that dermabrasion did help their scars and their face is smoother after treatment. The one word of caution they give is that you must seek out an experienced doctor who will recommend the right course of action for your acne scars.