What is dermabrasion?
Dermabrasion is the controlled thinning of the upper layers of the skin. The peaks of surface irregularities are abraded; during healing, the newly formed tissue gives a smoother surface.
The depth of the procedure is decisive. Superficial applications remain at the level of skin resurfacing, while deeper applications are effective in correcting scars, but healing time and risk increase as well.
How it differs from microdermabrasion
Microdermabrasion is a superficial care application that removes only the layer of dead cells; it requires no healing time and its lasting effect on a scar is limited.
Dermabrasion, by contrast, is a medical procedure: it reaches deeper layers, requires a wound healing process and is carried out by a doctor. The two are often confused; the difference in expectations arises from this.
In which situations is it considered?
- Surface irregularities and shallow scars after acne
- Improving the surface match of superficial scars and surgical scars
- Sun-related tissue changes and fine lines
- Lines around the lips
In deep, pitted scars it is not sufficient on its own; it is planned together with methods such as excision and resuturing, fillers or fat transfer.
The procedure
Depending on the extent of the area, the procedure is performed under local anaesthesia, sedation or general anaesthesia.
After the procedure the area behaves like a superficial wound: in the first days there is oozing and crusting, and appropriate dressing and moist wound care are required. Closure of the surface usually takes 7-10 days.
Once it has closed, there is marked pinkness in the area; this redness fades over weeks, and in some cases over months. Until the redness settles, it can be covered with make-up.
Points to observe during the healing period
- Sun protection is mandatory. Newly formed skin is sensitive to the sun; without protection, permanent darkening of the colour may develop. Protection is continued for at least a few months.
- The crusts must not be picked off; interfering early may leave a scar.
- In those with a history of cold sores (herpes), preventive medication is started before the procedure.
Risks
- Colour change. Darkening or lightening may be seen after the procedure; in darker skin types this risk is higher, and the depth of application is limited accordingly.
- Infection and cold sore activation.
- Prolonged redness.
- Formation of a new scar. Particularly with applications that are too deep.
- Small white bumps called milia; these are usually temporary.
Who is it not suitable for?
Active acne infection, active skin disease or infection in the treatment area, recent use of isotretinoin-derived medication, a tendency to keloid and hypertrophic scarring, uncontrolled diabetes and conditions that impair wound healing. Smoking delays healing, so stopping before the procedure is requested.
In darker skin types, the choice of procedure and its depth are assessed separately because of the risk of colour change.
Realistic expectations
Dermabrasion reduces surface irregularity; it does not remove scars entirely. Because the result depends on how the skin heals, it varies from person to person, and in some cases more than one session is needed.
Resolution of the redness is awaited before the result can be assessed; for this reason the final assessment is made months later.
Assessment
In scar treatment, the right method is determined by the type and depth of the scar. On examination it may emerge that some scars will not benefit from dermabrasion and that a different method is more suitable.
You may arrange an appointment for an assessment; information about your skin type and the medications you use is decisive in planning.