Dermabrasion

Dermabrasion is a skin resurfacing treatment that uses a device to sand away the top layers of skin.

The best candidates for dermabrasion are men and women who have wrinkling around the chin, mouth or cheeks. Patients who have noticeable or irregular scarring after trauma or surgery are also often good candidates for the procedure.

Since dermabrasion and other skin resurfacing treatments (such as chemical peels) often reduce the pigmentation of the skin, they are usually best suited for patients who have a light complexion. Any pigmentation changes are difficult to notice in a patient who has fair skin to begin with.

Patients with darker skin can still benefit from dermabrasion. However, the surgeon will need to take more precautions to avoid unwanted changes in the skin’s color.

Where a surgeon performs dermabrasion depends on the areas being treated. Small scars or small areas of skin can be treated in an office. Dermabrasion is often performed in operating rooms if the treatment area is large, such as most of the face.

Your surgeon will use a local anesthetic to treat a small area. When dermabrasion is performed in a surgical center or when a larger area is treated, the surgeon will usually use a local anesthesia and a sedative.

At the start of the dermabrasion procedure, the surgeon will mark the treatment area with a special purple marker. The patient is then given the local anesthesia and the sedative if it is being used.

Next, the surgeon will paint the treatment area with a surgical solution, which is purple. The solution accomplishes two things. It is antimicrobial or anti-infective agent. It also clearly marks the area that is going to be treated. The purple dye acts as a guide while the surgeon works. As the treatment goes deeper, more surface area and more dye is removed, allowing the surgeon to see how far they have gone and what remains to be treated. At the end of treatment, an absorbent bandage is placed over the treated skin.

How long the procedure takes depends on the size of the area. Dermabrasion can take anywhere from five minutes to about an hour.

Although dermabrasion is a type of surgery, it does not require any incisions.

When performed by an experienced facial plastic surgeon, dermabrasion should not cause visible or unwanted scarring.

It’s common to feel some stinging after dermabrasion, but pain and discomfort are usually minimal.

It’s common for fluid to seep out of the wound for several days after the surgery. Special cleansers and moisturizers should be applied to the skin to improve comfort and to keep the skin from drying out. Your surgeon will recommend that you clean the skin several times each day and apply the ointment after cleansing. You can cover smaller areas with a bandage.

Many people return to work within two weeks after dermabrasion. As the skin heals, it may be red and unpleasant to look at, which is why most people choose to avoid social and work situations for at least a week. If a small area has been treated, many patients return to work in 1-2 days with a bandage over the treated area.

It’s usually OK to start walking and other light physical activity the day after dermabrasion. Light activity helps minimize swelling.

You’ll want to avoid a more strenuous workout or exercise routine for about two weeks after your treatment. Your surgeon will let you know when it is OK to take up more vigorous exercise once again.

If you will be spending any amount of time outdoors after dermabrasion, be sure to wear a sunscreen with a high SPF. Sun exposure after any type of skin resurfacing procedure can lead to spotting or other changes in skin pigmentation.

Dermabrasion has similar risks as other skin resurfacing procedures, such as laser treatments or chemical peels. Scarring is very uncommon after any type of resurfacing procedure. Additionally, hyper or hypopigmentation is very rare after treatment, occurring less than 4 percent of patients.

The biggest complaint seen at the Hilger Face Center is that patients do not think the dermabrasion was effective enough in removing scars or minimizing wrinkles. Some patients decide to have a second round of treatment, several months after the first, to improve their results. About 15 percent of patients seek out a second procedure.

Dermabrasion isn’t recommended for all areas of the face. For example, the area around the eyes is usually much too delicate to be effectively treated with dermabrasion. Other resurfacing techniques, such as laser resurfacing or chemical peels, are usually recommended for the eye area.

• Some bloody discharge from the treated area is routine after surgery. When you are sent home following surgery, there is an absorbent dressing on the face and it is usually secured with a mesh elastic dressing. Some blood and serous fluid will be noted in the area of dermabrasion and it is most noted within the first 24 to 48 hours.
• Mild pain or a burning sensation is routinely expected after surgery, but most patients require very little pain medication.
• Swelling is also expected during the first 24 to 48 hours and may even cause some swelling of the eyelids if the cheeks or forehead have been treated.
• Redness in the area of surgery will gradually fade over the first weeks or occasionally months after surgery.

The day following surgery any absorbent dressing can be removed and the following cleansing program should begin:

• Using gauze squares or a washcloth, soak the treated areas with a solution of one (1) tablespoon of white vinegar and one (1) cup of cool water. This should be done at least 6 to 8 times per day until the skin is completely healed, usually within 7 to 10 days. Any bluish-gray coating should be gently soaked off. Pat the skin dry and apply a heavy layer of Aquaphor Ointment or A&D Ointment. Dilute the vinegar by half if it is too strong. You should keep the treated areas moist with ointments at ALL TIMES. Do not pick or remove the crusted areas. Do not allow areas to dry out or scab over.
• Sun avoidance is mandatory following dermabrasion surgery. The area of dermabrasion is exquisitely sensitive to the sun for 6 to 12 months following surgery, and sun protection is necessary. After the first two weeks, a sunscreen with a sun protection factor of SPF 15 (or greater) should be applied at least twice a day. This is very important.
• A thin layer of skin will have covered the area of dermabrasion within 9 to 14 days following surgery and once this occurs, the lubricating ointment will no longer be required.
• Oral acne medications can be initiated immediately following surgery, and topical acne preparations can be re-initiated with the approval of your doctor.
• Whiteheads or milium often develop within the first several weeks after surgery. These represent areas where a small oil gland has become plugged. Opening it to the surface with a small sterile needle or gently opening the poor with an abrasive cleanser) such as a Buf-Puf) can be undertaken under the direction of your surgeon.
• Most patients do not return to work for approximately two (2) weeks following the surgery. You will need to discuss the specifics of the time of your return to work with your doctor.