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Dermabrasion for Acne Scars, Wrinkles and Age Spots

Dermabrasion is a procedure in which the top layer of damaged skin is removed or “sanded” by a high-speed rotating brush or a diamond wheel. During healing, a new layer of skin replaces the old layer. This improves skin contour and gives it a smoother appearance. Dermabrasion is particularly effective in treating deep facial scars and defects, including chickenpox scars, acne scars, age spots, deep wrinkles and sometimes also color changes in the skin such as melasma or solar lentigines.

Although dermabrasion can improve the appearance of a scar, it cannot eliminate it completely. Deep or extensive scars may require multiple treatments. This procedure can be used in combination with other aesthetic procedures, like a facelift or chemical peel. Large scars may be treated with a combination of dermabrasion, scar revision, wrinkle fillers and laser treatment. Moreover, a variation of dermabrasion, known as dermaplaning, can be used to treat deep acne scars.

What Dermabrasion Can Do

Dermabrasion is most commonly used to improve the appearance of scars caused by acne, chickenpox and other diseases, previous surgeries and accidents. It can also be used to treat wrinkles (including prominent perioral dermatitis, a condition in which deep wrinkles form around the mouth), age spots and sometimes also color changes in the skin caused by chronic sun damage (though there are better ways to do it). This procedure is also one of the options to treat rhinophyma, a bulbous, red nose and swollen cheeks.

Dermabrasion is not suitable for individuals with dark skin due to an increased risk for discoloration and blotchiness and it is not effective for certain types of pigmented birthmarks, scars resulting from burns or congenital skin defects. It is no longer used for treating superficial facial growths and defects or removing tattoos as there are better options available today, such as laser resurfacing treatments or a variation of dermabrasion called microdermabrasion. However, dermabrasion is still the best treatment for deeper scars (particularly those caused by acne), while it is most effective when the treated area is small and localized.

How Dermabrasion Is Done

If, after a thorough medical examination, it was determined that dermabrasion is an appropriate therapy to use, photographs may be taken to help evaluate the improvement after the procedure. Patients prone to outbreaks of cold sores may be asked to take a medication to prevent the activation of the virus.

A spray that freezes and numbs the skin or an anesthetic solution are used as a local anesthesia, while general anesthesia is often required for extensive dermabrasion. The surgeon will use a high-speed, rotating instrument with an abrasive wire brush or a diamond wheel to remove the top layers of the skin. The procedure may take anywhere from a few minutes to an hour or even more, depending on the size and location of the skin to be treated. Sometimes, multiple sessions may be required.

What to Expect after Dermabrasion

The skin may appear red, sensitive and swollen after dermabrasion and feel as if it has been severely sunburned. A scab will begin to form as the skin heals. Aching, burning or tingling sensations in the treated area are common and eating and talking may be initially difficult. Furthermore, as the cells grow, the new skin may itch. Although severe pain is rare, the doctor may prescribe medications to help alleviate any discomfort. In some cases, antibiotics may be prescribed to help fend off potential infections. The new skin is initially often pink and whiteheads or enlarged pores may develop. However, over time whiteheads disappear and enlarged pores shrink to normal size. The new skin will gradually take on a normal appearance over a period of eight to twelve weeks.

Patients who have undergone dermabrasion should avoid unnecessary direct exposure to sunlight and, if possible, always use sunscreen when in direct sun for six months after the procedure. Patients are also advised to avoid strenuous sporting and other activities that may cause a bump to the face for two weeks following the procedure. And finally, male patients may need to delay shaving for a recommended period of time.

Potential Risks of Dermabrasion

Though dermabrasion is for most patients considered to be a safe procedure, some people may experience complications. Some patients may develop thickened skin or light or dark areas of skin following treatment. In such cases, cortisone creams and injections can help the thick skin return to normal, while increased pigmentation can be dealt with bleaching creams. Patients with acne, dermatitis and rosacea may experience flare-ups after the procedure. Other risks include those associated with any surgery such as bleeding, infection (including outbreaks of herpes infection) or allergic reaction to anesthetic that may occur during or after dermabrasion.

Patients should alert their doctor if skin remains red, itchy or elevated even after it has healed or if the treated area gets worse during the healing period. If the area becomes increasingly red, itchy or raised after a period of improvement, abnormal scars may begin to form.

Where to Find More Information:
Amercican Society of Plastic Surgeons
Dermabrasion reviews from Acne.org