Dermabrasion or surgical skin planing removes the epidermis and superficial dermis and helps to "refinish" the skin. Regeneration occurs from remaining structures such as hair follicles, sebaceous glands and sweat glands. The equipment, called a dermabrader, is a rapidly rotating abrasive device which may be gas or electricity driven. It is used to remove or "sand away" the upper layers of the skin so that the new skin that grows over is smoother in appearance. Dermaplaning is a similar technique in which a dermatome (an instrument that works like a electric razor) is used to "skim" off layers of skin. Dermabrasion is especially good for acne scars (but not the deep ice-pick scars which usually require prior punch excision) and wrinkles around the mouth. The benefits lasts 2 - 10 years.

Microdermabrasion is a mild form of dermabrasion which is relatively painfree and can be carried out in the doctor's office without any downtime.

Benefits

• Improve mild to moderate wrinkles, especially those around the mouth
• Improve mild to moderate sun-damage
• Remove actinic or solar keratoses (precancerous growths)
• Improve scars from trauma, surgery, chicken pox or acne vulgaris
• Improve rhinophyma (bulbous enlargement of the nose)

  Anaesthesia
  Depending on the size of the area being treated, general anaesthesia or local anaesthesia (including nerve blocks) with or without intravenous (IV) sedation may be used.

  Procedure
  There is much splattering of blood and tissue during the procedure so protective gowns and goggles must be worn by the patient and the physician and his assistants. The area to be treated is painted with gentian violet. Then 3 x 3 cm square areas of skin are sequentially frozen and abraded to the required depth. An antibiotic ointment or vaseline may be applied or the doctor may apply a dressing for the first 1 - 2 days. You may be admitted to hospital for 1 - 2 days if you are having full-face dermabrasion. Otherwise you will need someone to drive you home and to look after you for the first 1 - 2 days. Dermabrasion takes several minutes to 1 1/2 hours to perform.

   

  Post-operative course and after-care

• There is swelling which may shut the eyes and mouth and oozing of yellowish fluid from under the dressing. Talking and eating may be difficult and you may need to take a liquid diet.
• The swelling may be reduced by sleeping in a sitting or semi-reclining position.
• If a dressing is used, it is normally removed after 1 - 2 days to reveal red, raw skin.
• Care of the wound involves using wet compresses or frequent soaks several times a day followed by application of an antibiotic ointment or vaseline.
• Crusts should be softened and gently (not forcibly) removed, whenever possible. The crusts are usually shed after 7 - 10 days.
• There may be slight itching as the new skin grows which can be relieved with antihistamines or a mild steroid cream from the doctor.
• Sleeping pills and simple painkillers such as aracetemol may be taken, if necessary.
• Normal activity can be resumed after the crusts have shed.
• The skin remains pink for 6 weeks to 6 months and can be camouflaged with make-up.
• Sunscreens should be used when the skin is still red and should be continued indefinitely.

  Complications

• Bacterial infection are rare if the doctors instructions are carried out properly.
• Herpes labialis may recur after dermabrasion. This can be prevented by taking an anti-herpes drug such as acyclovir or famcyclovir 1 day before and continued for a total of 7 - 10 days
• Milia or tiny "whiteheads" may develop. They can be extracted with a number 11 scalpel blade.
• Redness may persist for 6 weeks to 6 months and can be concealed with green cosmetics.
• Enlarged pores may occur temporarily but usually settles when the swelling subsides.
• Hypopigmentation (reduced pigmentation) is usually temporary. Permanent hypopigmentation can occur if dermabrasion is carried out too deep, especially in darker skin types (phototypes IV and above). The lightened skin also loses its ability to tan.
• Blotchy hyperpigmentation (increased pigmentation) may develop especially in phototypes III and IV skins but is usually temporary lasting 3 - 4 weeks. It can be treated with hydroquinone lightening creams and regular application of sunscreens (see melasma).
• Scarring and keloids may rarely develop. The skin should improve day by day but if it becomes red, raised and itchy after it has healed, consult the doctor. It may indicate the development of a keloid. Isotretinoin treatment has also been reported to increase the risk of scarring. This is why doctors wait 12 - 18 months after stopping isotretinoin before performing dermabrasion.