From the beginning of time, people suffering from the disfigurement of facial scarring have searched for ways to improve these imperfections. There are a variety of dermatologic surgical techniques which are safe and effective. Although dermabrasion has been performed in one form or another for many years, refinements in technique, equipment, and pre- and post-operative care have enhanced its popularity.

What is dermabrasion?

Dermabrasion, or surgical skin planing, is a surgical procedure in which the dermatologist removes or “sands” the skin with a rotary abrasive instrument which improves its contour and gives it a smoother appearance.

When is dermabrasion indicated?

When dermabrasion was first developed, it was used predominantly to improve scars resulting from acne, chicken pox, and accidents. Today it is also used to treat other types of skin conditions such as tattoos, age “liver” spots, and changes caused by chronic sun damage such as wrinkling and precancerous degeneration.

What happens prior to surgery?

Before surgery, a medical history is taken and a careful examination is conducted in order to evaluate the condition of the patient’s skin. During the consultation, the dermatologist describes the types of anesthesia to be used, the procedure, and realistic results that can be expected. The doctor also reviews alternative treatments and possible risks and complications are explained. Photographs are frequently taken before and after surgery to help evaluate the amount of improvement. Printed pre-operative and post-operative instructions are often given to the patient. Medication to prevent activation of fever blisters (herpes simplex) may be given.

How is dermabrasion performed?

Dermabrasion can be performed in the dermatologist’s office or in an outpatient surgical facility. Medication to relax the patient may be given prior to surgery. The area is thoroughly cleansed with an antiseptic cleansing agent before application of a spray that freezes and numbs the skin. Alternatively, the skin may be swollen or “tumesced” with an anesthetic solution. A high-speed rotary instrument with an abrasive wheel or brush removes or abrades the upper layers of the skin and improves irregularities in the skin surface. In some cases, abrasive paper may be used and soothing ointments and dressings are then applied.

What happens after the surgery?

For a few days, the skin feels as though it has been severely sunburned. Medications may be prescribed to alleviate any discomfort the patient may have, but most people do not experience severe pain. Special dressings and the application of emollients help speed the skin’s recovery. Healing usually occurs within 10 days. The newly formed skin is pink at first and gradually returns to its normal appearance by eight to twelve weeks. Make-up can be used as a cover-up when the skin is healed, and people can resume their normal activities in seven to ten days. Patients are instructed to use a sunscreen daily and to avoid unnecessary direct and indirect exposure to sunlight for three to six months.

What are the limitations of dermabrasion?

Dermabrasion cannot be expected to eliminate or improve all scars in all patients. Some scars require the use of other procedures to obtain the best results. These include careful surgical removal of the scars followed by small skin grafts or suturing. Dermabrasion is then used to smooth over these fresh scars six to eight weeks later. Other patients may benefit from the use of filling substances in conjunction with dermabrasion. These include injectable collagen or fat which are used to elevate depressed scars. Some patients may benefit from repeat touch-up dermabrasion of areas that have not been sufficiently improved after the initial procedure. For more information visit the American Society for Dermatologic Surgery or the American Academy of Dermatology.