Dermabrasion - Indications, Procedure, and Side Effects

Introduction:

The word dermabrasion is a blend of two words: “Derma” means “skin,” and “abrasion” means “scraping off the uppermost surface.” Together, dermabrasion means “scraping of the uppermost surface of the skin.”

What Is Skin Made Up Of?

The skin contains two layers: the epidermis, the outermost layer, and the dermis, the inner layer with blood supply and collagen tissues. Dermabrasion targets the collagen tissues of the dermis layer. During this process, the damaged collagen tissues are destroyed, and new collagen is formed, thus improving the tone and texture of the skin.

Who Is Suitable for Dermabrasion?

Two elements are considered to be eligible for dermabrasion:

• Skin type.

• Medical history.

Skin Type: This treatment could generally change the skin tone to a dark tone.

Medical History: Medical conditions like allergies, rashes, skin reactions, and cold sores can result in an outbreak. Inactive acne, bad burns, chemical peels, and dermabrasion can cause infection.

How Is Dermabrasion Done?

Dermabrasion is usually done with a motor-driven device called a dermabrader. Dermabraders are made up of diamond heads that help abrade the skin by rubbing against it. The amount of pressure applied and speed depend on how deep the penetration has to be. If more abrasion is required, high speed and low pressure are applied. Manual dermabrasion is done with clean, sanitized sandpaper to treat localized areas, such as scars.

Technique:

The doctor and assistants wear sterile masks, shields, and gloves to protect against blood and aerosol particles.

Electric Dermabrasion:

• First, the area to be treated is prepared with a cleanser such as povidone-iodine.

• Then, depending on the patient's needs, the tissue to be treated is anesthetized. For confined region dermabrasion, a local anesthesia injection or nerve block is given. Full-face dermabrasion may require intravenous sedation or general anesthesia.

• The area to be treated is marked, and the dermabrader is applied. The surfaces is sectioned and treated one at a time.

• The skin is firm, and the dermabrader is moved across it with uniform gentle pressure.

• Extra attention is given to loose skin areas, like eyelids, lips, and nose.

Manual Dermabrasion:

Manual dermabrasion treats smaller areas and delicate skin and blends the resurfaced skin with adjacent untreated skin.

• The area is cleaned with chlorhexidine or another antiseptic solution and injected with a local anesthetic.

• Sterile sandpaper (or abrasive material) is used in a circular back-and-forth motion with gentle pressure until pinpoint bleeding is seen.

• Topical steroids may be prescribed to decrease inflammation. Following dermabrasion, the surface is wiped off with wet gauze, and an ointment is applied in the office. This procedure has to be repeated daily at home.

Redness, swelling, enlarged pores (usually temporary), and flakes can be seen.

What Is the Preparation for Dermabrasion?

Preparing a patient before and after dermabrasion is more critical. Patients should be screened for the following:

Dermabrasion is an outpatient procedure, and overnight stays may not always be needed.

Self-Care Routine Before the Treatment:

Patients should be screened for the following:

• Use of steroids.

• Blood, immune, or skin disorders.

• Overgrown or elevated scar.

• Use of blood-thinning medication.

• Viral infection.

Self-Care Routine After the Treatment:

• Stay out of the sun.

• Do not smoke.

• Avoid Aspirin and Ibuprofen.

• Avoid swimming.

• Avoid vigorous sports.

• Change the dressing.

• Sun protection agent.

• Skin lightening agent.

• Topical retinoid regimen.

• Go to all follow-up visits.

What Are the Conditions Treated Using Dermabrasion?

Dermabrasion was initially developed to diminish acne scars and pox marks. Over a while, it’s also used to reduce wrinkles and fine lines, remove tattoos, and reverse sun damage. Not all skin types and conditions can improve from dermabrasion, but many can.

Dermabrasion Can Improve:

• Fine lines from sun damage.

• Stretch marks.

• Wrinkles.

• Scars from acne, accidents, or surgery.

• Pox marks and tattoos.

• Age (liver) spots.

• Any dark patches on dark skin tone people.

• Red, thick skin on the nose (rhinophyma).

• Skin growths that are benign (noncancerous).

• Precancerous skin patches.

Dermabrasion Cannot Improve:

• Birthmarks.

• Burns.

• Moles.

Who Cannot Receive Dermabrasion?

Dermabrasion is not advised for patients with the following conditions:

• Active herpes simplex virus (HSV) infection.

• Patients with a history of HSV can be treated under the preventive measure.

• Patients on steroid therapy or have a history of steroid therapy in the last six months (steroids increase the risk of scar formation).

• Those who have active acne.

What Can Be Expected After Dermabrasion?

• The treated skin will be swollen and show redness.

• Itching is present as the new skin grows on the treated area.

• As healing progresses, the treated area shows some tingly, aching sensation.

What Are the Risk Factors of Dermabrasion?

Some medical conditions and medications can make you the wrong candidate for dermabrasion. Dermabrasion may not be a choice if there are:

• Rosacea is a condition of blushing appearance that may cause infection.

• Blood, immune, or skin disorders can slow the healing process.

• A brow lift or facelift procedure has been done recently.

• Dark-skinned people have a high chance of permanent discoloration or scarring.

• Herpes simplex infection slows healing and increases the risk of infection and scar formation by cold sores.

• There is a high chance of scarring when treating keloid (raised scar after injury).

• Acne medications like steroids or blood thinners taken in recent times may increase bleeding risk.

• Cold skin may be sensitive and challenging to handle during the procedure.

Are There Side Effects and Complications With Dermabrasion?

Complications after dermabrasion are rare. If present, the most common complications seen are:

• Infection.

• Swelling.

• Scaring.

• Acne outbreaks.

• Temporary or permanent uneven changes in skin color.

• When exposed to the sun after the procedure, the skin may darken temporarily or permanently.

• Temporary enlargement of pores.

What Are Alternate Options for Dermabrasion?

• Chemical Peels - Chemicals are used to soften the top layers of skin.

• Laser Skin Resurfacing - Laser is used only on fair skin tones.

• Microneedling - A physical device used on all skin types.

• Microdermabrasion - A spray of tiny abrasive crystals used on all skin types. It is more defined than dermabrasion and does not work on deep skin issues. Anesthesia is not required for this procedure, and skin texture improves daily.

Conclusion:

Dermabrasion is a time-tested, cost-effective resurfacing technique for scars, wrinkles, and photodamage. Its understanding is more significant than that of laser resurfacing or chemical peels. In expert hands, dermabrasion can achieve results comparable to laser therapy. However, when performed by an infrequent user of the procedure, the results achieved can be expected to be far less predictable than those of laser therapy.