Other associated terms: Dermaplaning, Dermasanding, Microdermabrasion
Overview
Dermabrasion is a non-invasive cosmetic procedure that is used to 
remove an upper layer(s) of skin by sanding. This is used to address issues with sun-damaged skin, dark spots, acne scarring, fine wrinkles and pre-cancerous growths (keratosis). It can also be used to remove tattoos.
However, tattoo removal is not always effective with this procedure as some color from the tattoo may still remain. Depending on the size of the area to be treated and the type of dermabrasion used, there will be a moderate amount of pain and swelling. However, this can be managed by medication and dressings prescribed by your doctor.
Alternatives to dermabrasion that can be considered are chemical peels. However, dermabrasion uses surgical instruments to remove skin layers, while a chemical peel will use varying degrees of caustic solutions.
In some cases, a surgeon will use a combination of procedures to suit the individual needs of the patient. Chemical peels, however, are used more for treating fine wrinkles, while dermabrasion is used for deeper skin imperfections such as acne scars and for darker skin types.
Patient Characteristics:
In general, the best patient candidates for dermabrasion are those who are in good health, both physically and psychologically. They should also have realistic expectations of procedural end results and understand physical limitations associated with procedure recovery. They should present their complete medical history to their doctor to include details regarding acne or other skin issues, radiation treatments or sunburn.
Dermabrasion Procedure:
Dermabrasion and dermaplaning are both performed in a relatively short period of time. The procedures can take anywhere from a few minutes to two hours. This will depend on the size and severity of the area to be treated. The procedure can also be performed in stages or the area may require multiple procedures. This is especially true when the scarring is deeper or the affected area is large in size.
For dermabrasion, the outermost layer of skin is removed, by the surgeon, with a motorized diamond particle burr or a rough wire brush. The surgeon’s skill will determine how much of the surface skin area can be safely removed.
In dermaplaning, a hand-held instrument (dermatome) is used. The dermatome resembles an electric razor with a blade that oscillates back and forth – this effectively “skims off” the surface skin layers surrounding the treated imperfections. This will continue until the surrounding skin is more even with the lower point of the imperfection. The surgeon will, afterwards, treat the skin in any number of ways (including wet or waxy dressings, ointments, a dry treatment, or a combination of these).
Either procedure may be performed under a local anesthesia, which will numb the local area. This can be combined with a sedative to relax you. A numbing spray, such a freon (cold), can be used along with or in place of a local anesthesia. Or, in more severe cases, your surgeon may prefer to use a general anesthesia that will place the patient completely asleep or in a “twilight” sleep.
Other Related Procedures:
Microdermabrasion:
Microdermabrasion is a less time consuming procedure that utilizes an instrument that combines sterile grit that is blasted onto the skin and a vacuum that removes the first surface layer of the skin. Sometimes called a “lunchtime” peel because it can be completed within a half hour and the patient can sooner return to normal activities.
Laser Dermabrasion:
Laser Dermabrasion is performed using two types of lasers (carbon dioxide and YAG). The laser light is used to burn away the surface layer of the skin – which promotes new skin grown in approximately 10 days. This procedure can address fine lines, birth marks moles and acne scars, facial hair and warts.
Dermabrasion Recovery:
During recovery from dermabrasion and dermaplaning, your face will feel irritated and raw (similar to sunburn). Some oozing may be present and this is to be expected. A yellow, clear fluid drains from the sites and is normal and expected. The scabs are usually removed with Moist wet packs can be recommended in order to fight infection which can lead to scarring.
Microdermabrasion recovery requires less time to heal than other types of dermabrasion. The disadvantage is that the end results may be minor and require additional treatments. Since no anesthesia is needed, there will be no anesthetic recovery time.
With laser procedures, the patient can expect complete results in approximately 18 months with initial redness lasting approximately 2 months. As with skin dermabrasion, in general, you will need to follow your doctor’s advice regarding the avoidance of sun exposure. This period of time should last at least 2 months. There may be some crusting and ooze formation which may necessitate some time off from work. However, there shouldn’t be any bleeding and the surrounding skin area should suffer little trauma.
Risks Associated With Dermabrasion:
As with all surgical procedures, there are inherent risks involved. The most common complications of the procedure are the formations of keloids (a type of scar that results from excessive collagen production). This type of scarring tends to be associated with dark skin types - so patients with darker toned skin should approach the dermabrasion procedure with caution.
Other potential complications can include; abnormal coloration of the treated skin, persistent redness/swelling of the skin, and a localized enlargement of small groups of blood vessels (telangiectasia). Finally, the formation of bumps can present, due to the obstruction of the sweat glands - although this can be treated, after healing, with retinoic acid.
Dermabrasion depends highly on aftercare. After surgery, the treated area is then dressed for quicker healing. An example could be a dressing as Vigilon (by Bard) is considered to be very efficient. Dressings should be changed every day for the first several days, after that the wound should be allowed to be healed in the open air. This technique will increase healing time up to five-seven days.
During the recovery period, the patient will be prescribed medication by their doctors, for example; pain medication and antibiotics. During the healing process the patients should either completely avoid sun exposure or diligently use a sun block, if sun exposure cannot be avoided.
There are some rules that are common to most skin repair procedures that should be followed by patients in order to speed up healing. These include:
Shaving of the treated areas is not allowed until cleared by the surgeon. The patient is advised to avoid smoking, alcohol use and non-prescribed painkillers. These things tend to reduce the healing capacity of the organism. Also, swimming and sports that require extreme physical activities should also be avoided.
If the patient should notice some unusual things on their skin (irregular scabs or yellow crusting), they should consult their doctor or the on-call medical team as soon as possible. It’s natural that every patient has their own issues concerning the healing process. However, proper aftercare and following your doctor’s recommendations can address most of the conditions caused by the procedure.
Other risks include: abnormal pigmentation, extended period of redness and dilation of blood vessels.
The patient should be aware that some scars will not be totally removed from the skin. If a patient does not want any possibility of scarring, he or she should not use this kind of treatment.
Procedure Costs:
The national average cost of dermabrasion is approximately $1500. However, there are other costs to factor in which can increase price. You should discuss the full cost (including all fees) with your doctor during your consultations. Financing is usually available to make the fees more affordable. The average cost for dermaplaning is reported at $300.
The costs associated with microdermabrasion depend on several factors. The procedure, itself, can be performed in the home, a spa, or in a certified medical facility. This all depends on the level (deepness) of the dermabrasion procedure. The cost may be as low as $150 – but keep in mind that multiple procedures may be necessary.
However, the cost for an individual procedure has decreased over the years. The reason is that the procedures, at one time, were usually performed only in hospitals. But they are now more likely to be performed in the doctor’s office surgical suite or in an accredited out-patient surgical center. Technological advances, in the past few years, have also been a major factor in decreasing the costs due to the improved ease of the operation.
10 Things to Discuss with Your Surgeon During Your Dermabrasion Consultation:
1. Are the results that I expect, realistic?
2. How is the dermabrasion performed and how long will it take?
3. How experienced is the surgeon performing the procedure? How many surgeries, this type has he or she performed?
4. What technique should be used, in my case? Why?
5. What are my anesthesia options? What are the qualifications of the anesthesia professional?
6. What are the total costs associated with my procedure?
7. What are the policies concerning surgical correction of unexpected complications?
8. What percentage of patients experience unexpected complication? What are these complications?
9. What recovery issues should I expect?
10. Has any license or malpractice insurance been revoked or suspended in this practice?