Dermabrasion, or skin sanding, is an effective technique for reducing heavy wrinkling around the mouth, minimizing the scarring of acne, and improving the appearance of facial scars.
-Andrew Barnett, MD
What do you mean by "sanding" the skin?
Sanding the skin is performed for much the same reason that a fine carpenter sands wood, to remove imperfections and irregularities and leave a smoother finish. Skin is composed of a number of layers, and has a limited ability to regenerate. After one dermabrades the skin to remove the outer layer, the skin regenerates, producing both a new superficial layer, and a thicker central layer. The central layer is composed of newly formed collagen. Together, these two layers give the skin a fuller, more youthful texture. The sanding also reduces the sharp edges of scars and wrinkles.
How do you actually perform dermabrasion?
Dermabrasion is performed with a medical dermabrasion wheel, referred to as a diamond fraize. The skin is numbed with local anesthetic, and the diamond fraize is than applied. By careful application, the layers are removed in a controlled fashion until the appropriate skin level is reached. A moisturizing ointment is than applied.
Is the procedure painful?
During the actual procedure, the local anesthetic eliminates pain. During the initial post dermabrasion period, pain medication is very effective in reducing discomfort. The sensation is similar to a sunburn. During the later post dermabrasion period, there is generally very little discomfort, although many patients say the skin feels "tight".
How long does it take to heal?
Healing takes five to ten days, during which time the patient cleans the skin frequently to prevent infection and applies a vegetable or petrolatum based moisturizing cream to soothe and assist in healing.
How does one look after the skin heals?
Initially, the skin is quite pink. This can generally be concealed with make-up starting soon after the skin heals. The reddish color fades over a number of months. Immediate improvement is seen in the wrinkling and scarring, and this becomes better with time.
Will my scars or wrinkles disappear?
No. The anticipated result is an improvement. That means that the wrinkles and scars should be less evident, and easier to conceal with make-up. There is no way known to completely eliminate scars or wrinkles.
What about skin color?
Short term discoloration is common, but generally fades. More highly pigmented skin may become lighter with time, a process called hypopigmentation. This is a definite limitation, and must be considered when recommending dermabrasion, or any resurfacing method, be it sanding, laser, or chemical peel. Sun tanning may produce a darkening called hyperpigmentation, another consideration.
Does that mean I can't suntan after dermabrasion?
During the first few months the skin is very sensitive to sun, and no tanning is allowed. While tanning is never recommended, it is permitted six months after a dermabrasion. The skin will however still be somewhat mere sensitive to sun exposure with resulting damage.
Do you always treat the entire face?
No. Dermabrasion is commonly applied to localized areas, such as the mouth region for "lipstick lines", or the cheeks for acne scars. At other times, the entire face is treated. Dermabrasion is also commonly combined with other procedures, such as a face lift.
How long does dermabrasion last?
Some aspects of dermabrasion are permanent, while others are affected by the natural aging process.
Are there any other risks?
Yes. Infection and scarring are possible, as well as increased sensitivity to touch and temperature change, acne breakout, increase or decrease in the dryness of the skin, and formation of tiny whiteheads or "milia". Repeated dermabrasions may be necessary to obtain the desired result. These risks are explained not to alarm you, but to allow you to make an informed decision. We will discuss this and other issues in greater detail at your consultation.
What about chemical peeling instead off dermabrasion?
Chemical peeling is a technique related to dermabrasion, and in some cases will be recommended over dermabrasion. Peeling works best with the multiple fine wrinkles caused by sun and age, and also with skin color changes referred to as dyschromia. It is generally not effective in treating acne scars and facial scars. At times, dermabrasion and peeling will be combined in a technique referred to as chemobrasion! The relative advantages and disadvantages of these two techniques will be discussed at your consultation.
What about laser resurfacing?
Another excellent technique, and one which I frequently perform. In general, if resurfacing is required over the entire face, I will recommend laser or chemical peel, whereas dermabrasion is excellent around the mouth and for smaller scarred areas. We will discuss all your alternatives at your consultation.
Is dermabrasion an office or hospital procedure?
This depends on the extent of dermabrasion planned, but generally, the procedure is performed in the office.
Will insurance coves the cost of dermabrasion?
Insurance companies differ in their covered benefits. Generally, if the procedure is for correction of scarring from an accident or acne, coverage is available. Verification of coverage prior to the procedure may be advisable. My office staff can help you with this.
Should I have dermabrasion?
Ultimately, that's a decision only you can make. At your consultation we'll explore the alternatives, discuss the anticipated results, address your concerns and questions, and try to reach a decision that's right for you.