Dermabrasion, At A Glance
- Best ResultsOne
- Treatment Recovery21 to 30 days
- Procedure Time60 minutes
- Skin SpecialistDermatologist
- Duration of Results10 years
- Back to WorkOne month
- CostOutdated procedure (Historical reference)
Dermabrasion was a popular procedure over 3 decades ago, before mainstream use of ablative carbon dioxide lasers. This technique was performed under general sedation for the treatment of severe acne scars, skin cancers, & deep wrinkling. This modality should not be confused with microdermabrasion which is still very popular today. Dermabrasion recovery was 14-28 days, most often followed by skin colour changes.
FactsFacts on Dermabrasion
- Dermabrasion is a medical procedure popular 3 decades ago
- This treatment is very different from microdermabrasion
- Microdermabrasion removes approximately 0.05 mm of skin
- Dermabrasion removes over 200-400 times this depth
- Dermabrasion was conducted in a surgical theatre under a general anaesthetic
- Most commonly wire brushes were used to remove layers of skin
- This was the treatment of choice in the 60s to 80s for severe acne scars & wrinkles
- Recovery following dermabrasion was 3 to 4 weeks
- This procedure is largely outdated & referenced for historical value
What is the difference between microdermabrasion & dermabrasion?
Microdermabrasion is a superficial treatment that removes the old skin cells from the uppermost layers of skin. Dermabrasion is a more aggressive technique that reaches over two hundred times the depth of microdermabrasion. It was a popular technique over three decades ago, preceding ablative laser resurfacing. Dermabrasion was used to treat severe acne scars, smoker’s lines & deeply etched wrinkles.
There was significant downtime & bleeding with dermabrasion while microdermabrasion resolves without any downtime or trauma. In summary these two procedures, whilst sounding similar lie on opposite sides of the spectrum.
What was dermabrasion used for?
Dermabrasion was used to treat deep dermal conditions including severe acne scars, deeply etched wrinkles (incl. Smokers lines), skin cancer & sun damage. Unwanted tattoos were also removed with wire, diamond fraise, or salt dermabrasion.
What has replaced dermabrasion?
With the event of ablative lasers in the 90s, dermabrasion was gradually out phased. Lasers such as the carbon dioxide & erbium lasers gave excellent results whilst decreasing the downtime, hypopigmentation & scarring associated with dermabrasion procedures.
The use of various deep chemical peels including the Phenol Croton Oil peel also outdated many dermabrasion protocols.
What was the recovery time from dermabrasion?
3 to 4 weeks, with post procedure redness ensuring for several more months. Skin colour changes including both hyper pigmentation (darkening) or hypo pigmentation (lightening) were commonly seen following dermabrasion, the latter was more commonly seen due to the depth of this procedure.
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Did dermabrasion hurt?
Hell yeah! The event was both painful and traumatic, hence was carried out under full sedation- general anaesthetic.
What were the risks associated with this procedure?
- Acute: Blood loss, infection.
- Post Procedure: Pigmentation loss (Hypopigmentation), demarcation lines, iatrogenic scarring, prolonged redness, textural change.
Dermabrasion was classed as a high risk, high gain procedure for patients & was performed by experienced dermatologists & plastic surgeons. My mentors performed this procedure & they had big balls. Laser resurfacing now-a-days is considered super easy compared to the days of dermabrasion.
How was dermabrasion performed?
This procedure was performed in an operating theatre under sterile conditions. The majority of patients were either very heavily sedated or under general anaesthetic. All staff in the theater had to wear protective clothing including eyewear & masks as aerosolized blood splatter was the norm.
The instruments of choice were wire brushes or a diamond fraise driven by a motor, much like a dremel tool (Google this for an indication of the process).
After each dermabrasion session the entire theatre had to be cleaned to remove blood products from the floor, walls, ceiling & personnel. Needless to say, this was an entirely gruesome procedure, however at the time, no other skin resurfacing procedures were available, apart from deep chemical peels.
How long did the results last for?
A very long time. Very rarely was dermabrasion repeated, partly due to loss of the appendageal structures that could make the second-round treatment tricky. Back in the day, this was the most aggressive skin treatment performed by dermatologists & plastic surgeons.
How can I treat hypopigmentation & scarring resulting from dermabrasion?
Unfortunately, the white skin from hypopigmentation is very difficult to re-pigment. Methods include microneedling with Latisse (PG analogue), tacrolimus (stimulates tyrosinase enzyme, enhances melanocyte migration), fractional CO2, ReCell, nUVB, excimer lasers, & focal psoralen.
A more sensible approach is to blend in hypopigmented areas so that demarcation lines are less obvious. Non-ablative fractional lasers such as Thulium or Diode 1927, medium depth peels or conservative ablative laser resurfacing can be helpful.
Davin’s take on dermabrasion
What a procedure back in the day! I was lucky enough to have seen one full on dermabrasion treatment in Sydney in 1994. I was gowned up from head to toe, with a face shield. Never forget it. I was covered in blood spray & nearly puked! Actually, it was awesome to watch. To be fair, this procedure was largely reserved for extreme cases of acne scarring, severe sun damage & super deep wrinkles. It worked well in the correct hands. My mentors were in the era of dermabrasion & deep phenol peels. They had skill sets & kahunas way beyond the current generation of ‘laser dermatologists’ including myself. This treatment was technically challenging and relied on fine motor skills, compared to pressing a button on a laser now a days.
In the late 90s, the Silk Touch Sharplan CO2 laser was invented. That changed many skin-rejuvenating & scar procedures as the laser offered much safer results, with very little bleeding.
Fast forward to 2006 fractional non-ablative lasers such as the blue dye Smurf look Fraxel came into the scene, followed closely with CO2 & modulated erbium lasers. This current repertoire of lasers (2020 & beyond), are somewhat underpowered compared to older devices like the Lumenis Ultrapulse. I still run this laser as well as an older but more powerful Sciton Joule (clocked laser).
With the event of time, powerful lasers are being replaced with gentler devices such as low powered fractional lasers, (HALO comes to mind), as well as RFM or radiofrequency microneedling.
I still see patients who have had dermabrasion in the past. Most are in their 70s to 80s. To be fair the results were generally good. Sure, deep rolling scars were still resistant, but etched lines, wrinkles, superficial scars (boxcar & even deep ice picks) were effaced with this procedure. Hypopigmentation was almost universally seen (hence not a sensible treatment option for skin of colour). I was fortunate to have studied dermatology as these treatments were being phased out, as it gives me a better perspective of the treatments available today & how super easy (and much safer) energy devices are.
Blessed and thankful to be in the transitional professional era of dermabrasion. Full respect to my mentors who had to perform this procedure, their skill sets were beyond doubt.
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