D is for Dermabrasion

by Dr Daniel Sister

Dermabrasion, as the name suggests, is a surgical procedure for skin resurfacing.

Dermabrasion has been practiced for many years (before the advent of lasers) and involves the controlled deeper abrasion (wearing away) of the upper to mid layers of the skin with any number of strong abrasive devices including a wire brush, diamond wheel or fraise, sterilized sandpaper, salt crystals, or other mechanical means. Dermabrasion should not be confused with microdermabrasion which is a newer, milder and non-surgical cosmetic procedure.

Dermabrasion procedures are invasive procedures that typically require a local anaesthetic. Since the procedure can typically remove from the top to the deeper layers of the epidermis, and extend into the reticular dermis, there is always minor skin bleeding. The procedure carries risks of scarring, skin discoloration, infections, and facial herpes virus (cold sore) reactivation. In aggressive dermabrasion cases, there is often tremendous skin bleeding and spray during the procedure that has to be controlled with pressure. Afterward, the skin is normally very red and raw-looking. Depending on the level of skin removal with dermabrasion, it takes an average of 7–30 days for the skin to fully heal (re-epithelialize). This procedure was often performed for deeper acne scarring and deep surgical scars. Dermabrasion is rarely practiced currently.

The purpose of surgical dermabrasion is to help diminish the appearance of deeper scars and skin imperfections.

More commonly, though, the goal is to smooth the skin and, in the process, remove small scars (as from acne), uneven skin tone from scars or birthmarks, sun damage, tattoos, age spots. Enter Microdermabrasion

Microdermabrasion, widely used today, is a light cosmetic procedure that uses a mechanical medium for exfoliation to gently remove the outermost layer of dead skin cells from the epidermis. Two components are used: an exfoliating material like crystals or diamond flakes and a machine based suction to gently lift up the skin during exfoliation. It is a non-invasive procedure.

Microdermabrasion is a fairly simple, easy, painless, non-invasive, skin rejuvenation procedure using a combination of a fine abrasive tip or crystals and vacuum suction applied to the skin. There are no needles or need for anaesthetic. The vacuum pressure and speed are adjusted depending on the sensitivity and tolerance of the skin. Microdermabrasion sessions can last anywhere from 5–60 minutes. Minimal to no recovery time is required and most people immediately return to daily activity after a session. Traditionally, crystal microdermabrasion system contains a pump, a connecting tube, a hand piece, and a vacuum source. While the pump creates a high-pressure stream of inert crystals, such as aluminum oxide, magnesium oxide, sodium chloride, and sodium bicarbonate, to abrade the skin, the vacuum removes the crystals and exfoliated skin cells. Alternatively, the inert crystals can be replaced by a roughened surface of the tip in the diamond microdermabrasion system.

Unlike the older crystal microdermabrasion system, the diamond microdermabrasion does not produce particles from crystals that may be inhaled into patients’ nose or blown into the eyes. Diamond microdermabrasion is regarded as having higher safety for use on areas around the eyes and lips. Generally, the slower the movement of the microdermabrasion handpiece against the skin and the greater the numbers of passes over the skin, the deeper the skin treatment.

Much like brushing one’s teeth, microdermabrasion helps to gently remove skin “plaque” and skin debris. Given that human skin typically regenerates at approximately 30 day intervals, skin improvement with microdermabrasion is temporary and needs to be repeated at average intervals of two – four weeks for continued improvement. Multiple treatments in combination with sunscreen, sun avoidance, and other skin care creams yield best results.

Microdermabrasion may be performed to help diminish the appearance of superficial hyperpigmentation, and photo-damage, as well as diminish fine lines, wrinkles, acne, and shallow acne scars. A further benefit of microdermabrasion is enhanced skin penetration by other skin creams and serums. Removing dead skin (stratum corneum of the epidermis) will aid in the penetration of skin care products and medications by up to 10-50%. The controlled skin exfoliation afforded by microdermabrasion will allow make-up and self-tanning products to go on much more smoothly.