Dermabrasion

Definition: What is surgical dermabrasion?

The Dermabrasion is a surgical, ablative procedure in dermatology. It involves the controlled mechanical removal of the outermost layer of skin (the epidermis) and parts of the underlying dermis using a rapidly rotating abrasive instrument, such as a diamond burr or a wire brush.

The aim is to smooth out deep skin irregularities such as pronounced scars or wrinkles. The procedure creates an open wound, which must heal under medical supervision.

Please note: risk of confusion: dermabrasion vs. microdermabrasion

What does the dermabrasion procedure involve?

Dermabrasion is carried out in an operating theatre or a clinical treatment room.

1. Anaesthesia Depending on the extent of the procedure, the area is numbed locally. Often, twilight sleep is also administered, or, for very large areas, a general anaesthetic is given.
2. Preparation The skin is thoroughly cleansed, disinfected and, if necessary, firmed using a cooling spray to enable more precise exfoliation.
3. Sanding The surgeon guides the rapidly rotating dermabrader over the skin, applying controlled pressure, and abrades the uppermost layers of skin layer by layer until the desired depth is reached, in order to smooth out the scar or wrinkle. This causes bleeding.
4. Wound care The resulting open wound is immediately treated with special ointments and dressings to aid healing and prevent infection.

When is dermabrasion an option? (Indications)

• Pronounced acne scars: In particular, „ice pick“ scars or undulating scar fields.
• Scar correction: Following operations or accidents.
• Rhinophyma: A tuber-like swelling of the nose in severe rosacea.
• Sometimes used to remove tattoos (now mostly replaced by laser treatment).

The recovery period: What you can really expect

Recovery following dermabrasion is a lengthy process that requires patience.

First week:
Initially, there is an open, weeping wound, which becomes covered in scabs within the first few days. Swelling and a burning sensation are normal. Strict hygiene and regular dressing changes by the doctor are essential.

Week two:
The scabs are starting to come away. Beneath them, new, very delicate, pink skin is beginning to show.

The following weeks and months:
The severe redness persists for several weeks to months and fades only slowly. The new skin is extremely sensitive to sunlight.

Risks and complications of dermabrasion

Dermabrasion is a less risky procedure than it used to be, but it still carries the risk of serious complications:

• Infections: Bacterial or viral (herpes) infections of the wound site.
• Scarring: Instead of an improvement, new, raised scars may develop.
• Pigment changes: Permanent light-coloured (hypopigmentation) or dark (hyperpigmentation) patches. This risk is particularly high in people with darker skin types.
• Persistent redness: In rare cases, the redness may persist for many months.
• Milia (milia): Small white cysts may form on the new skin.

If such complications arise, medically necessary and costly follow-up treatment may be required, which is often not covered by health insurance. Taking out follow-up costs insurance before the procedure therefore provides important financial protection in the event of unexpected events.

The role of modern alternatives (e.g. lasers)

In many areas where dermabrasion used to be the only option, more modern procedures such as the fractional laser therapy (e.g. CO₂ laser) is preferred.

These methods often allow for more precise control of the depth of ablation and may be associated with a lower risk of side effects such as pigmentation disorders. However, dermabrasion remains a valuable and effective treatment option for certain types of scarring and rhinophyma when performed by an experienced specialist.

Frequently Asked Questions (FAQ) about dermabrasion