Skin Resurfacing Options: Dermabrasion and Microdermabrasion

Dermabrasion and microdermabrasion are two related cosmetic procedures that can help eliminate or reduce the appearance of fine lines and wrinkles and other signs of aging. In both, the surface of the skin of the face is abraded to remove the top layer.

The difference between them is that dermabrasion removes a lot of the top layer of the skin and microdermabrasion removes only a small amount. Dermabrasion is usually a single treatment performed by a physician, while microdermabrasion may need to be repeated several times to give the best results. Dermabrasion also involves a recovery time, with the treated skin very red and even raw for a few days after treatment.

Dermabrasion is also used to treat acne scarring, hyperpigmentations, and small scars. It can also be used to remove tattoos. Dermabrasion is one form of skin resurfacing, other forms of which are laser skin resurfacing and chemical peels.


In dermabrasion, a surgeon will manually abrade your skin with a fine-grit surgical sandpaper or with a special sanding machine, or a small handheld drill with a sanding bit. The top layer of skin is removed to a controlled depth. Essentially, dermabrasion is a controlled injury to the skin, with the top layers of skin literally being sanded away to reveal new, fresh skin beneath.

You will be left with pink or red skin, or even crusted skin that may ooze a clear fluid in cases where more of the top layers must be removed. It may take a week or more to heal enough for you to go out in public.

Not everyone is a good candidate for dermabrasion. If you are prone to excessive scarring, or form pale or dark spots after skin injuries, dermabrasion is not for you. If you have darker skin or olive skin you may develop hyperpigmentation or hypopigmentation after dermabrasion.

If you have a history of oral herpes infections (cold sores or fever blisters), you must get a prescription for oral acyclovir (Zovirax) or a similar antiviral drug. If you do not and get a herpes outbreak while you are healing, the infection can spread to the treated area and result in scarring. Taking an antiviral drug decreases your chances of this happening. You should also not have dermabrasion if you have warts, rosacea, or autoimmune disorders. Tell your doctor if you have ever taken Accutane (isotretinoin).

A dermabrasion procedure normally takes from 15 minutes to 2 hours, depending on the size of the area being treated.

During the procedure, the surgeon will carefully sand or abrade your skin to the correct depth. After the treatment is completed, your surgeon will cover your face with a thin film of antibiotic ointment. Your face will be bandaged before you leave go home.

You will have to take it easy for at least a week. For the first week or two after your dermabrasion, you may be asked to sleep on your back with your head and shoulders elevated.

Your face will be swollen for a few days after dermabrasion. The treated skin will be very red and may actually become wet with clear fluid. Wash your hands well before you touch the treatment areas or change any bandages.

How fast you heal depends on the depth of your dermabrasion. If crusts or scabs form, do not pick at them. That will cause scarring.

After dermabrasion, you will have brand new skin and you must protect it. Ask your doctor when you can start applying cosmetics again. Use sun screen with a high SPF factor. Your skin is very fragile while it is healing. You may be pink for up to 5 months or more, depending on your skin's ability to bounce back and on the depth of the abrasion.

The risks associated with dermabrasion include viral infections and bacterial infections of the treated area, although this is rare. You also run the risk of forming keloids or other excessive scarring, or developing pigmentation problems.


As the name implies, microdermabrasion is a smaller, finer version of dermabrasion. It removes less of the surface of the skin and produces much more subtle results. Do not expect miracles or large amounts of improvement with microdermabrasion, but several sessions can help reduce fine lines and wrinkles.

With microdermabrasion, the skin is sort of sandblasted with several types of fine mild abrasives, including aluminum oxide crystals and vitamin C crystals. This process removes the dead cells that make up the top layer of the skin. It also stimulates collagen networking to further even out skin texture and appearance.

The best candidates for microdermabrasion are people with acne prone and blotchy skin, small scars, and fine lines. It is not recommended for anyone with recent herpes outbreaks, warts, active rosacea, or autoimmune system disorders.

Microdermabrasion does not hurt. Your skin may feel a little hot and be a bit pink for a few hours.

The procedure is usually performed by an aesthetician and not by a physician. In some states, anyone can perform microdermabrasion, while in other states a cosmetologist's license is needed. Treatments take about 30 minutes for the face, if your treatment includes the neck and upper chest area, it may last up to an hour. Most people get anywhere from four to eight treatments at 2-week intervals. The recommendation is to get a touch-up treatment every few months or so to keep your skin in good condition.

After each treatment, use a moisturizer and a sunscreen. Avoid direct sun exposure for a week after a treatment. Avoid using alpha hydroxy acid or glycolic acid products or skin exfoliation scrubs for 72 hours both before and after a treatment. Avoid heavy makeup, such as liquid or pressed powder foundations for 24 hours after a treatment. You can use eye makeup or lipstick immediately after a treatment.

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