Dermabrasion and Microdermabrasion

Dermabrasion vs. microdermabrasion

Dermabrasion produces substantial changes in the appearance of the skin by injuring it in a controlled manner using an abrasive. Dermabrasion is most often used to treat certain types of scarring and aged skin. Other options that produce similar results include laser surgery, moderate to deep skin peels, and the injection of fillers. Most often the facial skin is treated, but skin at any site can be treated. Dermabrasion is performed by dermatologists and plastic surgeons.

Microdermabrasion is a nonsurgical technique that affects only the superficial dead layer of the skin, producing transient changes. Microdermabrasion is often administered by nonphysician professionals.

Dermabrasion produces controlled skin damage involving the deeper layers of the skin. The resulting wound heals with a scar that is cosmetically superior to what was there originally. The conditions that seem to respond best to this approach include acne scarring, traumatic scars, rhinophyma (nose enlargement in rosacea), wrinkles, tattoo removal, and actinic keratoses (very early stage of skin cancer).

Currently, there are other available modalities, including laser surgery, which are more popular and probably more effective because they seem to be more controllable. Lighter-skinned individuals generally get more reliable results because they are less likely to develop increased pigmentation after the procedure. Patients who have recently been treated with isotretinoin (Accutane) should avoid dermabrasion for at least six months.

Microdermabrasion is a technique that affects only the most superficial layer of the skin, the stratum corneum. This layer is composed of dead horny cells that are exfoliated by this procedure. This procedure is safe for most people because it should not produce any significant damage to the skin. Patients who have an active skin disease such as acne should not receive treatment to the affected skin.

Since dermabrasion is a surgical procedure, local anesthesia is required and is occasionally supplemented by intravenous sedation. When the skin is appropriately numb, an abrasive device is applied to the skin. This device could be a rapidly rotating wire brush or a diamond encrusted wheel or even abrasive screening. The choice depends on the anatomical location as well as the particular area to be treated. A refrigerant spray is often used to reduce the movement of the skin during the procedure. The ability to perform this procedure is very dependent on the skill and experience of the operator.

Microdermabrasion involves spraying an inert crystalline material or rubbing a so-called crystalline impregnated wand with sufficient force to dislodge superficial skin cells without damaging the deeper layers of living cells. Aside from this superficial debridement, it produces mild inflammation and temporary swelling.

Dermatologists and plastic surgeons are most likely to perform dermabrasions. Microdermabrasion requires no specific expertise.

The wound produced by dermabrasion, like any other wound, must be kept clean and moist. Gentle removal of crust and debris can occur after removal of the postoperative dressing (usually 24-48 hours after the procedure). Petroleum jelly is generally applied to the wound surface frequently. Healing usually occurs within 10 days and redness dwindles after three to six weeks.

Since microdermabrasion does not produce a wound, there is no postoperative issues aside from mild redness. Over the short term, there may be some subtle decrease in wrinkling due to the swelling.

As with any surgical procedure, infections can occur and these are treated with antibiotics. Undesirable color is more common in darkly pigmented individuals. Keloids and hypertrophic scars can occur, especially in patients with a genetic predisposition to scar.

Microdermabrasion has few side effects, but it is best avoided if you are taking isotretinoin.

Since both of these procedures are almost always cosmetic, insurance coverage is usually not available.