Dermabrasion is a surgical skin-resurfacing procedure that physically removes the outer layers of skin using a rapidly rotating device, prompting your body to grow fresh, smoother skin in its place. It penetrates through the epidermis (the outermost layer) and into the upper dermis (the deeper layer), making it significantly more intensive than cosmetic treatments like microdermabrasion. Dermabrasion is most commonly used on the face to reduce the appearance of acne scars, fine wrinkles, and sun damage.
How Dermabrasion Works
During the procedure, a surgeon uses a handheld motorized device fitted with an abrasive tip to scrape away skin in a controlled manner. The tip is typically one of three types: a diamond-studded fraise (available in shapes like cones, cylinders, and wheels), a wire brush with small wires protruding from a central cylinder, or a serrated wheel. For smaller, more localized areas like individual scars, surgeons sometimes use sterile sandpaper by hand instead.
The goal is to remove skin down to the superficial or mid-level of the dermis. As the device reaches the upper dermis, pinpoint bleeding appears, and deeper passes produce more visible bleeding. This controlled injury triggers the body’s wound-healing response. Hair follicles and oil glands rooted in the dermis serve as the regeneration source for new skin. The process also disrupts the existing collagen structure, which stimulates cells called fibroblasts to produce fresh collagen and remodel the dermal layer. The result is skin that looks smoother and more even in texture.
Conditions It Treats
Dermabrasion is effective for a range of skin concerns, nearly all on the face:
- Acne scars, particularly the pitted or uneven type
- Surgical or injury scars
- Fine wrinkles, especially around the mouth
- Sun-damaged skin, including age spots
- Rhinophyma, a condition that causes swelling and discoloration of the nose
- Precancerous skin patches
- Tattoos
It works best on scars and texture irregularities rather than deep structural problems. The procedure won’t eliminate a scar entirely, but it can make it significantly less visible by leveling the surrounding skin.
What the Procedure Feels Like
Dermabrasion is performed under sedation, and your skin is numbed before the surgeon begins. In some cases, general anesthesia is used instead. The surgeon scrapes the targeted area layer by layer, continuing until reaching the depth needed to reduce the scar or wrinkle. The procedure is typically done in an outpatient setting, meaning you go home the same day.
Afterward, your skin will be red, tender, and swollen. This is normal and expected. The treated area essentially has an open wound that needs careful management as it heals.
Recovery Timeline and Aftercare
Recovery from dermabrasion requires consistent wound care. Starting the morning after the procedure, you clean the treated area by letting warm water run over it for about 20 minutes, then gently removing any crusting with a soft cloth or cotton swab and mild soap. For the first three days, this cleaning process happens three to five times per day. You also apply a thin layer of ointment after each cleaning and every four hours while awake to keep the skin moist. Vinegar soaks (a tablespoon of vinegar diluted in a cup of cool water, applied with gauze) help prevent infection and are used every four hours on exposed treated skin.
As the skin begins to heal and crusts less, the cleaning routine becomes less intensive. New skin gradually forms over the treated area, but redness can persist for weeks or even months. The key principle throughout recovery is keeping the skin clean, moist, and completely shielded from sunlight.
Sun protection is critical for the entire first year after dermabrasion. For the first few weeks, you should avoid direct sun exposure entirely. After about four weeks, daily SPF 30 sunscreen becomes essential, even on overcast days. Failing to protect healing skin from UV light significantly raises the risk of developing uneven pigmentation. Scheduling the procedure in fall or winter, when UV exposure is naturally lower, can reduce this risk.
Risks and Complications
The most common concern after dermabrasion is pigmentation changes. Skin that has been resurfaced can darken (hyperpigmentation) or lighten compared to surrounding areas, particularly with sun exposure during healing. People with darker skin tones face a higher risk of noticeable pigment changes.
If the wound is too deep or stays open too long during healing, new scarring can develop. Infection is possible with any procedure that creates an open wound, which is why the cleaning and ointment routine is so important. Small white bumps called milia can appear during healing but are typically temporary.
One important contraindication: if you have taken isotretinoin (a strong acne medication), you must wait at least six months after stopping it before having dermabrasion. Isotretinoin impairs the skin’s ability to heal properly and significantly increases the chance of scarring from resurfacing procedures.
Dermabrasion vs. Microdermabrasion
These two procedures share a name but differ dramatically in depth, intensity, and results. Dermabrasion is a surgical procedure performed by a physician that removes the epidermis and upper dermis. It requires sedation or anesthesia, and recovery takes weeks. Microdermabrasion is a gentle cosmetic treatment performed by an aesthetician that removes only the top layers of the epidermis. It requires no anesthesia and has little to no downtime. Think of microdermabrasion as a deep exfoliation and dermabrasion as a surgical reconstruction of the skin’s surface.
Microdermabrasion can brighten dull skin and improve mild texture, but it cannot address deep scars, significant wrinkles, or the other conditions dermabrasion treats. If your concern is primarily cosmetic freshness, microdermabrasion may be enough. If you’re dealing with pitted acne scars or noticeable wrinkles, dermabrasion provides a much more substantial result.
How It Compares to Laser Resurfacing
CO2 laser resurfacing is the most common modern alternative to dermabrasion. A controlled study comparing the two for wrinkles around the mouth found that laser treatment produced slightly better wrinkle improvement at six months and created skin that more closely resembled younger skin in its collagen and elastin structure. Thirteen out of the study’s subjects chose the laser-treated side as having the better result. However, laser treatment also caused more redness at the one-month mark and was more painful during the procedure.
Laser resurfacing offers more precise depth control than dermabrasion, which relies on the surgeon’s skill and feel. That said, dermabrasion remains effective for certain situations, particularly rhinophyma and some types of scarring, where the mechanical approach has practical advantages. Many surgeons choose between the two based on the specific condition being treated, the location on the face, and the patient’s skin type.