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Dermabrasion, or skin sanding, uses one of several devices
to remove the surface layer of your skin to remove wrinkles, correct scarring,
either from acne or surgery, or to remove actinic keratoses – growths that
result when fair-skinned people get too much sun in their younger years.
These keratoses are usually reddish and have a white scale
on top and need to be removed before they become cancerous. They are generally
rough to the touch, and may feel sore when you rub them, or when they come in
contact with clothing. Seborrheic keratoses, on the other hand, are commonly
non-cancerous but can be quite disfiguring as age brings on more and more of
these dark brown spots.
Dermabrasion involves the use of diamond fraises, ultra-fine
wire brushes or serrated wheels. The fraises look remarkably like buffing
attachments for the Dremel rotary tool, and contain miniscule chips of diamond.
The wire brushes and serrated tools are also micro-fine versions of similar
tools used with a Dremel or sander, to sand, buff or clean wood, and the hand
tool into which dermabrasion heads are inserted achieve speeds similar to a
Dremel - that is, about 18,000 to 35,000 revolutions per minute.
At that speed, it’s possible to remove too much surface skin
and create additional scarring, so it is important to choose a doctor or
technician with a lot of experience using the tool. In addition, those with
very fine, or thin, skin should consider laser procedures instead, as these
have potentially less risk for scarring.
If you choose dermabrasion to remove just a few wrinkles or
a small scar you will be awake but under a local anesthesia. If the procedure
is more extensive, your doctor may choose either sedation to calm you or
general anesthesia, which will keep you from experiencing pain or anxiety. With
modern anesthesia techniques, the risks are minimal but they still exist, so
make sure you are comfortable with being put under.
The length of the procedure varies depending on the extent
of wrinkling or scarring. A simple scar will take less than an hour, including
surgical prep time. More complex procedures can take several hours. If there is
a great deal of scarring, or many keratoses, your surgeon may choose to treat
you in several sessions.
Once the dermabrasion is complete, petroleum jelly or
antibiotic ointments will be smeared over the sanded surface to reduce scab
formation and scarring. Your doctor may also give you pain medication, and will
likely give you antibiotics. Take the first as needed and the second as
directed; infections can cause horrendous scarring.
After surgery, your skin will be quite red, hot and swollen.
The swelling can last up to three weeks, and may make it painful to talk or
eat, depending on how much of your face has been treated. Plan ahead by buying
straws, liquid food supplements like Ensure, and advising your family and
friends that talking, smiling and laughing will hurt you physically and may
stretch skin beyond its capacity to heal.
After the burning comes itching, as the skin starts to heal.
This can be very intense and uncomfortable, but resist putting ointments on
your face unless your doctor approves them. You may also use hypoallergenic
foundation to hide the redness, but again only with a doctor’s approval. Dermabrasion
can also cause enlarged pores, or whiteheads, as oil is trapped beneath the
healing skin, and any kind of substance applied to the skin will exacerbate
them, but they will go away in time.
You will need to avoid strong sunlight for up to 12 months,
until you skin tone returns to normal. You should definitely avoid the
chlorinated water of swimming pools, and extremely hot water for bathing or
showering, for at least a month, and alcoholic drinks will make your skin flush
even darker in the initial days after a procedure.
Unlike microdermabrasion, which peels a maximum of 15 microns from the
skin’s surface, dermabrasion goes quite deeply into the skin. This makes it
both more effective in removing scars but more invasive, and the dangers of
scarring or hyperpigmentation (dark or light spots or areas) are greater.
Dermabrasion is not an instant fix; that is, each treatment improves skin by
up to 50 percent, but no more, and additional treatments may be needed after a
year. Dermabrasion also can’t be used on the throat area.
I had a friend who had dermabrasion for acne scarring, and she was less than
pleased with the results. Of course, this may have been due to her skin type,
the skill of the operator or the fact that dermabrasion techniques were more
primitive ten years ago. I personally think that laser resurfacing is a kinder
and more effective method than dermabrasion for removing scars and keratoses,
but consult your doctor to make a final decision.
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