Dermabrasion is a procedure in which the surface layers of the skin are removed. This uses rough-edged tools, such as a diamond fraise or burr, or a wire brush, to gently peel away the top layers of the epidermis and thus allow new, smooth skin to grow back over the deeper layers.
This procedure requires a fair degree of skill, as scraping that is too deep or too extensive can cause long-term scarring and other complications. Also, risk and benefits should be considered individually, as skin types and health histories may vary.
Dermabrasion is painful and is therefore performed under local anesthesia. Sedation or even general anesthesia may be necessary if a more complex surgery is planned and especially if the patient is nervous or a large area is to be treated.
Microdermabrasion diamond peeling on the forehead. Image credit: Serko1982 / Shutterstock
Indications, risk and side effects
Dermabrasion is performed in patients with any of the following indications, although the list is not exhaustive:
- Skin growths or tags as a result of skin aging
- Fine wrinkles and lines on the face
- Premalignant tumors
- Acne scars
- Facial scars after trauma or surgery
- Radial elastosis and photoaging
Dermabrasion is a surgical procedure and complications of anesthesia can occur, as in any other patient. These include difficulty breathing and hypersensitivity to medications, bleeding from the surgical site, or infection entering through the abraded skin.
Dermabrasion during pregnancy
In pregnancy, profound hormonal changes take place that affect the functioning of many body systems. Some of the most important in relation to dermabrasion are the increased sensitivity of the skin and the presence of fluid retention. These are almost universal phenomena during pregnancy.
Increased sensitivity to trauma has led most dermatologists to avoid skin scraping during pregnancy. This could potentially lead to acne breakouts, skin irritation with scarring or hyperpigmentation, and spotting after healing.
Melasma is a condition that occurs during pregnancy in which the pregnant woman develops reddish-brown spots on certain parts of the body, including the face. It is also called a pregnancy mask. The appearance of this type of pigmentation during pregnancy has led to concerns about increased risks of scarring and hyperpigmentation after the dermabrasion procedure if done at this time.
Furthermore, anesthetic effects can be drastic and devastating, even if the risk is low. Since most indications for skin scraping are purely cosmetic, even if necessary, they are best delayed until the baby is safely delivered and no longer subject to the effects of anesthesia or associated side effects as described above.
Infection of the crudely treated area is another possible threat to the intrauterine fetus, although very little if the woman is under regular surveillance. However, with increased immune activity during pregnancy, the risk of infection with the need for antibiotic treatment should be avoided as much as possible during this sensitive period.
With the numerous physiological changes directed towards the maintenance and development of the fetus, wound healing is often delayed. This can lead to suboptimal recovery or prolonged healing time after dermabrasion in pregnancy. This is due to the longer time required for skin cells to mature at this time.
Finally, hypersensitivity to the chemicals used is another factor to consider. Some of them, such as alpha hydroxy acids, may even be unsuitable for pregnant women.
