The procedure of dermabrasion (synonym: skin abrasion) is a surgical method of aesthetic medicine. It involves mechanical abrasion of the epidermis (top layer of skin) to correct blemishes such as acne scars, perioral wrinkles (lines surrounding the mouth), or age spots (lentigo senilis).
Indications (areas of application)
- “Burnt out” scarring acne, e.g., after acne vulgaris.
- Scars after accident injuries
- Actinic pigmentation – so-called solar lentigines (sun-related spots) on the face and back of the hand.
- Elastosis of the skin – loss of elasticity of the skin due to light damage.
- Bourneville-Pringle disease (tuberous sclerosis) – genetically inherited disease characterized by malformations and tumors of the brain, malformations of internal organs and skin disorders (eg, hyperpigmentation).
- Syringomas – benign (benign) tumors of the sweat gland excretory ducts.
- Pseudoxanthoma elasticum – genetic disease characterized by fragmented and calcified (accumulation of mineral salts such as calcium) elastic fibers in the tissue. Elastic fibers are severely damaged, causing changes in the skin, vessels, gastrointestinal tract and cardiovascular system.
- Congenital nevus – benign, extensive brownish pigmentation disorders of the skin that are already present at birth.
- Rhinophyma – bulbous thickening of the nose, the cause of which is inflammatory hyperplasia (increased tissue growth) of the sebaceous glands of the outer skin of the nose.
Before treatment
Before the start of treatment should be an educational and counseling discussion between the doctor and the patient. The content of the conversation should be the goals, expectations and the possibilities of treatment, as well as side effects and risks. The patient should not take acetylsalicylic acid (ASA), sleeping pills or alcohol for a period of seven to ten days, as acetylsalicylic acid in particular delays blood clotting. To avoid wound healing problems, smokers should reduce their nicotine consumption to a minimum as early as four weeks before the treatment date. Particularly in the case of dermabrasion in the area of the mouth, it is important to ask whether there is a known tendency to flare-up infections of herpes simplex (lip herpes) or whether the patient is currently suffering from herpes. If this is the case, herpes prophylaxis should be given both 3-4 days before surgery and 7 days after. Women should be instructed to refrain from oral contraceptives (birth control pills) or other hormonal preparations for two weeks prior to the procedure, otherwise there is a risk of hyperpigmentation (increased brownish coloration of the skin) as the wound heals. On the day of dermabrasion, it is recommended to thoroughly cleanse the skin and avoid makeup. Immediately before surgery, the skin is cleansed with Hibiclens (antiseptic skin cleanser) or Phisohex (antibacterial emulsion for preoperative cleansing) and rinsed thoroughly. Before the application of local anesthetic (drug for local anesthesia), the area to be treated is marked
The procedure
Dermabrasion is a mechanical abrasive procedure. In this process, a fine wire brush or diamond burr is used to remove the top layer of skin down to the so-called stratum papillare. The depth of abrasion depends on the indication; in some cases, the skin layer is removed until small hemorrhages are visible. Both the instruments and the skin are cooled during the treatment (e.g. with moist compresses). The procedure is very well controlled surgically. The choice of anesthesia (numbing) depends on the extent of the treatment. Large-scale dermabrasion (e.g., on the face) requires general anesthesia. In contrast, local anesthesia is indicated for treatment of smaller defects such as tattoos on the extremities. The treated area is covered with a wound dressing made of fat gauze (this dressing prevents the wound from sticking), which is coated with an ophthalmic ointment containing corticoid. The wound dressing is then secured with an elastic bandage.
After treatment
The operated skin continues to be treated with ointments to prevent the wound from drying out and causing scarring. As healing continues, the skin is red and very sensitive.Scabs should not be removed under any circumstances, otherwise wound healing is jeopardized. Patients should not expose their skin to the sun for the first 2-3 months and should avoid oral contraceptives.
Benefits
The dermabrasion procedure shows impressive treatment results in aesthetic medicine. Both purely cosmetic treatment in the context of wrinkle reduction and medical reconstruction of severely damaged skin speak for the procedure. Dermabrasion enables the restoration of a youthful and refined skin appearance.
