Will Punch Excisions Work Without Dermabrasion?

If you are afraid of hyperpigmentation dermabrasion can lead to that as well. In fact dermabrasion can be the most aggressive of them all compared with laser resurfacing and chemical peels. Most surgeons can do punch excisions. You might want to consider excisions and then fractional resurfacing. A multilayered approach is best with co2 laser resurfacing most often done at the end for a polishing effect.

You have a lot of questions, far more than can be answered in this context. You should see someone who does this kind of work regularly. Darker skin does not preclude most therapies, and indeed, small areas treated with these therapies are less likely to darken than larger areas. Punch excision almost always needs some "sanding" to make it as even as possible. find someone, bring your questions, and get them answered.