Dermabrasion: What You Need to Know

Medically reviewed by Dr. A. David RahimiBoard Certified DermatologistReviewed on October 16, 2023
Written byJolene EdgarUpdated on October 12, 2023
RealSelf ensures that an experienced doctor who is trained and certified to safely perform this procedure has reviewed this information for medical accuracy.You can trust RealSelf content to be unbiased and medically accurate. Learn more about our content standards.
Medically reviewed by Dr. A. David RahimiBoard Certified DermatologistReviewed on October 16, 2023
Written byJolene EdgarUpdated on October 12, 2023
RealSelf ensures that an experienced doctor who is trained and certified to safely perform this procedure has reviewed this information for medical accuracy.You can trust RealSelf content to be unbiased and medically accurate. Learn more about our content standards.

Dermabrasion is an intensive skin-resurfacing procedure performed by a dermatologist or plastic surgeon. It involves the controlled sanding or planing away of the outer to middle layers of skin, to remove surface (epidermal) and deeper (dermal) damage and encourage new skin growth. 

It’s a surgical procedure, one that’s much more invasive than microdermabrasion and offers more significant benefits for treating scars (including acne scars), age spots, sun damage, and fine lines and wrinkles. It can spot treat small areas, like the upper lip or cheeks, or it can be performed over the entire face.

Despite this treatment’s intensity, it’s  important to have realistic expectations about results. The American Society for Dermatologic Surgery notes that “typically, a 50% improvement in the skin condition is considered a good result.”

Dermabrasion was a very popular treatment option, but it’s been overtaken in recent years by newer skin rejuvenation procedures such as laser resurfacing, which often comes with less downtime and carries a lower risk of complications. Lasers can also treat specific areas more precisely, and the treatments are easier to perform safely. 

Dr. A. David Rahimi, a board-certified dermatologist in Los Angeles, still performs dermabrasion, especially for patients with severe acne scarring. “I combine it with fillers and subcision to improve deep atrophic and rolling scarring,” Dr. Rahimi explains. However, he does warn his patients that the recovery time takes twice as long as after a CO2 laser treatment. He also cautions that dermabrasion can permanently change skin color and texture in the treated area.

Dr. Ava Shamban, a board-certified dermatologist in Beverly Hills, also cautions that there’s a much higher rate of infection during the healing process with dermabrasion versus fractional lasers. “To treat deep lines, folds, and wrinkles, there are better procedures available—including lasers and chemical peels—with far fewer negative potential outcomes and significantly less downtime,” says Dr. Shamban.

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Pros

  • This treatment is “ideal for specific and isolated concerns, such as a post-traumatic or surgical scar that is significantly raised,” says Dr. Shamban. 
  • It’s an effective option to treat for growths (actinic keratoses), as well as an enlarged nose (rhinophyma) caused by rosacea.
  • Dermabrasion boosts new collagen production, which can help reduce wrinkles.
  • It can be less expensive than laser resurfacing.

Cons

  • Dermabrasion carries a risk of pigmentation issues, so it’s recommended only for people with Fitzpatrick skin types I or II: pale white or fair skin.
  • Most patients need at least two weeks of downtime after their procedure, and some have redness for even longer than that. “Generally, the main healing process is two weeks, but redness can persist for six months,” notes Dr. Shamban.
  • It can’t effectively treat congenital skin defects, most moles, pigmented birthmarks, or scars caused by burns.

RealSelf Tip: Dermabrasion can be used to remove tattoos, but it’s not the treatment option of choice because it often results in incomplete tattoo removal, scarring, and pigment abnormalities, according to one study. Most dermatologists recommend laser and light-based technologies for tattoo removal.

  • Average Cost:
  • $2,075
  • Range:
  • $500 - $5,000

The price you pay will depend on the experience level and credentials of your provider, their location, the size of the area treated, and whether you have any complementary treatments at the same time.

See our complete guide to dermabrasion costs

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The dermabrasion photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Dermabrasion is not recommended for people with olive, brown, or very dark skin, because postoperative hyper- or hypopigmentation could make their skin color darker, lighter, or blotchy. This discoloration can be temporary or permanent.

You’re also not a good candidate for a dermabrasion facial if you have:

  • An autoimmune condition that affects healing
  • A genetic disposition to keloids
  • Severe acne that’s being treated with isotretinoin (aka Accutane)
  • Recurrent flare-ups of herpes (cold sores) or other skin conditions, like infections
  • Burns from radiation

People who’ve recently had facial plastic surgery, such as a brow lift or facelift, may not be candidates, depending on the specific areas they want to have resurfaced. As a study on treatments that complement facelifts explains, “There is a dual insult to the facial skin when a facelift is combined with simultaneous skin resurfacing." The combination of injuring the skin's superficial and deeper layers creates "a potential for increased risk of skin necrosis.” However, "resurfacing of the skin that is not undermined during a facelift, such as the perioral [around the mouth] skin, is considered very safe.”

This outpatient procedure takes between 30 minutes and 2 hours, depending on the extent of your treatment plan. Here’s what to expect:

  • Your doctor will start by numbing your skin with a topical anesthetic and, possibly, local anesthesia injections. Some providers, including Dr. Rahimi, use solid CO2 (aka dry ice) to freeze the skin prior to treatment. 
  • If you’re having dermabrasion over your entire face, you may even be given general anesthesia. 
  • Once your skin is fully numb, an assistant will hold it taut while the doctor moves the dermabrader device—a handheld rotating instrument, often with a wire brush—across your skin, removing the outer and middle layers. 
  • Afterward, your doctor will apply a moist, nonstick dressing (like an occlusive silicone sheet), to help prevent infection and encourage healing. 
  • They’ll change this dressing at a follow-up appointment the next day.
  • You’ll be given instructions on how to change dressings at home after that, as well as how to clean, treat, and apply ointments to the skin.

When performed by a qualified, experienced physician (not administered by a nurse or aesthetician), a dermabrasion procedure is considered safe for people with a very light skin tone. 

Safety and good aesthetic results hinge directly on the provider performing the procedure. “If too much pressure is applied, the excess force will remove too much skin—potentially, all the skin layers down to the fat—leaving a lighter area, at best, or a shiny scar, at worst,” says Dr. Shamban.

The most common risk with dermabrasion, according to the American Society of Plastic Surgeons (ASPS), is developing either hyperpigmentation or hypopigmentation. “Permanent darkening of the skin may occur in some patients due to sun exposure in the days or months following surgery. On the other hand, some patients find the treated skin remains a little lighter or blotchy in appearance.”

Additional complications are much the same as those associated with other kinds of surgery: scarring, bleeding, infection, and possible allergic reaction. 

The American Society of Plastic Surgeons also warns that you could develop whiteheads or large pores, though these side effects typically disappear on their own.

You shouldn’t feel anything during the procedure thanks to the anesthesia, but recovery is known to be painful—even “excruciating,” according to Dr. Shamban. 

Most doctors prescribe pain medication for at least the first few days, to help keep you comfortable. After that, most patients reduce the discomfort with over-the-counter pain relievers.

Your doctor will recommend activities or medications you may need to stop or start before your dermabrasion appointment. 

It's likely that you’ll need to stop:

  • Certain medications, including blood thinners or prescriptions that may cause hyperpigmentation
  • Smoking and drinking
  • Exposure to UV rays, including indoor tanning

And you may be asked to start:

  • Being even more strict about your sun protection in the two months prior to your procedure. Limiting your sun exposure and using a broad-spectrum sunscreen with an SPF of 30+ can help reduce your risk of skin discoloration post-procedure.
  • Using topical hydroquinone a few weeks before the procedure, to further decrease your skin discoloration risk. .
  • Taking an antiviral medication to prevent an outbreak. All patients with a history of herpes simplex virus should be placed on antiviral prior to the procedure, and some surgeons advocate for giving every patient an antiviral prior to the procedure.
  • Taking an oral antibiotic, to prevent an acne outbreak (if you’re prone).

You might also want to consider:

  • Getting Botox injections at least three days before the procedure; according to the Mayo Clinic, they “help most people achieve better results.”
  • Using a retinoid (a prescription vitamin A cream or gel) in the weeks before your procedure.

You’ll also need to arrange for someone to take you home, since your procedure will likely involve anesthesia, sedation, and/or anti-anxiety medications such as Valium or Ativan (among others).

Plan for about two weeks of downtime after dermabrasion. 

During your initial recovery:

  • Your face will feel tight, swollen, achy, and itchy. Some patients also report feeling a burning sensation. 
  • Eating and talking may be difficult for a few days post-op.
  • It’s normal to have oozing, scabbing, and crusting within those first two weeks.
  • As new skin grows, you may feel very itchy—but it’s important not to touch your face, or you'll risk infection. 
  • You’ll also need to avoid activities like sports or swimming, which could hurt your face. 
  • Dr. Shamban also cautions that “full sun avoidance is key during healing.” 

Redness or pinkness may subside after several weeks, but more typically it lingers for three months or more. 

Your final results should be visible within three to six months.

RealSelf Tip: Dermabrasion results are not permanent, but they can last for years with good skin care and diligent sun protection. During the first year after your procedure, your new skin will be especially sensitive to sunlight. Be diligent about wearing sunscreen with an SPF of 30 or higher—and avoid direct sun exposure altogether.

There are several key differences between dermabrasion and microdermabrasion. 

  • A microdermabrasion facial removes only the topmost layer of dead skin cells, while dermabrasion sands off both dead cells and living layers of skin.
  • Dermabrasion can be performed only by a plastic or dermatologic surgeon, while you can have microdermabrasion performed by an aesthetician at a doctor’s office, spa, or salon. 
  • Because it doesn’t go beyond the skin surface, microdermabrasion isn’t effective for treating pitted acne scars, deep wrinkles, or stretch marks. It will leave your complexion smoother and more refined with little to no downtime, but you can expect to need additional treatment sessions every two to four weeks to maintain your results.

Microdermabrasion is safe for all skin tones, while its more aggressive counterpart is only considered safe for very light skin tones.

Interested in dermabrasion?

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Updated October 12, 2023

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