Avoid Scabs when Healing from Dermabrasion and Laser Treatments?

Question

In many places, I read that it's best to avoid any scab formation when someone gets Dermabrasion or laser treatment. When I was little, I always thought that the best way to preserve a wound was with it's own crust and wait until it fell of by it's own. So the question is: why is now the standard in dermabrasion and laser treatments to keep the scabs from forming? Why not let the body heal by it's own? Isn't it more dangerous to keep any wound open?

Vivek Bansal, MD · Answer

Scabs get pulled off and cause scar tissue; the use of a moist gauze to cover these areas seem to enhance healing. We avoid the scab formation, and the scars all seem to be reduced, and the pigment seems to be preserved.

Otto Joseph Placik, MD · Answer

Wounds heal best and fastest when they are moist. However, that is an environment that also favors bacterial growth. Allowing a wound to dry or scab, will generally cause a lower incidence of infection but ultimately will slow down wound healing. Therefore the optimal enviroment is to keep a wound clean and moist to minimize and expedite wound healing.

Martie Gidon, MD, FRCPC, FAAD · Answer

Many studies have shown that keeping skin moist and covered helps skin heal quickly with the least chance of scarring.

Chad L. Prather, MD · Answer

In the old days, the thought was that scabs helped healing.  We know now, however, that is not the case.  Allowing a wound to dry after laser, dermabrasion, or surgery and form a scab delays healing and leads to less aesthetic outcomes.  The epidermal cells must migrate and repopulate into the areas that they have been removed from with the laser or dermabrasion wheel.  If this occurs quickly, there is less downtime and faster healing.
A scab is really a big roadblock for migrating epidermal cells... it makes them go under the scab rather than directly into the wounded tissue, so the epidermal cells take longer to get there. Rather, keeping the wound moist in order to prevent a scab from forming optimizes the cosmetic outcome.  The epidermal cells can march right through the moisture and repopulate the wounded area.

Peter A. Aldea, MD · Answer

Good question. Scabbing is NOT a good way to heal. It is a lousy way to heal. For a wound to heal its best, it must be kept well hydrated and moist (just like a new plant which is germinating). Allowing the raw wound to dry increases the likelihood of deeper injury and potential permanent scarring.
When you undergo a Laser (photoelectric) peel, Dermabrasion (mechanical) peel or Chemical peel, the mechanism removes a variable thickness of the outer skin HOPING the remaining deeper layer and its oil / sweat glands would regenerate the top skin layer. ANYTHING which interferes with this regeneration process such as dryness (IE SCABBING), infection (staph, Herpes, fungus etc),  prior radiation or electrolysis etc may result in a full thickness injury and permanent scar.

Avoid Scabs when Healing from Dermabrasion and Laser Treatments?

Answers (6)