Dermabrasion and Microdermabrasion

Dermabrasion and Microdermabrasion

Dermabrasion and Microdermabrasion

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Dermabrasion & Microdermabrasion - Skin Deep Dive

  • Dermabrasion:
    • Mechanical resurfacing; ablates to papillary/reticular dermis.
    • Tool: High-speed rotary abrader (wire brush, diamond fraise).
    • Indications: Deep acne scars, traumatic scars, rhinophyma.
    • Deeper penetration; significant downtime; anaesthesia required.
  • Microdermabrasion:
    • Superficial exfoliation; removes stratum corneum.
    • Tool: Fine crystals (e.g., aluminium oxide) or diamond-tipped wand + suction.
    • Indications: Fine lines, dull skin, mild hyperpigmentation.
    • Gentler; minimal downtime; no anaesthesia.

Dermabrasion vs Microdermabrasion: Skin Layers Affected

⭐ Dermabrasion carries a higher risk of scarring and pigmentary changes, especially in darker skin types, compared to the more superficial microdermabrasion.

Dermabrasion & Microdermabrasion - When to Resurface

  • Dermabrasion (Deeper Resurfacing):
    • Significant acne scars (e.g., ice-pick, boxcar)
    • Deep wrinkles, traumatic/surgical scars
    • Rhinophyma, extensive actinic damage
    • Pre-malignant lesions (actinic keratoses)
  • Microdermabrasion (Superficial Exfoliation):
    • Fine lines, early photoaging
    • Mild, superficial acne scarring
    • Dull complexion, uneven skin tone/texture
    • Superficial dyschromia (e.g., melasma, PIH)

⭐ Microdermabrasion is generally safe for all skin types (Fitzpatrick I-VI) with minimal risk of post-inflammatory hyperpigmentation, making it a preferred option for superficial concerns in skin of color.

Dermabrasion & Microdermabrasion - No-Go Zones

  • Absolute Contraindications:
    • Active infections (bacterial, viral e.g., herpes simplex)
    • Recent isotretinoin use (within 6-12 months)
    • History of keloids/hypertrophic scarring
    • Immunodeficiency states
    • Bleeding disorders
  • Relative Contraindications:
    • Active acne, rosacea
    • Darker skin phototypes (Fitzpatrick IV-VI)
    • Prior radiation therapy
    • Unrealistic expectations

⭐ Recent isotretinoin use (within 6-12 months) is a critical contraindication due to impaired wound healing and increased risk of atypical scarring.

Dermabrasion & Microdermabrasion - How It's Done

Dermabrasion

  • Technique: Controlled surgical skin planing; removes epidermis & superficial dermis.
  • Instrument: High-speed rotary device + abrasive attachments (diamond fraise, wire brush).
  • Anesthesia: Local (infiltration, nerve blocks), tumescent, cryoanesthesia (ethyl chloride/Frigiderm spray), or general.
  • Key Steps:
    • Pre-op: Antiviral prophylaxis (HSV). Skin cleansing.
    • Intra-op: Skin held taut. Precise depth control. Debris wiped.
    • Post-op: Occlusive dressing, strict sun avoidance.

Microdermabrasion

  • Technique: Superficial epidermal exfoliation. "Lunchtime peel".
  • Instruments:
    • Crystal-based: Fine inert crystals (e.g., Al₂O₃) abrade, vacuum removes.
    • Diamond-tip: Diamond-encrusted tip abrades, vacuum removes. (No loose particles)
  • Anesthesia: Typically none; topical anesthetic if patient is sensitive.
  • Key Steps: Skin cleansed. Multiple passes. Moisturizer & sunscreen post-procedure.

Dermabrasion equipment and procedure

⭐ Dermabrasion requires pre-operative antiviral prophylaxis (e.g., acyclovir) to prevent herpes simplex reactivation, especially for perioral procedures.

Dermabrasion & Microdermabrasion - Healing & Hues

  • Dermabrasion Pre-op: Antiviral prophylaxis (e.g., Acyclovir) if history of herpes simplex to prevent reactivation.
  • Post-procedure Care (Both):
    • Gentle wound care; keep moist.
    • Strict sun avoidance (SPF 30+).
    • Liberal use of emollients.
    • Expect erythema, edema; resolves gradually.
  • Microdermabrasion: Superficial; minimal downtime; repeat sessions often needed.

⭐ Post-inflammatory hyperpigmentation (PIH) is a common concern, especially in darker skin types (Fitzpatrick IV-VI); meticulous sun protection is key to prevention and management after both procedures. Advise broad-spectrum sunscreen.

Dermabrasion & Microdermabrasion - Uh Oh Moments

  • Dermabrasion Risks:
    • Pigmentary changes (hyper/hypo)
    • Scarring, keloids
    • Infections (bacterial; viral: HSV reactivation)
    • Milia, acneiform eruptions
    • Prolonged erythema
  • Microdermabrasion Risks:
    • Mild: transient erythema, petechiae
    • Very low scarring/pigmentary risk

⭐ HSV reactivation is a key dermabrasion risk, especially perioral; antiviral prophylaxis is often indicated.

High‑Yield Points - ⚡ Biggest Takeaways

  • Dermabrasion reaches deeper dermis for significant resurfacing; Microdermabrasion is superficial, targeting stratum corneum.
  • Indications: Dermabrasion for deep acne scars, rhinophyma; Microdermabrasion for fine lines, dullness, mild texture issues.
  • Dermabrasion has longer recovery and higher risks like pigmentary changes, scarring, and infection.
  • Contraindications for Dermabrasion: active infections (e.g., herpes), recent isotretinoin use, keloidal tendency.
  • Microdermabrasion is safer for darker skin types (Fitzpatrick IV-VI) due to lower dyspigmentation risk.

Practice Questions: Dermabrasion and Microdermabrasion

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