Dermabrasion or " sanding" is a procedure used in selected cases to remove irregularities in the skin surface. It is performed by employing a rotating wire brush or diamond wheel to plane down or sand the irregular area. An improved appearance is obtained by making the surface uniform.
Old acne scars and chicken pox marks can be improved as well as certain superficial skin discoloration. Dermabrasion is also used to treat fine lines and wrinkles especially those in the upper and lower lip regions. The surgeon is able to produce a fine and easily controllable depth of abrasive surgery. It must be emphasised that in severe acne scarring several procedures will be necessary over a period of time.\par \par The patient is admitted on the morning of sur gery. Small areas can be treated under local anaesthesia. Large areas are best treated under general or twilight anaesthesia.
At the end of the procedure Vaseline ointment is applied to decrease irritation. The patient is discharged home with detailed post operative instructions the same day. These instructions must be adhered to methodically.
Crusting develops on the abraded area within 2 days and gradually lifts off by 10 days depending on the depth of the abrasion. A smooth pink or brownish skin results that gradually returns to normal colour in the next 6 to 8 weeks.
Swelling invariably occurs in the immediate post-operative period. Keeping the head elevated helps to reduce this problem. Discomfort occurs and responds well to medication you will leave the Hospital with a course of antibiotics. If insomnia is a problem, sleeping tablets are prescribed. Milia, tiny white firm bumps in the skin can appear from 3 to 4 weeks post-operatively. Pigment alteration occurs in all patients for several weeks. Initially the abraded area will appear pink and less pigmented than the surrounding skin. It may take up to 6 weeks to regain normal pigmentation. Final pigment adjustment may take several months.
It is important to remember that exposure to sunlight within eight weeks following treatment may result in unfavourable discoloration. Hyper-pigmentation is directly related to the sun" s rays. All patients are strongly urged to stay OUT of the sun for this length of time. Hyper-pigmentation may be permanent.
At approximately 2 weeks post operatively you will be allowed to apply an emollient sunblock cream.
Your sunblock needs to be at least SPF 15 and should be used DAILY. In your interest, we highly recommend your wearing sunblock cream daily under any makeup used forever.
Dermabrasion may be difficult for the patient post operatively. Most patients would wish to stay out of the limelight until healing has occurred or until such time as makeup can be applied to hide the initial effect. \par \par It is recommended that patients sleep upright for the first few days to help reduce the swelling. All prescribed ointments should be applied meticulously as directed by the surgeon. After a few days the face can be washed three times daily with a soft cloth and lukewarm water. The soft crusts which form will lift off in 5 to 10 days. At this stage a bland soap can be used and unmedicated makeup applied. In men, shaving can restart.
Excessive pigmentation is seen in about 10% of the cases. It is usually temporary but can last several months. It must also be emphasised that permanent or decreased pigmentation can result but this is rare. Unfavourable healing is rare too but can occur particularly if a deep abrasion is performed. Thickened keloid scarring can result and mar the result. Further treatment would be necessary.
Avoid excessive straining, lifting, bending, intense sunlight or extremes of temperature or strong winds for 6 weeks. In addition it is vitally important to avoid contact with persons who have herpes simplex (fever blister or cold sores), shingles or chicken pox, impetigo or any other contagious skin disease. If you inadvertently come into contact with such persons, you would notify the office immediately allowing us to prescribe a preventative treatment where time is of the essence.
Pinkness, dryness and itching can be reduced with a mild anti-inflammatory lotion or cream.
The result of a successful dermabrasion can be extremely pleasing, especially if the original blemishes were very noticeable.