Procedure guide
What dermabrasion does for scars and wrinkles, and what to expect.
Written by Orr Shauly, MD, plastic surgery resident. Updated .
For information and education only, not medical advice.
The short answer.
Dermabrasion mechanically sands away the outer layers of skin with a rotating tool or abrasive paper, so that new skin heals smoother and more level, most often for raised or acne scars, surgical scars and wrinkles around the mouth.1,2 New skin usually covers the surface within 5 - 7 days, with redness lasting up to about 4 weeks.3 In a randomized, blinded trial of 15 patients, manual dermabrasion improved surgical scars in 80% at 6 months.4
- 5 - 7 Days
- for new skin to form
- Typical time for the treated surface to reepithelialize after dermabrasion.3
- 80%
- of surgical scars improved
- Patients whose treated scar half looked better at 6 months in a randomized, blinded split-scar trial.4
- About 1 / 3
- develop milia
- Share of patients who develop small white cysts after dermabrasion, which usually clear on their own.1
What dermabrasion is.
Dermabrasion is one of the oldest resurfacing techniques. A handheld rotary tool with a diamond fraise or wire brush, or abrasive paper used by hand, removes the outer skin down to a controlled depth in the dermis.1,2 The pattern of bleeding guides depth, from fine pinpoint bleeding in the upper dermis to more scattered bleeding deeper down.1,2
Its main use today is leveling raised scars, especially acne scars, so they sit even with the surrounding skin. It works well for isolated scars and the lip border, but even treatment of large areas is technically demanding.2,3 Unlike chemical peels and heat-based lasers, dermabrasion leaves a permanently thinner dermis rather than a thickened one.2
How dermabrasion compares.
| Treatment | Depth | Best Suited For |
|---|---|---|
| Dermabrasion1,2 | Into the dermis, controlled by the surgeon | Raised and acne scars, surgical scars and perioral wrinkles |
| Microdermabrasion1 | Outer epidermis only | Mild sun damage, fine lines and blending, over 5 - 12 sessions |
| Ablative Laser2,5 | Into the dermis, with heat | Similar uses, with a bloodless field and more precise depth |
In a split-scar comparison, dermabrasion and high-energy CO2 laser produced comparable improvement in surgical scars, with similar healing time and redness, although the laser side bled less.5
Who is a candidate.
Fitzpatrick skin types I - III usually heal with a uniform blended color. Type IV calls for caution, and types V and VI are best not dermabraded because of the risk of darkening.1 A small test spot in a hidden area can be considered first, although it does not predict the overall outcome.1
- Avoid: Active cold sores or skin infection, severe radiation damage and congenital conditions affecting skin appendages.1
- Use Caution: A history of keloids or thick scars, deep burns and darker skin types.1
- Isotretinoin: Textbooks list recent use as a contraindication, while a 2017 consensus found insufficient evidence to delay manual dermabrasion but advised against powered dermabrasion during treatment.1,6
- Scar Type: Deep, wide or ice-pick scars may not improve much and may need multiple treatments.1
How dermabrasion is performed.
- Preparation: Antibiotics and antiviral medication are started beforehand, and makeup is removed.1
- Anesthesia: General anesthesia or sedation with nerve blocks is used, and some surgeons freeze the skin to stiffen it.1,3
- Protection: Everyone in the room wears eye and face protection because tissue and blood are sprayed.1
- Treatment: Scars and wrinkles are marked, and the tool is moved carefully, especially near the lips and eyelids, until the target bleeding pattern appears.1,2
- Dressing: Ointment is applied, with or without a nonstick dressing.1,2
Recovery.
| Time | What Usually Happens |
|---|---|
| First Hours2 | A wet dressing is used until bleeding stops, then ointment is applied |
| Days 5 - 73 | New skin covers the treated area |
| About 1 Week1 | Oral antibiotics and antivirals are completed |
| Weeks 2 - 41,3 | Redness fades and milia may appear, usually clearing on their own |
Risks and complications.
- Darkening: Hyperpigmentation is most common in skin types III - IV and in patients who skip sunscreen, and it usually responds to topical treatment.1
- Lightening: Hypopigmentation results from treatment that is too deep and usually improves with time.1
- Milia: Small white cysts develop in about 1 / 3 of patients, usually 2 - 4 weeks after treatment.1
- Scarring: Gouging from an angled tool or treatment that is too deep can scar, and early steroid injection helps limit thick scars.1
- Infection: Infection should be rare, and antivirals are given to prevent cold sore outbreaks.1
- Tissue Injury: The rotating tool can catch and tear free edges such as the lips and eyelids, so surgeons control its direction carefully.1
Patients are counseled that deep wrinkles and scars will not be completely removed and that more than one session or fillers may be needed.1
What the evidence shows.
- Surgical Scars: Sanding facial scars 6 - 8 weeks after surgery improved the treated half in 80% of 15 patients, with 47% having an excellent response.4
- Tools Compared: In 21 patients, a powered diamond fraise and hand sanding with drywall screen worked equally well for scars after skin cancer surgery.7
- Electrobrasion: In a randomized, double-blind trial, dermabrasion and an electrosurgical alternative both improved scars, with no significant difference between them.8
- Scar Reviews: A review of 214 randomized trials included dermabrasion among the mechanical treatments with demonstrated efficacy for postoperative scars.9
- Acne Scars: A systematic review found only one recent dermabrasion study for acne scars, while microdermabrasion gave the weakest results of the treatments reviewed.10
What we don't know yet.
Common questions.
What is the difference between dermabrasion and microdermabrasion?
Dermabrasion removes skin into the dermis under anesthesia and can level scars and deeper lines. Microdermabrasion is an office treatment that only exfoliates the outer skin, so it helps fine lines and texture but not deeper scars.
Can dermabrasion remove acne scars?
It can level raised and shallow scars, but deep, wide or ice-pick scars may improve only partly and often need more than one treatment or other methods.
How long is recovery after dermabrasion?
New skin usually forms within about a week, and redness can last for several weeks. Daily sunscreen is important for months afterward.
Is dermabrasion safe for darker skin?
Darker skin has a higher risk of uneven pigment after dermabrasion. Textbooks advise caution in skin type IV and generally avoiding it in types V and VI.
When can a surgical scar be dermabraded?
In one randomized trial, facial surgical scars were sanded 6 - 8 weeks after surgery, and most improved. Your surgeon can advise on timing for your scar.
Is dermabrasion right for me?
Only an in-person evaluation can answer that. This guide is educational and cannot assess an individual case. A qualified plastic surgeon or dermatologist can examine your skin and scars and discuss options with you.
Key terms.
- Dermabrasion
- Mechanical removal of the outer skin layers to a controlled depth so smoother skin can regrow.
- Microdermabrasion
- A superficial office treatment that exfoliates only the outer skin with crystals or a diamond tip.
- Diamond Fraise
- A rotating metal wheel coated with industrial diamonds used for dermabrasion.
- Dermasanding
- Dermabrasion performed by hand with sterile abrasive paper or screen.
- Milia
- Small white keratin cysts that can appear on healing skin.
- Papillary Dermis
- The upper layer of the dermis, just beneath the epidermis.
- Reepithelialization
- Regrowth of the outer skin layer over a wound.
References.
- 1.Broughton G 2nd, Baker JL Jr. Dermabrasion. In: Janis JE, editor. Essentials of aesthetic surgery. New York: Thieme; 2018. p. 259-68.
- 2.Basci D, Kenkel J. Nonsurgical facial rejuvenation and skin resurfacing. In: Chung KC, editor. Grabb and Smith's plastic surgery. 8th ed. Philadelphia: Wolters Kluwer; 2020. p. 459-71.
- 3.Gold MH. Dermabrasion in dermatology. Am J Clin Dermatol. 2003;4(7):467-71. PubMed
- 4.Poulos E, Taylor C, Solish N. Effectiveness of dermasanding (manual dermabrasion) on the appearance of surgical scars: a prospective, randomized, blinded study. J Am Acad Dermatol. 2003;48(6):897-900. PubMed
- 5.Nehal KS, Levine VJ, Ross B, Ashinoff R. Comparison of high-energy pulsed carbon dioxide laser resurfacing and dermabrasion in the revision of surgical scars. Dermatol Surg. 1998;24(6):647-50. PubMed
- 6.Spring LK, Krakowski AC, Alam M, Bhatia A, Brauer J, Cohen J, et al. Isotretinoin and Timing of Procedural Interventions: A Systematic Review With Consensus Recommendations. JAMA Dermatol. 2017;153(8):802-9. PubMed
- 7.Gillard M, Wang TS, Boyd CM, Dunn RL, Fader DJ, Johnson TM. Conventional diamond fraise vs manual spot dermabrasion with drywall sanding screen for scars from skin cancer surgery. Arch Dermatol. 2002;138(8):1035-9. PubMed
- 8.Kleinerman R, Armstrong AW, Ibrahimi OA, King TH, Eisen DB. Electrobrasion vs. manual dermabrasion: a randomized, double-blind, comparative effectiveness trial. Br J Dermatol. 2014;171(1):124-9. PubMed
- 9.Kodumudi V, Gomez-Lara A, Baghchechi M, Gharavi N, Rosenthal A. Postoperative scar treatment modalities: a systematic review of randomized controlled trials. J Cosmet Laser Ther. 2025;27(6-8):207-18. PubMed
- 10.Kravvas G, Al-Niaimi F. A systematic review of treatments for acne scarring. Part 1: Non-energy-based techniques. Scars Burn Heal. 2017;3:2059513117695312. PubMed