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Dermabrasion

  • Ramona BehshadEmail author
Chapter

Abstract

Dermabrasion (DA) has been in the dermatology armamentarium since the early 1900s with both aesthetic and therapeutic indications. DA physically removes the superficial skin layers in a stepwise fashion and allows healing to occur with a more cosmetically acceptable result. There are a variety of abrasive instruments available to perform DA. Mechanical DA uses a rotating diamond fraise or wire brush attached to a motorized hand piece to abrade the epidermis and papillary and/or reticular dermis. The wire brush has numerous small caliber, stainless steel wires that project circumferentially from the curved side of a cylindrical hub, while the diamond fraise consists of a stainless steel cylinder to which industrial-grade diamonds are bonded to create the abrasive surface. Selection of an appropriate end piece for use in the handheld rotary motor is up to the preference of the surgeon, but there has been a slow movement toward the diamond fraise because it is less aggressive and more forgiving than the wire brush (Alt, J Dermatol Surg Oncol 13:618–624, 1987). An alternative to mechanical DA is manual DA, which is performed in an analogous fashion by hand with a variety of coarse surfaces such as sandpaper, drywall screen, electrocautery tip cleaners, the diamond fraise unattached to the electric motor, abrasive pads, tangential planning or scalpel sculpting with a standard #15 surgical blade or razor blade, as well as the standard curette. Regardless of motorized or manual DA selected, depth of injury is controlled by the amount of pressure holding the instrument tip against the skin, the speed of rotation/abrasion, the coarseness of the tip chosen, and the patient’s skin type and texture (Orentreich and Orentreich, Dermatol Clin 13:313–327, 1995). The operator has excellent control of the anatomic depth of tissue removed, since the depth of tissue can be visualized sequentially from epidermis and the papillary, superficial, and deep reticular dermis.

Keywords

Dermabrasion Scar revision Rhytids Mechanical resurfacing Wrinkles Acne scars 

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of DermatologySaint Louis UniversitySaint LouisUSA

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