In this article, you are going to learn about a procedure that’s called dermabrasion. Don’t confuse it with microdermabrasion, I will write about microdermabrasion in the future(here it is). For now, let’s dig into the biology and the structure of the skin. That way you can understand better how this operation works.
Biology and Structure of the Skin, a few basic things before we go ahead.
“What is skin?” Skin is the organ that consists the outer covering of the body. It is the largest organ of our body and performs a variety of functions, heat regulation, evaporation control, touch and protection of the inner body parts such as muscles, bones and other organs. These are just a few, we will return to the functions in just a minute.
- The Epidermis – here you will mostly meet four kinds of cells, keratinocytes, melanocytes, Langerhans cells and Merkels cells.
Epidermis is divided into 5 sublayers,
- The epidermis is the outermost layer of the skin. It helps in regulating the body temperature and it serves as a waterproof barrier between the body and the environment. It also protects us from Ultra Violent Radiation(Sunlight), various pathogens and other harmful agents. The epidermis has no blood supply and for this reason, is nourished by diffusion from the dermis. The epidermis is the layer of the skins that always gets removed/damaged with dermabrasion. That means that after the operation we have Zero protection from Sunlight.
- The Dermis – is a layer of the skin that is beneath the epidermis, dermis, and epidermis are tightly connected with each other. The dermis is primarily composed of connective tissue (collagen fibers, elastin, extra fibrillary matrix) and is responsible for the sense of heat and touch. It has nerve endings, hair follicles, sweat glands, sebaceous glands, apocrine glands, lymphatic vessels and blood vessels. The dermis is divided into two regions, papillary region, and reticular region. The reticular region is the deeper one and sometimes acne can cause scars that deep. Tattoo inks are held in the dermis.
- The Hypodermis (or subcutaneous tissue)– As you can imagine, the hypodermis lies below the dermis. It contains about 50% of body fat which is used mainly for insulation. The hypodermis has a lot of functions, but the main is to store fat. The hypodermis has another reason to exist though. This is to attach the skin to muscles and bones that exist beneath it. In this layer, you will also find fibroblasts, which are the cells that synthesize the extracellular matrix and collagen, both very important when it comes to scar healing.
History and evolution of dermabrasion
Dermabrasion is a surgery operation performed by a medical professional such as a dermatologist or plastic surgeon. This person is specially trained for this procedure. Dermabrasion has very long history and the modern technique was developed back in 1905. Since then few things have changed. Dermabrasion was used as a mean of making the skin look younger removing facial blemishes and other scars. The idea behind this operation is that you can remove a controlled thickness of damaged skin and then through normal wound healing rejuvenate skin and make you look younger, with less scarring, if any. The effectiveness depends on many factors, such as the depth of the scars, the skill of the doctor and others that we will discuss bellow.
In dermabrasion, we mechanically remove the outer layers of the skin. The depth of the procedure varies. The “first” level is removing the epidermis. Till that deep, the procedure is considered very safe, even though some pigmentation might occur in some cases. The wound heals in 7 to 10 days after the operation. The “second” level is deeper wounding of the skin extending into the dermis, sometimes till the reticular region(the deeper region of the dermis). Dermal regeneration is much slower because many cells that are needed for the healing process get removed/damaged also. You will need months before you heal completely. You also have a greater risk of complications. Specifically, penetrating till the reticular region has a high risk of scarring. As you can understand for someone with thick scars, will need thick wounds through dermabrasion to remove them completely but that might leave him with even worse scars if something goes wrong. This is the reason many scars don’t fade completely even after dermabrasion, most people prefer the safe way that removes some part of the scarring. The skill of doctor plays an important role here.
Cost and Doctor Selection
The cost of Dermabrasion usually fits somewhere between 200~2500$. I recommend not to be stingy, do research of the doctor that is about to operate you and be sure he/she has lots of experience. Paying more money in advance will save you from troubles and more “follow-ups” afterward that might cost you more. After all, when it comes to your face, you want someone you know you can trust. As I said before the skill of the doctor is important, too deep and you might get bad scars or very long healing time, too shallow and you won’t have great results. A good rule of thumb here is going to a doctor that has experience.
Follow Up, What after?
After you do the procedure you are not finished. There are many things you have to do. You must avoid the sun at any cost. I don’t recommend sunscreen except if you totally trust that the company has ingredients that won’t do more bad to your skin than the sun will. Also, you should take care of your skin immediately after the dermabrasion. The way you will take care of your skin will determine the success of dermabrasion. You have to keep it moist, that will help you avoid scabbing and scarring in some cases. Don’t forget that it is a wound and not only that, it is a wound that you don’t want to leave scars. So treat it every day with extreme care. Ask your doctor what should you do for best results, and follow the advice given. Don’t forget that bandages don’t protect you from Ultra Violent sunlight as sunscreens do, don’t get deceived, you are not protected. Most of all and extremely important EAT WELL. Nutrition is critical when it comes to wound healing. Since you won’t get enough sun, you might consider a vitamin D supplement. No sun exposure equals lower levels of vitamin D, you should also ask your doctor about that. I would recommend a multivitamin (including vitamin D) in the healing period.
***Since many men ask, doing two “light” dermabrasion procedures is pointless if a part of the scar is in the dermis, not the epidermis, no matter how many times you “change” your epidermis, your dermis will remain intact as well as it’s scaring.
Dermabrasion and acne
- What happens if you still have acne? Is dermabrasion going to help? NO, it won’t. Dermabrasion is a procedure that helps you get rid of shallow acne scarring and discoloration(darker skins be careful!) with great results. It also helps improve deep scars. But if you still have acne, that means that your skin is not healthy yet. A dermabrasion procedure will be like having a broken leg and go out running to strengthen it. Not a good idea. If you have acne, you should do what you can for your skin to be healthy again and then IF you need a dermabrasion procedure go for it.
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