Skin Resurfacing

What is skin resurfacing?

Skin resurfacing is any procedure that removes the top layer of your skin and allows new, healthier, and smoother looking skin to become the new surface. Make sure that you clearly understand what the procedures can and cannot do for you. All of them have some risks.

When is it done?

Skin resurfacing procedures are done to improve the health and appearance of scarred skin or skin damaged by acne, the sun, or chemicals. Even if your skin does not have a lot of damage, skin resurfacing may be done to keep the skin looking youthful, smooth, and healthy.

How do I prepare for this procedure?

Before agreeing to a procedure:

• Find out as much as possible about the best procedure for you.
• Learn about the risks involved.
• Get information about the healthcare provider you may be considering to do the procedure. Always select a board-certified dermatologist or plastic surgeon with training and experience in the procedure you want to have.

Health insurance does not usually cover cosmetic surgical procedures such as skin resurfacing. Call your health plan to find out what is covered.

Ask your healthcare provider what you need to do to prepare for the skin resurfacing procedure.

Most resurfacing procedures are done in your healthcare provider's office. You will be going home that same day. Arrange to have someone take you to and from the procedure.

What happens during the procedure?

There are several ways to remove a layer of skin:

• dermabrasion
• microdermabrasion
• chemical peels
• laser resurfacing

Dermabrasion is a surgical procedure that affects deep layers of the skin. It uses a rotating brush to take off the top layers of the skin. Dermabrasion sands down the skin to create smoother skin with fewer wrinkles. Dermabrasion may be used to remove:

• acne scars
• other scars
• sun spots
• wrinkles
• liver spots, freckles, and other pigmented areas
• tattoos

You will be given a regional anesthetic to prevent pain in the area where you are having the surgery. You may also be given a sedative, which will make you sleepy. Your healthcare provider will use a diamond sanding brush to sand the skin. The skin thickness will be worn down by the brush, creating smoother skin. Often your provider will do more than 1 treatment, and you may have dermabrasion along with another technique, such as a chemical peel, several weeks later.

After a dermabrasion your skin will be tender and swollen for several days, with the most swelling in the skin around the eyes. Your skin will look like it has a bad sunburn.

Weeks later your skin may have areas of darkened skin or small, white dots like acne. This is normal and it usually goes away.

In microdermabrasion tiny crystals are used to polish the skin. A vacuum technique is used to remove the crystals. No anesthetic is needed. Microdermabrasion gives the skin an overall fresh, healthy-looking glow. Mild and temporary redness occurs after treatment. Five or 6 treatments every 1 or 2 weeks yield the best results.

Chemical peels use a chemical to treat fine lines under the eyes and around the mouth. This procedure can reduce or get rid of some of the wrinkles caused by aging, hereditary factors, and sun damage. Severe wrinkles, sags, and bulges do not respond well to chemical peeling.

In general, the reaction following a chemical peel is like a sunburn. The type of chemical peel that is done affects the type of skin reaction:

• Superficial peels cause redness that is followed by scaling for 3 to 7 days.
• Medium-depth and deep peeling usually cause swelling and water blisters that may break, crust, turn brown, and peel off in 7 to 14 days.

You may need pain medicine before or after a deep peel procedure.

When laser resurfacing is done, a beam of laser light is used to remove layers of the skin. It can be used with other procedures. It is effective on sun-related skin changes, scars on the face, and blemishes. Before the procedure is done, you will be given a local anesthetic to keep you from feeling pain. The laser gives your healthcare provider more control over how deep he or she goes into the skin.

A few days after laser resurfacing, your face may be pink or red and thinly crusted. It will take 5 to 7 days for the skin to heal. It takes up to 6 months for all of the redness to go away.

Many dermatologists and plastic surgeons perform all 4 of these procedures. Which procedures are best for you depends on several things. Your provider can discuss this with you.

What are the benefits of this procedure?

The benefits of skin resurfacing procedures are:

• smoother skin
• fewer wrinkles
• younger looking skin
• improvement of damaged skin

The effects of skin resurfacing procedures usually last months to years.

What are the risks of this procedure?

Each skin resurfacing procedure has risks.

The risks of dermabrasion and microdermabrasion are:

• scarring
• skin color changes, that is, a permanent darkening or lightening of your natural skin color
• infection

The risks of chemical peels are:

• scar formation with deep peels
• infection
• pain after the procedure

The risks of laser resurfacing are:

• infection
• allergic skin reaction
• lightening of your skin color over the resurfaced area
• scarring
• tooth enamel injury if your teeth are not well covered and protected during the procedure
• injury to the surface of the eyes (corneal abrasion) if your eyes are not covered during the procedure

When should I call my healthcare provider?

Call your provider right away if:

• Your skin begins to bleed.
• You develop a fever or other signs of infection.

Call during office hours if:

• You are having pain from the procedure.
• You have questions about changes in your skin color.