Dermatology · patient guide
Dermabrasion — mechanical resurfacing, done properly.
A clinically reviewed guide to dermabrasion — how it differs from microdermabrasion and laser resurfacing, who it suits, what the recovery honestly looks like, and how to avoid the pigment problems that catch people out.
Why patients choose us
- 01
A consultant dermatologist or plastic surgeon
Dermabrasion is a surgical resurfacing procedure — not a beauty-room treatment. Depth control is the difference between a good result and a scar.
- 02
The right tool for the scar
Ice-pick and boxcar scars sometimes need subcision or fractional CO2 rather than dermabrasion. We say so before you book.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Key facts
What dermabrasion is — and, more usefully, what it is not.
A mechanical resurfacing procedure — a category of its own, distinct from the beauty-room microdermabrasion and from laser resurfacing.
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Mechanical, not chemical or laser
A high-speed rotary wheel or wire brush removes the epidermis and part of the dermis. Depth is controlled by the operator, second by second.
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Not microdermabrasion
Microdermabrasion sands the outermost dead skin only — no downtime, no clinical effect on scars. Dermabrasion is a proper surgical procedure.
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A different tool from CO2 laser
Fractional CO2 and Er:YAG lasers ablate skin with heat; dermabrasion does it with friction. Results overlap, but each has its own best indication.
The journey
From consultation to review — step by step.
Consult, test patch if needed, procedure, aftercare, six-to-eight week review.
Phase 1 · Before
Assessment, planning, test patch
Phase 2 · Procedure
Theatre, anaesthetic, resurfacing
Phase 3 · After
Aftercare and review
- 01
Before
You tell us what you would like treated
A short, confidential form. What you want changed, your skin type, past treatments and any tendency to scar or pigment.
- 02
Before
Consultant assessment
A named dermatologist or plastic surgeon examines the area, confirms whether dermabrasion is the right tool and discusses alternatives.
- 03
Before
Test patch if needed
For darker skin (Fitzpatrick IV–VI) or unusual scars, a small test patch is treated first to check for pigment change or keloid tendency.
- 04
Procedure
The procedure itself
LA, IV sedation or GA depending on area size. Sterile technique, high-speed rotary abrasive wheel, careful depth to the reticular dermis.
- 05
After
Aftercare — the part that matters most
Occlusive dressing, meticulous cleansing, no picking of crusts, prophylactic aciclovir if HSV history, and strict sun avoidance for six months.
- 06
After
Six to eight week review
Re-epithelialisation is complete by two weeks; erythema fades over months. We review at 6–8 weeks and again at six months.
Re-epithelialisation: 7–14 days. Erythema fades over: 2–6 months. Strict sun avoidance: 6 months.
When it helps
When dermabrasion is the right tool.
The situations we see most, plus the one red flag that means postponing rather than proceeding.
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Ice-pick and boxcar acne scars
Deep, sharply demarcated acne scars — often the best indication for dermabrasion when combined with subcision.
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Traumatic tattoos
Ingrained dirt or gunpowder from a wound — dermabrasion removes the pigmented epidermis and superficial dermis.
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Actinic (sun) damage
Diffuse photo-damage, fine wrinkling and actinic keratoses on the face — resurfaces the damaged epidermis.
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Rhinophyma
Thickened, bulbous nasal skin from long-standing rosacea — dermabrasion sculpts and smooths the contour.
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Surgical or traumatic scars
Blends the edges of a healed scar with surrounding skin — usually 6–8 weeks after the original wound.
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Perioral rhytides
The fine vertical lines around the mouth — a classic indication where dermabrasion still outperforms many lasers.
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Pre-malignant lesions (selected)
Widespread actinic keratoses when field treatment is preferred — usually alongside a dermatologist’s wider plan.
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Red flag: active infection or recent tan
Active HSV, impetigo or a recent sun tan means postponing — treating on top risks scarring and pigment change.
Resurfacing options
Dermabrasion is one option among several.
What each alternative actually involves — and which fits which skin and which scar.
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Dermabrasion
Mechanical resurfacing to the reticular dermis with a rotary wheel or wire brush. Best for deep acne scars, perioral lines and rhinophyma.
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Microdermabrasion
A very superficial exfoliation of the stratum corneum. No downtime, no anaesthetic — cosmetic polish rather than scar treatment.
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Fractional CO2 laser
Ablative fractional resurfacing. Comparable results to dermabrasion for many scars, with more predictable depth and less operator variability.
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Er:YAG laser
A gentler ablative laser with shallower thermal damage — quicker healing, less erythema, but often needs more sessions.
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Deep chemical peel (phenol)
Chemical resurfacing to the papillary or reticular dermis. Excellent for perioral lines; cardiac monitoring required for phenol.
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Microneedling with radiofrequency
Fractional dermal remodelling with minimal epidermal disruption. Safer in darker skin; multiple sessions needed.
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Subcision
A needle released tethered acne scars from below — often the essential first step before dermabrasion or laser.
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Consultation only
An honest discussion of whether any procedure is warranted, and which combination fits your skin and scarring.
Our vetted London network
A small panel of resurfacing specialists, we picked them.
Consultant dermatologists and plastic surgeons across central London. Introductions are made privately, once we understand your skin and what you would like changed.
Selection criteria
How we choose every clinician in our network.
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Consultant dermatologists or plastic surgeons — not aestheticians
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Sterile theatre or minor-ops suite, not a treatment room
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Test-patching offered for Fitzpatrick IV–VI skin
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Prophylactic antivirals and antibiotics prescribed where indicated
Safety and red flags
The complications worth knowing — honestly.
Dermabrasion is safe in the right hands and the right patient. Most trouble comes from wrong skin type, sun exposure, unrealistic expectations or a recent tan.
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Hypertrophic scarring
Overly deep abrasion or aggressive aftercare can leave a raised scar. Skilled depth control and honest patient selection prevent most cases.
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Hypopigmentation
Permanent loss of pigment is the classic long-term risk — most common in Fitzpatrick skin types IV–VI. A test patch is essential.
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Post-inflammatory hyperpigmentation
Darker skin can develop patchy brown pigmentation for months. Strict sun avoidance and topical tyrosinase inhibitors reduce the risk.
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Infection
Bacterial infection is uncommon with proper aftercare; prophylactic antibiotics are used selectively. Persistent redness or pus needs review the same day.
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Prolonged erythema
Pink to red skin for two to six months is normal after dermabrasion. Concealer-friendly by six weeks in most people.
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Milia formation
Tiny white cysts appear as skin re-forms — a temporary nuisance that resolves or is easily removed at the six-week review.
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HSV reactivation
Cold-sore virus reactivates readily on abraded skin. Prophylactic aciclovir is prescribed for anyone with a history of oral or facial HSV.
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Isotretinoin history
Historically avoided within six months of isotretinoin; more recent evidence permits earlier treatment but the decision is a judgement call by the consultant.
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Sun avoidance for six months
The single biggest determinant of a good result. High-factor sun protection and physical avoidance from day one, without exception.
Reasons to think again — or postpone
- · Keloid tendency in you or first-degree relatives
- · Fitzpatrick IV–VI skin without a test patch first
- · History of oral or facial HSV without aciclovir cover
- · Unrealistic expectations of a single-session cure
- · Active skin infection or inflammatory acne
- · A recent sun tan or plans to travel to sun
- · Anticoagulants that cannot be safely paused
- · Current smoking — impairs healing meaningfully
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used, the note the consultant sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and depth
Why the procedure was done — acne scarring, rhinophyma, actinic damage — and the depth of abrasion (papillary or reticular dermis).
- 02 Technique
Anaesthetic and instrument
Whether it was done under LA, IV sedation or GA, the abrasive used (diamond fraise or wire brush), and the area treated in centimetres.
- 03 Findings
Intra-op notes and prophylaxis
Notes on bleeding, immediate result, and any antivirals or antibiotics started.
- 04 Impression
Aftercare, review and expected course
Read this first: dressings, cleansing, sun-avoidance rules, when to worry, and the review dates at six weeks and six months.
Recognised by major UK insurers
Cover for dermabrasion varies by insurer and by indication — usually funded for post-traumatic or reconstructive cases, self-pay for cosmetic scar revision. We confirm cover before booking.
Frequently asked
Everything we get asked about dermabrasion.
Quick answers on downtime, pain, darker skin, laser comparisons and long-term care.
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What is dermabrasion, and how is it different from microdermabrasion?
Dermabrasion is a surgical resurfacing procedure that removes the epidermis and part of the dermis with a high-speed rotary abrasive wheel — done under anaesthetic and followed by real downtime. Microdermabrasion is a superficial cosmetic exfoliation with no downtime and no clinical effect on scars.
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Is dermabrasion still done, or has laser replaced it?
Both are used. Fractional CO2 and Er:YAG lasers have taken over much of the field because depth is more predictable, but dermabrasion still has the edge for deep perioral lines, rhinophyma and selected acne scars — particularly in experienced hands.
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How long does it take to heal?
Re-epithelialisation completes over 7–14 days behind an occlusive dressing. Erythema (pinkness) then fades over two to six months. Full collagen remodelling continues for a year.
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Does it hurt?
During the procedure you feel nothing — either the area is fully numb, or you are sedated or asleep. Afterwards there is soreness and a raw, weeping feeling for a few days, controlled with simple painkillers.
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Is dermabrasion safe for darker skin?
It can be, but the risks of hypopigmentation and post-inflammatory hyperpigmentation are meaningfully higher in Fitzpatrick IV–VI. A test patch is essential, and microneedling with radiofrequency is often a safer first choice.
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When can I go back to work and normal life?
Most people take 10–14 days off. Make-up is usually possible by two weeks. Sun exposure must be avoided for six months, and high-factor sun protection continued indefinitely on the treated area.
Sources and further reading
- British Association of Dermatologists. Patient information leaflets.
- American Academy of Dermatology. Dermabrasion — patient overview.
- European Dermatology Forum. Guidelines on resurfacing procedures.
Reviewed by the Pulse Atlas Editorial Board · Published 2026-07-30 · Next review 2027-07-30 · Reading time 5 min
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