Dermabrasion

The charts below show the chances of developing various side effects from dermabrasion.1-3,7,8 For some side effects, we currently do not have enough data to provide a percentage.

Certain/Likely Side Effects (% = Incidence)

SHORT TERM Scabbing of treated skinup to 100%
SHORT TERM Sun sensitivityup to 100%
SHORT TERM or LONG TERM Redness (erythema)*13% to 100%
SHORT TERM Clogged sweat glands in the skin (milia/milk spots)**5% to 100%
SHORT TERM Red, itchy, scaly rash (eczema)incidence not known

*Skin redness (erythema): Skin redness after dermabrasion is normal and may persist for weeks or sometimes even months.1

**Clogged sweat glands (milia): Clogged sweat glands are very common after dermabrasion but may be removed by simple extraction.2 

Possible/Rare Side Effects

LONG TERM Prolonged or permanent
lightened skin (hypopigmentation)*
up to 10%
LONG TERM Prolonged or permanent darkened skin (hyperpigmentation)**2-8%
SHORT TERM Treated area looks
different from surrounding skin
(treatment demarcation lines)
incidence not known
SHORT TERM Flare-up of cold
sores or fever blisters (herpes simplex)
incidence not known
SHORT TERM Bacterial or viral infectionsincidence not known
LONG TERM Unapparent scars becoming
visible (unroofing of unapparent scars)
incidence not known
LONG TERM Spider veins (telangiectasia)incidence not known
LONG TERM Raised scars (keloid or
hypertrophic scarring)
incidence not known

*Lightened skin (hypopigmentation): In hypopigmentation, the return of pigment begins at about 4-6 weeks and may take up to a year.1 Hypopigmentation is more common in dark-skinned individuals.2

**Darkened skin (hyperpigmentation): Hyperpigmentation usually resolves slowly over several months.1 Hyperpigmentation is more common in dark-skinned individuals.2

†Cold sores or fever blisters (herpes simplex): Patients with herpes simplex infections (such as patients who have developed cold sores in the past) may experience a herpes flare after dermabrasion. Doctors should either avoid dermabrasion in areas where flare-ups have previously occurred, or preventively treat patients with antiviral medications before and after dermabrasion.2

‡CAUTION. Keloid scarring:  Keloid scarring occurs in a small number of patients. Black patients are more likely to develop keloid scars. Patients who have experienced keloid formation or have a family history of keloid formation are at greater risk for developing keloid scars from dermabrasion.2

‡CAUTION. Hypertrophic scarring: Hypertrophic scarring occurs in a small number of patients after dermabrasion and is more common in darker-skinned individuals. Hypertrophic scarring after dermabrasion was first reported in patients who were taking isotretinoin therapy. To reduce the risk of hypertrophic scarring, doctors recommend waiting at least 6 months after stopping isotretinoin therapy before undergoing dermabrasion. Still, the connection between isotretinoin and hypertrophic scarring is not ironclad. Some people choose to undergo dermabrasion while taking isotretinoin and do not develop hypertrophic scarring. Others develop hypertrophic scarring even though they never took isotretinoin.1-3

Sometimes, acne may reoccur after dermabrasion.2

Studies:   

Two studies have looked at the side effects of dermabrasion.

  • Study 1:

    • Authors: Aronsson et al.7
    • Total # of patients: 25
    • # of female patients: 18
    • # of male patients: 7
    • Age of patients: 20-42
    • Duration of treatment and follow-up: 1 session, follow-up at 3 months and 1 year
    • Side effects:
      • Hyperpigmentation: 8% Milia (clogged sweat glands) (frequency not reported)
  • Study 2:

    • Authors: Maddin et al.8
    • Total # of patients: 54
    • # of female patients: (not reported)
    • # of male patients: (not reported)
    • Age of patients: (not reported)
    • Duration of treatment and follow-up: 1 session, follow-up at 12 months
    • Side effects:
      • Persistent erythema (redness): 13%
      • Milia (clogged sweat glands): 5%
      • Hypopigmentation: 10%
      • Hyperpigmentation: 2%

Study 1: In a study published in 1997 in the journal Acta Dermato-Venereologica, Aronsson and colleagues performed dermabrasion on 25 patients and followed up with the patients 3 months and 1 year after treatment. The researchers found milia (clogged sweat glands) in most patients, but all of these later disappeared. Because most patients had fair skin, few experienced pigmentation problems. Only two patients, who had had severe scars, developed hyperpigmentation after dermabrasion. The researchers also found a slight tendency to form hypertrophic scars in a few patients (frequencies not reported).7

Study 2: In a study published in 1960 in the Canadian Medical Association Journal, Maddin and colleagues looked at the side effects of dermabrasion in 54 patients. The researchers found persistent erythema (redness), milia (clogged sweat glands), hypopigmentation, and hyperpigmentation in a minority of patients. They did not observe keloid or hypertrophic scar formation in any of the patients.8

References
  1. Rivera, AE. Acne scarring: a review and current treatment modalities. J Am Acad Dermatol 59, 659-676 (2008).
  2. Roenigk, HH. Dermabrasion: state of the art 2002. J Cosmet Dermatol 1, 72-97 (2002).
  3. Levy LL, and Zeichner JA. Management of acne scarring, part II. A comparative review of non-laser-based, minimally invasive approaches. Am J Clin Dermatol. 13(5), 331-340 (2012).
  4. Frank W. Therapeutic dermabrasion: back to the future. Arch Dermatol 130(9), 1187-1189 (1994). 
  5. Nelson BR, et al. A comparison of wire brush and diamond fraise superficial dermabrasion for photoaged skin: A clinical, immunohistologic, and biochemical study. Journal of the American Academy of Dermatology 34(2), 235-243 (1996).
  6. Pavlidis L, and Spyropoulou G.A. A simple technique to perform manual dermabrasion with sandpaper. Dermatol Surgery 38(12), 2016-2017 (2012).
  7. Aronsson A, Eriksson T, Jacobsson S, and Salemark L. Effects of dermabrasion on acne scarring. A review and a study of 25 cases. Acta Derm Venereol. 77(1), 39-42 (1997).
  8. Maddin S, Danto JL, and Steward WD. Dermal abrasion for the removal of acne scars. Can Med Assoc J. 82, 1072-4 (1960).