Marisa Marques

Dermobrasion

(outpatient surgery)

Mechanical or surgical abrasion of the skin is indicated for – Surface irregularities (actinic damage, scar and acne pits) – Pigmentation disorders – Wrinkles Dermabrasion, mechanically abrades the epidermis and upper portion of the dermis.

Although dermabrasion has become less popular as the use of laser resurfacing has increased, it is still an effective treatment with broad application. Wrinkles can be lowered and smoothed mechanically. For resurfacing, dermabrasion is most useful for perioral lines, particularly those of the upper lip. After the epidermis is removed, the pink epidermal–dermal junction is encountered. As treatment continues, fine punctate bleeding indicates the level of the papillary dermis. At the papillary–reticular junction, bleeding is increased and the surface becomes rougher, indicating the end point of treatment for most patients. The patient may clean the areas and apply more ointment as needed. Re-epithelialization is usually completed within 7 to 10 days.
 
Postoperative care
All patients with history of herpes, are treated prophylactically with antiviral agents to minimize the risk of disseminated herpes simplex. The patients are instructed to: -Use a hair dryer dayly to dry all exudates and maintain the eschar – Applies a generous layer of cream to the eschar. These applications, performed several times daily, begin the separation of the coagulum. The patient is told not to peel the coagulum from the abraded area. – Exposure to direct or reflected sunlight must be avoided for at least 12 months following treatment, and a pediatric sunscreen 50+ must be properly applied during this period.
 
Complications
Dermabrasion presents complications similar to those presented by chemical peeling, including hyperpigmentation, hypertrophic scarring, and milia, although pigmentation changes are less of a problem. In general, patients with darker skin types have a greater tendency to develop posttreatment hyperpigmentation, whereas patients with light skin are more prone toward posttreatment hypopigmentation. In the rare instance in which hyperpigmentation occurs, it usually undergoes spontaneous regression over a period of 3 to 18 months. When regression does not occur, secondary chemobrasion may help to establish a uniform color match.


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