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Dermabrasion Procedure For Acne Scar TreatmentDermabrasion as an ablative surgery procedure is used for physically removing the epidermis and dermis of the skin in a controlled fashion using a fine wire brush or a diamond fraise. This technique is also widely used for removing facial rhytids and for treating various other skin conditions. It is considered one of the best acne scar treatment out of the large number of acne scar treatment options available with cosmetic surgery. The ablation produced by the dermabrasion for the acne scar treatment helps in skimming off the damaged dermis and epidermis and rejuventating the skin. A dermabrasion procedure for removal of facial rhytids or acne scar treatmentshould be performed only after all the precautions for preparing the surgery have been taken.
Acne Scar Treatment - Dermabrasion Treatment ToolsMost dermabrasion instruments for dermabrasion procedure or acne scar treatment use a wire brush or diamond fraise for producing the wound or for acne scar treatment. The instruments vary in quality, coarseness, and shape. A powered low to high rpm hand held motor is employed for driving the wire brush or diamond fraise. A spray refrigerant is used for preparing the skin immediately before dermabrasion.
Acne Scar Treatment-Dermabrasion ProcedureDermabrasion treatment as an skin refreshning or acne scar treatment procedure should be performed in an operating room using strict exposure and safety precautions. Because of the risk of exposure to blood-borne pathogens through the microdroplets of blood and tissue aerosolized during the procedure, all operating rooms needs to be cleansed thoroughly and sterilized before and after dermabrasion procedures.
The instruments and equipment that is used for acne scar treatment procedure also needs to be sterilized to avoid any contamination.
Most dermatologic surgeons today have specific surgical rooms or suites in which to conduct the procedure for the acne scar treatment. These rooms should have proper ventilation, lighting, operating tables, and equipment for patient monitoring and/or anesthesia.
Preparing the skin immediately before the procedureBefore the acne scar treatment is performed the skin is pretreated with an ice pack for 20 to 30 minutes immediately before the dermabrasion. The skin is sprayed with a liquid refrigerant. Several short blasts of the spray in a small area are well tolerated. The area to be dermabraded is manually stabilized by the surgeon and the assistant together according to the normal contour of the patient’s tissue. For the optimum results with dermabrasion for acne scar treatments, it is essential for the skin to be firm.
AnesthesiaThe use of anesthesia for the dermabrasion procedure as an acne scar treatment or othewise varies from surgeon to surgeon as well as from procedure to procedure, like the procedure performed for acne scar treatment can be a little different than removing facial rhytids.
Anesthetic considerations include the size of the area to be dermabraded (eg, the central cheek versus the full face), the depth of the acne scars and required dermabrasion, the patient’s pain tolerance, and the patient’s overall health.
Most dermabrasion acne scar treatment procedures can be performed using local anesthesia alone or in conjunction with some form of sedation. Pretreatment with pain medication is often employed for the comfort of the patient.
Instead of using a separate refrigerant, a refrigerant topical anesthesia can also be used to help freeze the skin prior to the dermabrasion procedure is performed for the acne scar treatment. A variety of refrigerants combined with anesthesia are available in certain countries.
An assistant will usually spray the refrigerant and hold the skin taut while the anesthesia can be administered by the surgeon.
But many cosmetic surgeons of today prefer using anesthesiologists or nurse anesthetists to provide adequate anesthesia – either general or IV sedation.
Control of Dermabrasion ProcedureFor the ablative resurfacing with dermabrasion to be effective, it is required that the dermabrasion be carried down to the dermis, but avoiding the subcutaneous layer at all costs. It is required from the cosmetic surgeon to determine the most appropriate wire brush or diamond fraise to be used.
Once appropriate anesthesia has been administered, the surgical field may be painted with a gentian violet solution to help outline the defects to be treated. The purple color of the gentian violet is used as a guide during the dermabrasion procedure to maintain orientation because of potential bleeding while dermabrading. The dermabrasion is performed to the desired depth using specific criteria. A decrease in pigmentation is encountered while going through the epidermis.
The procedure proceeds in a set pattern, treating one anatomic unit at a time – each surgeon will have their own preferences. Some cosmetic surgeons like to dermabrade the forehead first, then the cheeks, chin, upper lip and lastly the nose. Others may use a different treatment pattern.
The areas dermabraded are treated one anatomic unit at a time with feathering at potential lines of demarcation. The procedure may require 15 minutes to 1 hr depending upon the size of the acne scar treatment area involved.
Care with the dermbrasion procedureDermabrasion is a technique-dependent procedure,one needs enough operative experience to be well versed with the technique prior to performing this therapy. More experienced surgeons can achieve better results. The Fast removal of acne scars performed by an inexperienced surgery always has risks of complications after the surgery.
Care needs to be taken with the diamond fraises or wire brushes as well. These should be moved in steady, firm, back and forth strokes using even pressure throughout. Wire-brush end pieces are moved unidirectionally. The depth of the dermabrasion can be controlled depending on the depth of the acne scar to be removed.
As the skin thaws, bleeding begins. Various biologic and non-biologic sterile dressings are used to stop the bleeding and cover the wound. Intensive Post operative care with dermabrasion or acne scar treatment is some what similar to that of chemical peeling.
Though one has to undergo a fair amount of discomfort and post operative care is required, derbmbrasion is the most trusted effective acne scar treatment.
Michael H. Gold, Dermabrasion in Dermatology, Am J Clin Dermatol 2003; 4 (7): 467-471
Deborshi Roy, MD, Ablative Facial Resurfacing, Ophthalmol Clin N Am 18 (2005) 259 – 270