Dermabrasion vs. Microdermabrasion: What’s The Difference?

Sure, dermabrasion and microdermabrasion sound similar, but they are very different procedures. Here’s what you need to know about the benefits of each.
Written by Amber Katz
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Dermabrasion vs. Microdermabrasion: What’s The Difference?Nicola Fioravanti/Unsplash

Even the most skincare savvy among us may be confused by the differences between dermabrasion and microdermabrasion. After all, they practically share the same name and can both be effective skin resurfacing procedures. Here, we’re breaking down the two treatments in terms of invasiveness, technology, and what aesthetic concerns each address to help you understand which might be the best choice for you.

Dermabrasion vs. Microdermabrasion

Yes, dermabrasion and microdermabrasion are similar in theory, but they are very different in reality. “While both sound similar and are resurfacing procedures that damage the skin in a specialized manner to improve it, they are otherwise pretty dissimilar,” says New York City-based board certified dermatologist Blair Murphy-Rose, MD. Dermabrasion and microdermabrasion differ greatly in their intensity, depth of skin damage and, therefore, in the results, downtime, and associated risks.

In a nutshell, dermabrasion is the mechanical removal of the epidermis and upper layer of the dermis. Microdermabrasion, meanwhile, is a minimally invasive treatment option that exfoliates the surface of the skin. While microdermabrasion is suitable for all skin types, dermabrasion is best for people with lighter skin — usually Fitzpatrick skin types I through III, explains Jennnifer Levine, MD, a double board certified facial plastic and reconstructive surgeon in NYC.

Now that we understand the differences between the two, it’s time to explore the ins and outs of each.

Dermabrasion 101

Dermabrasion is a surgical method that uses a high-speed rotary tool to abrade the skin in order to resurface it, Dr. Murphy-Rose says. She likens the device to a “sanding-like” tool that can penetrate deep into the skin. “Layers of skin are essentially removed down into the upper dermis and then, through the natural healing process, a new layer of healthier, smoother skin replaces them,” she adds.

The procedure typically requires local or general anesthesia and comes with one to two weeks of downtime. High-quality dermabrasion can reduce deeper wrinkles, lines, pigmentation, and other textural abnormalities (like scars), explains Jessica Weiser, MD, a board certified dermatologist in NYC. But it’s not without risk. “Dermabrasion carries risk of infection, discoloration, and scarring,” she says.

Popular Types of Dermabrasion

Dermabrasion can be performed with a motor-powered diamond fraise, wire brush, or serrated wheel. Alternatively, it can be done manually using a medium-grade drywall sanding screen. “Dermabrasion rapidly planes the skin surface,” Dr. Weiser explains. The tool used will likely depend on what you are trying to treat. “The wire brush is best used for deeper scars and irregularities, whereas the fraise and wheel are typically utilized to soften the edges of skin removed by the wire brush,” Dr. Weiser says.

What to expect from dermabrasion

Prior to dermabrasion, you’ll be treated with pain medication, local anaesthetic for nerve blocks, and, on occasion, general anesthesia. “Eyes are covered to protect from possible spray, and the skin is sometimes treated with gentian violet stain to monitor how deep the treatment is extended,” Dr. Weiser shares. “The skin is held taut and then abraded, leading to a raw skin surface and some bleeding.”

You can expect significant redness, swelling, and moderate pain (managed by pain medication). Bleeding may also occur after treatment. “As the area heals, scabbing or crusting will occur and the redness and swelling will eventually subside over one to two weeks,” Dr. Murphy-Rose says. “You will need to follow your doctor’s instructions and take very good care of your skin during the healing process to prevent infection.” You’ll also want to ask your doctor when it’s safe to go into the sun again. “During the healing process, you should avoid all exposure to sunlight on the treated area,” she says. Most doctors will also advise avoiding strenuous exercise for about a month post-procedure.

Microdermabrasion 101

While dermabrasion lives at the invasive side of the aesthetic procedure spectrum, microdermabrasion falls at the other end. “Microdermabrasion is a non-invasive procedure that removes the dead skin cells from the epidermis to help exfoliate the skin surface,” Dr. Weiser explains. It does not, however, reach the viable skin cells of the lower epidermis and superficial dermis. Microdermabrasion can improve superficial skin concerns such as fine lines, brown spots, and enlarged pores, Dr. Murphy-Rose says.

Microdermabrasion, which is generally considered painless and involves little to no recovery time, can be done with a diamond or crystal tip tool. “A handheld device sprays tiny crystals onto the skin causing light skin abrasion or exfoliation to the outermost ‘dead’ skin cells with minimal discomfort, no real downtime, and without the need for anesthesia,” Dr. Murphy-Rose explains.

There are also over-the-counter skincare devices with microdermabrasion in their names. These are exfoliators designed to mimic the benefits of the in-office procedure at-home — albeit in a less intensive manner.

Popular Types of Microdermabrasion?

Microdermabrasion is best suited for younger skin. It can also be a helpful treatment option for acne-prone skin types. The most common forms of microdermabrasion include:

  1. Crystal Tip: “Crystals are sprayed on the skin surface and a vacuum-based tip suctions up both dead skin cells and loose crystals,” Dr. Weiser says. It’s best for acne because the crystals also have antibacterial properties.
  2. Diamond Tip: This technique involves a tip made from natural or synthetic diamond chips with attached suction. “The diamond abrades the dead skin cells which are removed by the vacuum-based suction,” she notes.
  3. Dermasweep: A gentler vacuum pump with a silk, nylon, or polyester bristle-tipped head is used to allow for greater customization.

What to expect from microdermabrasion

Unlike the seven to 14 days of downtime associated with dermabrasion, there is little to no downtime with microdermabrasion. “There is a mild scratching sensation over the skin surface — sometimes in single or repeated passes — depending on the skin type,” Dr. Weiser says. Post-treatment, your skin may appear pink or red. Dr. Levine likens it how the skin looks after a scrape. “Any procedure or product that causes exfoliation will make you more sensitive to the sun, so excellent sun protection is essential,” Dr. Murphy-Rose advises. She recommends applying mineral sunscreen daily and wearing a hat and sunglasses after microdermabrasion. Other tips? Skip washing your face the day of. In the following days, opt for a gentle cleanser and moisturize liberally. “You can otherwise go about your regular routine without limitations,” Dr. Murphy-Rose says.

Which Procedure Is Best for You?

Generally speaking, microdermabrasion can be an effective treatment option for patients with acne, pore congestion, and oily skin. At lower settings, it can be used for drier skin types as well. “Very sensitive skin does not respond well to microdermabrasion, and treatment should also be avoided in patients on Accutane therapy where the skin surface is very fragile,” Dr. Weiser notes. It is also not a good choice for patients with rosacea, eczema, and lupus because the treatment stimulates blood flow to the skin, which can worsen certain skin conditions.

Dermabrasion, meanwhile, is best suited for those with significant textural abnormalities such as scarring, wrinkles, and sun damage. It can be used to treat small areas with deep wrinkles (think: lines around the mouth). “These wrinkles are hard to treat and need a treatment that will go deep enough to fully address the wrinkle,” Dr. Levine explains. As such, it is also good for scars and acne scarring. Additionally, someone who has failed to achieve desired results from fractional laser resurfacing may be a candidate.

But it’s not for everyone. “Because it can go deep, it may lead to the stimulation of melanocytes, causing the cells to produce more or less pigment,” Dr. Levine notes. Therefore, it is not recommended for people with darker skin. “Darker skin types may be more prone to adverse effects like pigmentation changes, and anyone prone to keloid formation should avoid dermabrasion,” Dr. Murphy-Rose explains. “Any underlying medical conditions causing poor wound healing would be a contraindication to treatment.”

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AMBER KATZis a contributing writer for AEDIT.

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