Editor’s note: This article has been excerpted from the new Physiology of the Skin, Third Edition book by Zoe Draelos, MD, and Peter T. Pugliese, MD, which was released in February 2011 by Allured Books. The book can be purchased online at www.AlluredBooks.com.
There are two basic methods of altering the surface of the skin: chemical and physical. Chemical alterations are accomplished by applying acids to the skin causing the cells of the stratum corneum to separate and slough off. Superficial chemical peels using glycolic and salicylic acid make the skin smooth and soft by this mechanism. Another mechanism of removing the stratum corneum cells is to physically rub, blast or grind them off. This physical type of removal is used in microdermabrasion and dermabrasion.
Dermabrasion was first developed as a medical procedure to improve the appearance of scarred skin and was later adapted to photoaged skin. It was originally done with a wire brush that literally ground off the surface of the skin. This procedure was quite bloody and painful, but was successful in improving severely scarred skin by smoothing the surface of the skin. The healing time was prolonged, taking weeks for the scabs to resolve and months for the redness to improve. In addition, sometimes the treated skin became lighter than the untreated skin as it healed, making skin color an issue. Dermabrasion could not be used on people who had deeply pigmented skin.