# Dermabrasion for Acne Scars: What the Literature Says and Why I Don’t Recommend It What the literature says about dermabrasion for acne scars, why I stopped recommending it, and what I use the technique for today. [Dr. Walter Zamarian Jr.](https://www.walterzamarianjr.com/us/walter-zamarian/) · CRM-PR 17.388 · RQE 15.688 Published February 19, 2026 · Updated October 24, 2026 [Read the article ↓](#leitura) ## At a glance: does dermabrasion work for acne scars? The medical literature describes dermabrasion for shallow acne scars, but I don’t recommend it for acne or acne scarring. Over large areas, such as a whole cheek, it can leave the skin permanently lighter (hypopigmentation). Today, I use the technique only to revise surgical or traumatic scars on the face. - Literature: improves shallow scars; does little for narrow, deep ones. - Risk: permanent color change, higher over large areas and in darker skin. - My practice: I don’t treat acne or acne scars with dermabrasion. - Current use: facial scar revision, which takes 20 to 30 minutes. - Isotretinoin: I wait 12 months after it has been stopped. - Alternatives: there are options with a lower risk of discoloration, which I don’t offer. My [dermabrasion](https://www.walterzamarianjr.com/us/face/dermabrasion/) page explains how I use the technique today, in facial scar revision. In this article, I go over what the literature says about dermabrasion for acne scars and why I stopped recommending it for them. The comparisons with other treatments are for education only: I don’t offer lasers, peels, microneedling, or fillers. ## Not all acne scars are alike Depressed acne scars are usually described as three types [1]. Ice-pick scars are narrow and deep, like a puncture. Boxcar scars have sharp edges and a flatter base. Rolling scars create an undulating surface, because fibrous bands beneath the skin pull it down. There are also raised, hypertrophic scars, which call for a different approach altogether. The type matters because each one involves a different problem: the edge of the scar, a tether beneath it, or lost volume. A treatment that smooths the surface does not release a fibrous band, and many people have more than one type of scar in the same area. ## What the literature describes Dermabrasion mechanically removes the outer layers of the skin with a wire brush or a diamond burr; the skin then regrows from the structures left deeper down. A 2022 review describes it as particularly effective for superficial rolling and boxcar scars, with minimal improvement in deep ice-pick scars [1]. The same review reports complications such as persistent pain, redness, and permanent discoloration, notes that results depend heavily on the operator, and warns that going deeper than intended can cause new scarring. The authors add that dermabrasion has gradually been replaced by chemical peels and lasers, which offer similar, if not greater, resurfacing capacity with a less extensive recovery [1]. The specific evidence is also thin. A systematic review of acne-scar treatments covering ten years of publications found a single study in the abrasive-technique category, and it assessed microdermabrasion, not surgical dermabrasion [2]. ## Why I don’t use dermabrasion for acne For many years, dermabrasion was widely used for acne scars, and I used it for them myself in the past. I stopped recommending it because of hypopigmentation: when dermabrasion covers large areas or goes deeper, it can damage the cells that produce pigment, and the treated area may end up permanently lighter than the rest of the skin. The risk is higher in darker skin. The American Society of Plastic Surgeons (ASPS) lists a change in skin pigmentation as the most common risk of dermabrasion: the skin may darken with sun exposure, or the treated area may stay a little lighter or blotchy [3]. Because acne scarring usually spreads across the cheeks, treatment would have to cover exactly that kind of large area. A permanent light patch there can draw more attention than the scars it was meant to soften. ## Where dermabrasion still has a role Today, I use dermabrasion only in the revision of surgical or traumatic scars on the face: scars that have become wide, raised, or irregular, on a small, well-defined area. The ASPS lists dermabrasion among the surface treatments used in scar revision [4]. I wait at least six months for the scar to mature. I start with dermabrasion, then remove the old scar and stitch the skin closed again, changing its direction or using a Z-plasty or W-plasty when needed. In my hands, the procedure takes 20 to 30 minutes. I use total intravenous anesthesia (TIVA), as I do for almost all my surgeries. When the revision is done without a facelift, you can go home the same day if you wish: since I schedule these cases for the afternoon, discharge is at around 10 p.m. For most revisions, one session is enough; for very extensive or deep scars, I may suggest a second stage after six months, but that is the exception. I prefer to schedule it between March and September, which is fall and winter in Brazil, when sun exposure tends to be lower. During recovery, the area is covered with silver sulfadiazine until the new skin forms, around day five to seven. After that, I ask you to wear SPF 30 or higher sunscreen twice a day, and I add a lightening cream around day 14. Redness fades over about two months, and I recommend avoiding tanning for at least six months. ## Isotretinoin: the interval I follow Many people with acne scars have taken isotretinoin. Before a scar revision with dermabrasion, I wait twelve months after the medication has been stopped. In 2017, a consensus from the American Society for Dermatologic Surgery concluded that superficial, focal dermabrasion may be safe when performed by a well-trained clinician, even with recent use of the medication [5]. Even so, I keep to a twelve-month interval in my practice. Don’t stop any medication on your own. ## Other approaches described for acne scars The literature describes other techniques for each part of an acne scar: subcision to release the bands under rolling scars, focal techniques such as TCA CROSS and punch excision for ice-pick scars, and chemical peels for the surface [1, 2]. For acne scarring, there are also options such as fractional lasers and radiofrequency microneedling, with a lower risk of discoloration than extensive dermabrasion. I don’t offer these treatments. My article on [dermabrasion, chemical peels, and laser resurfacing](https://www.walterzamarianjr.com/us/blog/dermabrasion-vs-chemical-peel-vs-laser-resurfacing/) explains how they differ. Whatever the technique, no treatment erases an acne scar completely. A responsible goal is to make it less noticeable, and the degree of improvement varies from person to person. For acne scarring, see a clinician who performs these treatments and can explain what each one can change in your skin. ## Frequently asked questions Does dermabrasion work for acne scars? The literature describes it for shallow scars, but I don’t recommend it for acne or acne scarring, because of the risk of hypopigmentation over large areas. I use dermabrasion only to revise surgical or traumatic scars on the face. Is dermabrasion the same as microdermabrasion? No. Microdermabrasion is a superficial cosmetic treatment that removes only the outermost layer of the skin. Surgical dermabrasion uses a high-speed diamond burr, reaches the superficial dermis, and requires anesthesia. Do you offer laser or peels for acne scars? No. I don’t offer lasers, peels, microneedling, or fillers. They appear in this article only to explain what the literature describes. I have taken isotretinoin. Can I have a scar revised? Yes, twelve months after stopping the medication. That is the interval I follow in my practice. Can I go in the sun after dermabrasion? Avoid tanning for at least six months and wear SPF 30 or higher sunscreen twice a day. New skin discolors more easily. ## Is a scar on your face bothering you? If your scar is from surgery or an injury, [write to us on WhatsApp](https://www.walterzamarianjr.com/us/contact/): Bruna, my AI assistant, handles the first contact and then puts you in touch with Isanna to arrange a consultation with me. I’ll examine the scar and your skin and explain what a revision can improve, and what it cannot change. ## References - Tam C, Khong J, Tam K, et al. [A Comprehensive Review of Non-Energy-Based Treatments for Atrophic Acne Scarring](https://pmc.ncbi.nlm.nih.gov/articles/PMC8963193/). Clin Cosmet Investig Dermatol. 2022. - Kravvas G, Al-Niaimi F. [A systematic review of treatments for acne scarring. Part 1: Non-energy-based techniques](https://pmc.ncbi.nlm.nih.gov/articles/PMC5965325/). Scars Burn Heal. 2017. - American Society of Plastic Surgeons. [Dermabrasion Risks and Safety](https://www.plasticsurgery.org/cosmetic-procedures/dermabrasion/safety). - American Society of Plastic Surgeons. [Scar Revision Procedure Steps](https://www.plasticsurgery.org/reconstructive-procedures/scar-revision/procedure). - Waldman A, Bolotin D, Arndt KA, et al. [ASDS Guidelines Task Force: Consensus Recommendations Regarding the Safety of Lasers, Dermabrasion, Chemical Peels, Energy Devices, and Skin Surgery During and After Isotretinoin Use](https://pubmed.ncbi.nlm.nih.gov/28498204/). Dermatol Surg. 2017. ## About the author I am Dr. Walter Zamarian Jr., a plastic surgeon in Londrina, Brazil. My practice focuses on deep plane facelift surgery with fat grafting. Here I explain my approach, the available evidence, and the limits of each treatment. CRM-PR 17.388 · RQE 15.688 [Read about my training and practice →](https://www.walterzamarianjr.com/us/walter-zamarian/) This article provides general information and does not replace an individual medical consultation. [← Back to the blog](https://www.walterzamarianjr.com/us/blog/) [Explore my options](https://wa.me/16402248116?text=Hi%21%20I%20read%20%E2%80%9CDermabrasion%20for%20Acne%20Scars%3A%20What%20the%20Literature%20Says%20and%20Why%20I%20Don%E2%80%99t%20Recommend%20It%E2%80%9D%20on%20the%20blog%20and%20would%20like%20to%20know%20which%20procedure%20is%20right%20for%20me.)