Pinpoint bleeding skin#

Atrophy of the pilosebaceous unit induced by isotretinoin may increase wound healing time. Patients on isotretinoin or who have been treated with isotretinoin in the previous six months are historically considered poor candidates for dermabrasion. It has been suggested that all patients should receive antiviral prophylaxis prior to dermabrasion. Patients with a history of HSV should be prophylactically treated with antiviral medication, such as acyclovir or valacyclovir, from two days prior to two weeks after the procedure. The infection should be dormant for at least six to eight weeks prior to the procedure. Patients with active herpes simplex virus (HSV) infection should not be treated with dermabrasion.

Pinpoint bleeding skin#

Ablation of skin down to the dermis disrupts the collagenous infrastructure, increasing fibroblast activity and resulting in the formation of new collagen type I, dermal remodeling, and clinical improvement in the appearance of the skin. Hair follicles and sebaceous glands rooted in the dermis are crucial to the regeneration of the abraded dermis and epidermis. Dermabrasion of tissue beyond this level significantly increases the risk of adverse events, such as scarring and dyspigmentation.

ĭermabrasion can be safely performed to the level of the superficial or mid-reticular dermis. The reticular dermis is made up of large collagen bundles, which appear as yellow parallel fibers superficially, and frayed white fibers in the deeper reticular dermis. The papillary dermis has a rich vascular supply pinpoint bleeding is observed upon abrasion of this layer.

To safely perform dermabrasion, the surgeon must be familiar with the appearance of each of these layers. The dermis is subdivided into the more superficial papillary dermis and deeper reticular dermis. From superficial to deep, the epidermis is composed of the stratum corneum, stratum lucidum (in acral areas), stratum granulosum, stratum spinosum, and stratum basale. The skin is divided into two layers: the epidermis and the dermis.