What does a microdermabrasion treatment do to the skin?

Microdermabrasion is a minimally invasive skin treatment that exfoliates the outermost layer of skin. Depending on the device, a practitioner may use crystal microdermabrasion, where fine crystals are passed over the skin, or a diamond tip combined with suction to remove dead skin and surface debris.

The treatment is commonly used to improve uneven skin tone, fine lines, enlarged pores, age spots and superficial dark spots. Some microdermabrasion treatments are also used to reduce the appearance of mild acne scars, although deeper scarring is unlikely to respond in the same way.

By removing surface build-up, microdermabrasion facials can leave the skin looking smoother and, in some cases, brighter. The treatment may also help stimulate blood flow to the treated area and stimulate collagen production as part of the skin's natural renewal response.

Southwark Council's A-Z of Special Treatments describes microdermabrasion as a treatment that uses a handheld device to gently exfoliate the outermost layer of the skin. Because it targets the uppermost layer, it is generally less intensive than deeper chemical peels or surgical dermabrasion.

Can microdermabrasion make skin worse?

Microdermabrasion can damage the skin if treatment irritates more of the protective surface layer than intended. Over-treatment can disrupt the skin barrier and increase dryness, sensitivity and inflammation. Stroud District Council's guidance on non-surgical cosmetic procedures warns that these treatments can carry serious health risks if things go wrong and says practitioners should be trained and able to respond to complications. More serious problems may arise where treatment is too aggressive for the patient's skin type or is performed on already compromised skin.

Can microdermabrasion cause scarring?

Scarring is uncommon but can occur if the skin is significantly injured or a patient is prone to raised scars. A proper consultation should therefore consider any history of abnormal scarring or previous reactions before treatment goes ahead. Deep scars are also unlikely to be substantially improved by a superficial treatment. Unexpected scarring, particularly alongside burns or delayed healing, should be medically assessed.

Can microdermabrasion trigger breakouts or make acne worse?

Some people notice spots or breakouts after microdermabrasion, but active acne can also make skin more vulnerable to irritation. A consultation should consider whether inflammation, broken skin or another condition makes treatment unsuitable at that time. The NCBI review lists active skin infections as contraindications. Patients should also disclose acne medicine such as isotretinoin so suitability can be assessed. Cosmetic Surgery Solicitors supports claims involving negligent acne treatments and skin resurfacing procedures.

Can microdermabrasion cause pigmentation changes?

Yes. Pigmentation changes are a recognised risk following skin irritation or injury.

Post inflammatory hyperpigmentation can occur when inflammation causes increased melanin production, leaving dark marks after the skin heals. DermNet explains that post-inflammatory hyperpigmentation can follow skin injury and is often more noticeable or persistent in darker skin tones.

People with dark skin or a history of pigmentation after injury may be at higher risk. Sun exposure can also darken existing marks, so sun protection is important during recovery. Although microdermabrasion may improve superficial uneven skin tone, a consultation should establish whether it is suitable for the person's skin type and concern.

What should skin normally look like after microdermabrasion?

Most patients experience only mild and short-lived changes after treatment. Treated skin can look pink or red, feel sensitive and become slightly swollen for a short period.

Southwark Council notes that the skin can appear red immediately after microdermabrasion and that this redness usually fades after a few hours. Some people may also experience temporary tenderness, dryness or sensitivity while the treated skin recovers.

Dry or flaking skin can also occur while new skin replaces the dead skin cells removed during exfoliation. These changes should gradually settle rather than worsen.

When does redness become a warning sign?

Redness on its own is not usually a sign that microdermabrasion has gone wrong. The important factors are how severe it is, whether it is improving and whether other symptoms are developing.

Redness may need further assessment if it:

• Becomes more intense rather than fading
• Persists well beyond the expected recovery period
• Is accompanied by significant pain, heat or blistering
• Develops alongside swelling that continues to worsen
• Appears with open, weeping or slow-healing skin

A healthcare professional can assess whether persistent redness is caused by irritation, a burn, infection or another complication.

What causes microdermabrasion burns?

Microdermabrasion burns may occur when friction, abrasion or repeated treatment causes excessive irritation to the skin surface. This risk may increase if a practitioner performs too many passes, uses unsuitable settings or repeatedly treats the same area without taking the patient's response into account.

Possible signs of a burn include:

• Severe or persistent stinging
• Blistering
• Raw or broken skin
• Pain that gets worse after the procedure
• Pronounced peeling or crusting

A burn is not automatically evidence of negligence, but it may support a claim if substandard treatment caused an avoidable injury.

Who may be at higher risk of complications?

Microdermabrasion is suitable for many people, but a practitioner should not assume that it is appropriate for every patient. A proper consultation should consider the person’s skin type, medical history, current skin condition and any recent treatments or medicines that could affect healing.

Sensitive or rosacea-prone skin

People with sensitive skin, very sensitive skin or rosacea-prone skin may react more strongly to exfoliation and suction.

The practitioner should assess how reactive the skin is and decide whether treatment intensity needs to be reduced, modified or avoided altogether. Proceeding too aggressively may increase the risk of prolonged redness, irritation or other skin damage.

Active acne

Active acne can make the skin more inflamed and vulnerable to irritation.

If there are inflamed spots, pustules, open areas or broken skin, microdermabrasion may not be suitable until the condition has settled. Treating already inflamed skin could aggravate irritation and make recovery more difficult.

A practitioner should therefore assess the severity and location of the acne before deciding whether treatment should go ahead.

Open, broken or sunburned skin

Microdermabrasion should not be carried out over open wounds, broken skin or areas affected by sunburn.

These areas already have a damaged skin barrier, so further exfoliation could worsen irritation, delay healing or increase the risk of complications.

A history of cold sores

Patients with a history of cold sores should tell the practitioner before treatment, particularly if the area being treated is around the mouth or face.

Skin treatments can sometimes trigger a recurrence, so this should be considered as part of the suitability assessment and treatment plan.

A tendency to develop raised scars

Patients who have previously developed raised scars, including hypertrophic or keloid scars, may need additional consideration before treatment.

Although microdermabrasion is a superficial procedure, a history of abnormal scarring can still be relevant when assessing how the skin may respond if irritation or injury occurs.

Recent cosmetic skin treatments

Recent chemical peels, laser treatment or other treatments may leave the skin more sensitive than usual.

A practitioner should establish what procedures have recently been carried out and whether the skin has had enough time to recover before further exfoliation is performed.

Medicines that may affect healing

Current or recent medicines can also affect suitability.

This may include acne medicine or other treatments that make the skin more sensitive, dry or prone to irritation. The practitioner should ask about relevant medication as part of the consultation and take this into account before treatment begins.

A thorough consultation gives the practitioner the information needed to assess risk and decide whether treatment should proceed, be modified or be postponed.

How can over-treatment make the skin worse?

Microdermabrasion removes part of the skin's protective surface, so the skin needs time to recover between treatments.

Repeated exfoliation before the skin heals may increase irritation and barrier damage rather than creating smoother skin. Practitioners may recommend different intervals depending on skin type, treatment intensity and recovery. If the area remains red, painful or compromised, another session should not go ahead without reassessment.

How should skin be cared for after treatment?

Aftercare is intended to protect sensitive skin while the outer barrier recovers. The practitioner should explain what the patient should and should not do following treatment, including which products or activities could increase irritation.

Use gentle skincare

The treated skin may be more sensitive than usual, so harsh or abrasive products should generally be avoided during the early stages of recovery.

Advice may include:

• Using a gentle cleanser instead of physical scrubs or exfoliating brushes
• Keeping the skin moisturised while it heals
• Delaying strong active skincare products until sensitivity has settled
• Avoiding scratching, picking or pulling flaking skin

Using products that are too harsh too soon after treatment may increase irritation and make it harder for the skin barrier to recover.

Use sun protection

Freshly treated skin can be more vulnerable to sun exposure, so sun protection is an important part of aftercare.

Patients may be advised to:

• Apply broad-spectrum SPF 30–50 daily after treatment
• Limit unnecessary sun exposure while the skin heals
• Avoid allowing the treated area to become sunburnt

This can also help reduce the risk of pigmentation changes becoming more noticeable after treatment.

Avoid heat and further irritation

If the treated area remains flushed, sensitive or slightly swollen, activities that increase heat or irritation may make symptoms worse.

This can include avoiding excessive heat and delaying other treatments until the skin has recovered sufficiently.

Follow the advice given by the clinic

Patients should follow the aftercare instructions provided for their individual treatment, as these may differ depending on skin type, treatment intensity and how the skin responds.

If symptoms begin to worsen despite following that advice, or the skin is not healing as expected, the clinic should be contacted for further assessment. Where symptoms are severe or continue to deteriorate, medical advice should be sought.

When should medical advice be sought?

Medical advice should be sought if the skin is not recovering as expected or symptoms become more severe. A GP, dermatologist or other appropriate healthcare professional may need to assess persistent pain, blistering, open skin, increasing redness, infection symptoms, significant pigmentation changes or unexpected scarring. Photographs and medical records can also help document how the problem developed.

When can worsening skin indicate negligence?

Skin worse after microdermabrasion does not automatically mean negligence has occurred. A claim generally requires evidence that the practitioner failed to meet the expected duty of care and caused avoidable harm. Cosmetic Surgery Solicitors explains this test in our cosmetic surgery claims process.

Before treatment

The practitioner should assess suitability, including skin type, medical history, medication, existing conditions and recent treatments. The patient should also be told about relevant risks, realistic outcomes and alternatives, including where microdermabrasion is unlikely to improve a deeper concern.

During treatment

The procedure should be performed to an appropriate standard using a technique and intensity suitable for the patient's skin. The practitioner should monitor the area and respond if it becomes unusually irritated rather than continuing despite signs of damage.

After treatment

The practitioner should provide clear aftercare instructions and explain what recovery should look like. If the patient reports worsening symptoms, the clinic should assess the concern and arrange appropriate advice or medical review where needed.

What evidence can support a claim?

Evidence can help show what treatment was given, how the skin changed afterwards and whether the clinic responded appropriately.

Useful evidence may include:

• Consultation and consent records
• Treatment notes and device settings where recorded
• Dated photographs of redness, burns, pigmentation or scarring
• Messages, emails or calls with the clinic
• GP or dermatologist records
• Receipts for medication, corrective treatment or other expenses
• Independent medical evidence where appropriate

CSS's cosmetic surgery compensation guide explains how evidence and the effects of an injury may be considered when a claim is assessed.