Procedure

Microdermabrasion

A handheld device sands the dead top layer off the skin with fine crystals or a diamond tip while a vacuum lifts the debris away. It leaves skin smoother and brighter for a few days. Newer treatments now do more for acne, pigment and scarring.
Dr. Schwarz, MD · Board-certified dermatologistLast reviewed September 8, 2026
16:9 hero for Microdermabrasion. Never cropped: the tone strip and the corner logo depend on the full frame.

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Microdermabrasion was standard when I trained and has quietly been overtaken — not because it is unsafe, since it is one of the gentlest things in an office, but because a superficial peel does everything it does and reaches further, often for the same money. It still earns a place for a low-risk polish before an event, or for skin that cannot tolerate acids or retinoids, and it is one of the treatments I worry least about on deeper skin tones. Sanding the dead layer does not reach indented scars, pigment held in the deeper layer, or wrinkles, and no number of sessions changes that. If those are your goal, spend the money elsewhere — a course of ten is the part I would push back on.

— Dr. Schwarz, Board Certified Dermatologist

Key Facts

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Also calledMicroderm, crystal microdermabrasion, diamond-tip microdermabrasion, power peel
DowntimeNone. Mild pinkness for a few hours
SessionsOften sold as 5 to 6, spaced 1 to 2 weeks apart, then monthly maintenance
Typical costAbout $75 to $200 a session in the US, and often bundled into a facial. Varies widely by city and provider
Results timelineSkin looks brighter the same day. The effect lasts days rather than months
PainNone. A scratchy, sandy feeling with a light pulling from the vacuum
Skin tone safetyOne of the safer in-office exfoliations for all skin tones, as long as passes are gentle and suction is kept low

What It Is

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An office exfoliation with a handheld device that abrades the surface while a vacuum pulls the loosened material away. Crystal machines spray a fine stream of aluminum oxide crystals at the skin and suck them back up; diamond-tip machines use a roughened tip with suction and no loose crystals. Both remove the stratum corneum, the flat dead cells on top of living skin, and neither goes deeper. It is not dermabrasion, an older surgical procedure done under anesthesia that sands into the deeper layers, and it is not microneedling, which makes tiny channels into the dermis. It is often a step inside a facial rather than sold on its own.

How It Works

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The device sands away the dead cell layer while the vacuum lifts debris and the skin slightly toward the tip, so the abrasion is even. Three things follow: light reflects off a smoother surface so skin looks brighter, skin feels softer, and moisturizer sinks in rather than sitting on top. Skin rebuilds the layer within days, which is why the effect is measured in days, not months. Repeated treatment produces small changes in the epidermis, the upper part of the skin, but the abrasion stops well above the dermis, where collagen sits and where indented scars and deep pigment live. It also does not reach inside the pore, where most acne begins. That boundary is the whole story of what microdermabrasion can and cannot do.

Skin is about two millimetres thick on the face. How deep a treatment reaches decides what it can change, and whether it treats all of the skin or scattered columns of it decides how long you take to heal.

How it works
Compare
Skin basics
EPIDERMISDERMISFAT0.05 mm — pigment0.5 mm — texture + pores1.0 mm — collagen1.5 mm — deep dermisNEEDLINGNON-ABLATIVE LASERABLATIVE LASERSTAYS IN THE TOP LAYER

This works in the epidermis, the top layer, only about a tenth of a millimetre thick. That is the right depth for surface pigment, flaking and rough texture, and it is why nothing at this depth can change a scar or a wrinkle that is set in the layer below. A peel or a scrub takes the skin off evenly from the surface down. Everything above the line goes and nothing below it is touched, which is why peels suit surface pigment and rough texture, and why the whole face flakes for a few days after.

Needles make hundreds of separate channels and leave the skin between them untouched. That untouched skin is what heals the rest, so recovery is quick — but a needle only injures the skin to start repair. It removes nothing.

The light passes through the surface and heats a column underneath it. The surface stays whole, so you leave red rather than raw — and it takes a course of sessions rather than one.

The laser removes columns of skin outright: the white gaps here are tissue that is gone, and new skin grows in from the sides. The strongest of the four, and the longest to heal.

The outer layer, and the only one anything in a jar reaches. It renews itself constantly: a cell made at the bottom takes about a month to reach the surface and flake off. Most of what a skincare product does, it does here.

The living layer underneath, holding the blood vessels, the nerves and the collagen. It is where lasting change happens and it is hard to reach: most of what is sold for the skin never gets this far.

What It Treats

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No strong evidence for any condition.

Not the Best For

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Keratosis Pilaris
Keratosis Pilaris
Weak evidence
Sanding the surface has the same problem as a body scrub: the plug sits inside the follicle, below where it reaches. Any smoothness is short-lived, and it adds redness. On deeper skin tones the irritation can leave dark marks, so it is one to skip.
Close-up of the lower cheek, nose and mouth of a young person with medium-brown skin, turned three-quarters away from the camera against a pale blue background. Scattered flat dark brown marks are spread across the cheek, with a few small raised spots still active among them.
Post-Inflammatory Hyperpigmentation
Weak evidence
Sands off the very top of the skin, which is above where the pigment actually sits, so it does little for brown marks and nothing for gray ones. Repeated sessions add friction and inflammation to skin that marks easily. Money spent here is better spent on daily sunscreen and a treatment that reaches the pigment cells.
Sun Spots (Solar Lentigines)
Sun Spots (Solar Lentigines)
Weak evidence
Polishes off the very top layer of skin, which makes it briefly smoother and brighter. The pigment in a sun spot is held in ridges below that layer, so it is not reached. It is often sold as a treatment for spots and it is not one, and repeated sessions can irritate skin enough to leave marks of their own.
Stretch Marks
Stretch Marks
Weak evidence
It polishes the surface layer, and the tear that made the stretch mark is well below that. It is commonly sold as a stretch mark treatment and the published results are minimal. If a clinic is offering this as their answer, it is worth asking what else they do.
Wrinkles and Fine Lines
Wrinkles and Fine Lines
Weak evidence
Sands off the outer dead layer, so skin feels smoother and looks brighter for a few days. It does not reach the dermis, which is where wrinkles are, so it does not change them. Pleasant, safe on most skin, and frequently sold as an anti-aging treatment when it is not one.
Close-up of the cheek, nose and mouth of an adult with light skin, turned three-quarters away from the camera against a pale blue background. The surface of the cheek is uneven, dimpled with shallow depressions and small pits that catch the light. There are no active spots — the change here is in the texture of the skin rather than its color.
Acne Scarring
Weak evidence
Polishes the very top layer of skin, which is nowhere near deep enough to reach the collagen that makes a scar. It can leave skin looking brighter for a few days. It is widely sold for acne scarring and it does not change acne scarring.
Scars, Wrinkles and Deep Pigment
Doesn't work
Microdermabrasion works above the layer where scars, wrinkles and deeper pigment sit. There is no meaningful change to these, at any number of sessions.

Pros and Cons

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Pros
  • Very low risk The dead layer only, with no acid, heat or needles.
  • Comfortable and quick No numbing, no stinging, 20 to 30 minutes.
  • An immediate polish Brighter and smoother the same day, and makeup sits better.
  • Predictable Very little can go wrong.
Cons
  • Largely superseded A light peel or a home retinoid does the same and more.
  • Weak evidence beyond the surface A little surface smoothing, nothing deeper.
  • Short-lived The dead layer is back within days, so nothing is being held.
  • Usually sold as a course A package does not add up to much more than one.
  • Suction is where harm comes from Too high or too long, it bruises and bleeds.

How to Prepare

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1 week before3 to 5 days beforeOn the day
Hair removal
1 week before
Stop waxing, threading and hair removal creams on the area.
Actives
3 to 5 days before
Stop retinoids (tretinoin, adapalene, retinol), benzoyl peroxide and exfoliating acids. Skin thinned by them abrades faster than expected.
Skin condition
On the day
Do not come with a sunburn, a fresh tan, an active cold sore, a rosacea flare or inflamed acne. Clean skin, no makeup.
If crystals are used
Contact lenses come out and eye protection goes on.

What Happens

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ArrivingThe treatmentLeaving
Arriving
Skin is cleaned and dried, the provider picks a crystal or diamond tip and sets the suction, and eye protection goes on, which matters more with a crystal machine. No numbing. Your provider will ask about these things.
The treatment
The handpiece is drawn across taut skin in overlapping passes, usually two or three per area. A full face takes 20 to 30 minutes. It often finishes with a mask, serum, moisturizer and sunscreen, and is sometimes done just before extractions or a light peel. Not painful, more like fine sandpaper with steady pulling from the vacuum.
Leaving
Skin is pink, smooth and slightly tight, a little like mild windburn. The nose and upper lip feel most sensitive, and the machine noise bothers some people more than the feeling. Most of the pinkness is gone within a few hours. Products sting more than usual, so stick to plain moisturizer and sunscreen.

Recovery

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Days 1 to 3Days 3 to 7Weeks 1 to 2
Days 1 to 3
Some people get a couple of days of dryness or fine flaking. Skin is more sun-sensitive now than at any other point.
Days 3 to 7
The dead layer rebuilds, and skin looks and feels its best.
Weeks 1 to 2
The polish fades. There is no lingering effect to wait for, which is why sessions are booked one to two weeks apart.

Aftercare

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Same day2 to 3 days1 week
Makeup and exercise
Same day
Both fine, though the next morning is more comfortable for makeup. Rinse sweat off gently.
Actives
2 to 3 days
Restart retinoids and exfoliating acids after 2 to 3 days.
Sun and scrubs
1 week
SPF 30 or higher daily for at least a week — freshly sanded skin burns easily and sun is the main cause of a dark mark afterward. No physical scrubs or brushes that week.

Risks

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Most people leave pink and are normal within hours. The problems that do occur nearly all come from too much suction or too many passes over one patch.

Bruising or pinpoint red dots
Suction too high or held too long. It clears over a week or two, and the settings should be lowered next time.
Grazes or scabs
Usually around the nose, the upper lip or a bony edge where the tip lingered. Leave them to heal and do not pick.
A dark mark
New brown marks two to four weeks later, more likely after heavy passes or sun exposure. More visible on deeper skin tones, and the earlier they are treated the shorter they last.
A cold sore outbreak
The treatment can set one off. Antiviral medicine works best started early.
Ongoing stinging or redness
Skin still raw or reactive after a week has been over-treated. The next session should be gentler or skipped.

In Deeper Skin Tones

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One of the more forgiving in-office treatments for deeper skin tones. No acid, no heat, no light, and the abrasion stops at the dead surface layer, well above the pigment-making cells. It does not cause the pale patches that deeper treatments can, and the usual pre-treatment creams are not needed.

The risk that does exist is the general one: anything that irritates skin can leave a brown mark, and on deeper skin tones those marks are more visible and slower to fade. Here that means over-treatment — repeated passes over one patch to make it feel smoother, suction turned up, or a session on skin that is already flaring. One or two gentle passes and stopping at pink rather than red is the whole precaution.

Melasma deserves its own note. It is aggravated by friction and heat as well as by sun, and microdermabrasion is friction. Some providers use it as part of a melasma plan and others avoid it entirely. If you have melasma, this needs a provider who treats melasma regularly and a test area before a full face.

It is also worth saying what it will not do. Microdermabrasion is often sold for dark marks and uneven tone, two of the most common reasons people with deeper skin tones seek treatment. Those marks sit in or below the base of the epidermis, and sanding the dead layer does not reach them. A pigment cream, azelaic acid, a retinoid, a superficial peel and daily sunscreen all have better evidence.

If You Stop

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Nothing rebounds. The dead surface layer rebuilds within a few days, so stopping just means the polished feeling fades. Skin does not become duller, more sensitive, or dependent on treatment, and there is nothing to taper. If you stopped because of irritation, that settles over a week or two with plain moisturizer and sunscreen.

Combining Treatments

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Same day
Extractions
Often combined at the same visit, since the plugs release more easily.
Same day
Home skincare
Retinoids, vitamin C, azelaic acid, benzoyl peroxide and sunscreen all continue.
Same day
Light peel or mask
Sometimes done right before one, with the peel kept light.
Pause a few days
Exfoliating actives
Pause them for a few days either side.
Wait 1–2 weeks
Other procedures
Leave 1 to 2 weeks around a peel, laser, microneedling or waxing on the same area.
Wait 2 weeks
Flaking or pink skin
Not on skin still flaking or pink from something else.
Wait 1 week
Between sessions
At least a week apart, longer if skin has not settled.
Wait 6 months
Isotretinoin
Most providers wait about 6 months after finishing.

Insurance Coverage

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Insurance does not cover it. It is cosmetic in every setting.

Ask Your Doctor

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If you are pregnant or breastfeeding
Ask the doctor managing your pregnancy or breastfeeding first, though a surface exfoliation is one of the more straightforward things to discuss.
If you have active inflamed acne
Sanding over pustules and cysts irritates them and spreads bacteria across the face. Wait until the skin is calm.
If you have rosacea
Friction and suction set off flushing and stinging, and many people with rosacea do not tolerate it.
If you have melasma
Friction can worsen it. This needs a provider who treats melasma specifically, and a test area first.
If you take a blood thinner
Suction bruises more easily and pinpoint bleeding is more likely, so settings should start low.
If you get cold sores
Say so before, and reschedule if one is active.
If you have warts anywhere on the face
The device spreads them across the treated area. Deal with them first.
If you finished isotretinoin recently
Most providers wait about 6 months, since the skin is fragile.
If you have eczema or psoriasis there
Broken or scaly skin should settle first.
If your goal is scars or wrinkles
Wrong procedure. A retinoid, a peel, microneedling or a laser is the conversation to have instead.
If you have a deeper skin tone
The risk is a temporary dark mark from over-treatment, not anything permanent. Ask for gentle passes and low suction.

At-Home Versions

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Leave-on chemical exfoliants, salicylic 0.5 to 2% or glycolic 5 to 10%
Good alternative
A different mechanism with better evidence than sanding, used two or three times a week. This is the sensible default for anyone wanting smoother skin at home.
At-home microdermabrasion wands and kits
Okay alternative
Much weaker suction and a gentler abrasive than an office machine. Safe if used lightly and infrequently, and the result is a mild polish rather than anything lasting.
Scrubs with fine rounded particles
Okay alternative
The same surface polish for a few dollars. Coarse gritty scrubs, including crushed shell and pit powders, cause micro-grazes and are worth avoiding.
Cleansing brushes and silicone tools
Okay alternative
Mild mechanical exfoliation. Daily use on already-exfoliated or inflamed skin causes more irritation than benefit.
Home dermabrasion tools and sanding discs sold online
Bad alternative
Do not. These are sold on the confusion between microdermabrasion and dermabrasion, and abrading below the surface without training causes scarring.

How It Compares

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Superficial chemical peel
Different job
Dissolves the dead layer instead of sanding it and gets inside the pore, so it works on clogged pores and post-acne marks as well as on texture. Costs a few days of flaking, which microdermabrasion does not.
Topical retinoid
Better
Does at home, daily and cheaply what microdermabrasion does occasionally, and reaches deeper, with effects on acne, pigment and fine lines that no surface treatment matches. Needs weeks of adjusting and some irritation up front.
Hydradermabrasion devices
The same
Wet resurfacing machines that use the same sanding idea with fluid and suction, more comfortable, and it delivers serums at the same time. Heavily marketed, and the evidence behind it is not stronger than for what it replaced.
MicroneedlingDiagram: how Microneedling works in the skin
Microneedling
Different job
Aimed at indented scars and texture, which microdermabrasion does not touch. More downtime per session, more cost, and usually done once active acne is controlled.
Home chemical exfoliants
Better
Salicylic and glycolic products used a few times a week give a similar or better surface result for a fraction of the price, with more irritation if overused.

Finding a Provider

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Microdermabrasion is done by licensed estheticians in most US states, and in medical offices by aestheticians, nurses and physician assistants. Rules vary by state. Ask which machine is used, how many passes they plan, what the suction is set to, and whether the tip or crystal stream is cleaned between clients. With a crystal machine, ask about eye protection. Red flags: promises to remove acne scars, wrinkles or melasma, suction high enough to leave bruises or red dots, going over one patch again and again, pressure to buy a package of ten on a first visit, and anyone calling it dermabrasion, which is a far more serious procedure.

Myths

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  • "Microdermabrasion removes acne scars." It does not reach them. Indented, rolling and icepick scars sit in the dermis, and the abrasion stops at the dead layer on top. Microneedling, lasers, subcision and filler are aimed at that problem.
  • "It is the same as microneedling." Different treatments, different targets. Microneedling makes tiny channels down into the dermis to trigger collagen repair. Microdermabrasion sands the surface and never breaks it.
  • "It shrinks pores." Pore size does not change. Clearing the plug and the dead skin around the opening makes pores look smaller for a few days, which is real and temporary.
  • "Stronger suction means better results." Higher suction mainly produces bruising and pinpoint bleeding, and there is no evidence a more aggressive session gives a better outcome.
  • "It is too harsh for sensitive skin." Often the opposite. For people who react badly to acids and retinoids, a gentle microdermabrasion is one of the more tolerable ways to exfoliate, as long as the settings are low.

Questions Patients Ask

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Is microdermabrasion still worth doing?

It depends what you want. As a comfortable, low-risk polish before an event or for skin that cannot handle acids, it does what it says. For acne, scarring, wrinkles or pigment, other options have overtaken it, and a superficial peel or a home retinoid will usually do more for the same money.

Does it help acne scars?

No. Indented scars sit in the deeper layer and the treatment stops at the dead cells on top. Microneedling, lasers, subcision and filler are what that needs.

How is it different from microneedling?

Microneedling makes tiny channels into the deeper layer to trigger collagen repair, with a few days of redness. Microdermabrasion sands the surface and never breaks the skin. The similar names cause most of the confusion.

Is it different from dermabrasion?

Completely. Dermabrasion is a surgical resurfacing done under anesthesia that sands into the deeper skin, with weeks of recovery and real scarring risk. Microdermabrasion is a surface polish with none of that.

How often should I have it?

Courses are usually five or six sessions one to two weeks apart, then monthly. The effect of each session fades within days, so it comes down to how often you want that day of smoothness.

Is it safe on deeper skin tones?

Yes, and one of the gentler options, because it uses no acid, heat or light and does not reach the pigment cells. The thing to avoid is over-treatment, since irritation can leave a temporary dark mark.

References

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