Microdermabrasion and Dermabrasion not in 3rd Ed

Question 1

The most common indication for dermabrasion is facial acne scars

Answer 1

T

Question 2

Regarding dermabrasion, wounds need to be limited to a deep-reticular dermal depth, as wounding deeper than this results in surface changes that are perceived as a scar.

Answer 2

F mid-reticular depth

Question 3

Traditional dermbrasion utilises a wire brush or diamond fraise on a rotary hand engine to mechanically remove tissue.

Answer 3

T

Question 4

Scarring, dyspigmentation and infection are potential complications of any deep abrasion procedure.

Answer 4

T

Question 5

Acne scars that disappear by stretching the skin are an indication for recontouring with dermabrasion.

Answer 5

F Scars that don’t disappear with stretching.

Question 6

Dermabrasion should not be combined with CO2 laser.

Answer 6

F Can be combined to ‘tighten’.

Question 7

Surgical procedures for scars should be performed 6-8 weeks or more before dermabrasive or laser resurfacing.

Answer 7

T

Question 8

CO2 laser and Nd:YAG laser will tighten and smooth superficial acne scars and rhytides.

Answer 8

F - Er:YAG (not Nd:YAG).

Question 9

Dermabrasion is a helpful resurfacing adjunct for sculpting the elevated ridges of wrinkles that persist despite 2-3 passes with an ablative laser.

Answer 9

T

Question 10

Dermabrasion removes the thermal coagulum left after heat-induced injury of CO2 lasers, thereby promoting healing and reducing postoperative erythema.

Answer 10

T

Question 11

Rhinophyma tends not to respond to dermabrasion.

Answer 11

F Responds well.

Question 12

There is a significant risk of scarring associated with dermabrasion of rhinophyma.

Answer 12

F Minimal risk due to sebaceous nature of rhinophymatous tissue.

Question 13

Epidermal naevi, seborrhoeic keratoses, syringomas, angiofibromas and trichoepitheliomas can be dermabraded with good results.

Answer 13

T

Question 14

Decorative tattoos can be abraded followed by the application of 1% gentian violet directly to the abraded surface and dressed with Adaptic gauze.

Answer 14

T Gentian violet promotes removal of tattoo pigment by stimulating phagocytes to carry away abraded pigment.

Question 15

Traumatic and surgical scars cannot be treated with dermabrasion.

Answer 15

F Can perform as early as 6-8 weeks following injury of surgery.

Question 16

Cosmetic patients undergoing dermabrasive surgery should expect 50-70% improvement in the appearance of deep acne scars and adynamic rhytides.

Answer 16

F 30-50%.

Question 17

Distensible acne scars and dynamic rhytides that disappear by stretching are best treated with tissue tightening procedures such as ablative and non-ablative laser resurfacing treatments.

Answer 17

T

Question 18

Sharp shoulders of scars of chicken pox or acne and deep non-distensible rhytides should be treated with surgery only.

Answer 18

F Can treat with mechanical dermabrasion or laser sculpting.

Question 19

For full-thickness defects, surgical excision punch grafting and/or dermal grafts should be performed at least 6-8 weeks before resurfacing.

Answer 19

T

Question 20

Patients with a history of impetigo should have a nasal swab to assess for S.aureus colonisation prior to dermabrasion.

Answer 20

T These patients will need prophylactic Abs.

Question 21

Only patients with a history of HSV require prophylactic antiviral medication for dermabrasion.

Answer 21

F All patient should take until fully re-epithelialised. 14 days is recommendation.

Question 22

Most herpetic infections occur 1-2 days after resurfacing surgery.

Answer 22

F 7-9 days after.

Question 23

Delayed re-epithelialisation and hypertrophic scarring have been reported in patients undergoing dermbrasion during or shortly after isotretinoin therapy.

Answer 23

T

Question 24

Dermabrasion should be postponed 1-2 months after a course of isotretinoin.

Answer 24

F 6-12 months.

Question 25

Topical tretinoin cream applied daily for 2-3 weeks before dermabrasion has been shown to reduce the time required for re-epithelialisation.

Answer 25

T

Question 26

A test spot dermbrasion is recommended in patients with a history of keloids or koebnerising conditions.

Answer 26

T

Question 27

There is no need to observe universal precautions in performing dermabrasiion.

Answer 27

F Aerosolised viral particles can be produced.

Question 28

The areas to be abraded should be outlined preoperatively with gentian violet while the patient is lying supine.

Answer 28

F Patient sitting.

Question 29

Dermabrasion should be performed along the angle of the mandible and along the inferior jawline.

Answer 29

F Should perform to 1-2 fingerbreadths below to hide transition zone.

Question 30

Partial abrasions (eg. around mouth, nose) should follow lines of facial cosmetic subunits.

Answer 30

T

Question 31

Tumescent anaesthesia should be used to anaesthetize the entire face for dermabrasion.

Answer 31

T

Question 32

Some microdermabrasion devices employ aluminium oxide crystals, which are sharp-edged and hard, as an abrasive.

Answer 32

T

Question 33

Microdermabrasion is essentially painless, quick, easy to perform and has few associated risks.

Answer 33

T

Question 34

The clinical benefits of microdermabrasion can be profound.

Answer 34

F Clinical benefits are modest.

Question 35

Following treatment with microdermabrasion, mild erythema is present, but resolves quickly.

Answer 35

T

Question 36

Eye protection is not needed for microdermabrasion.

Answer 36

F Corneal abrasions can occur from crystals.

Question 37

The fraises used for dermabrasion are available in a variety of sizes, shapes and grades of coarseness.

Answer 37

T

Question 38

Cone-shaped fraises should be used on broader surfaces on the forehead and cheeks.

Answer 38

F Confined areas around nose, mouth, eyelids.

Question 39

Wheel-shaped fraises or the wire brush should be used on confined areas around the nose, mouth and eyelids.

Answer 39

F On broader surfaces.

Question 40

The extra coarse fraise is more forgiving than the wire brush.

Answer 40

T

Question 41

The bristles of the wire brush are angled such that clockwise rotation cuts more deeply in the skin, whereas counterclockwise rotation brushes the bristles over the surface more gently.

Answer 41

T

Question 42

For dermabrasion, the abrading endpiece is passed over the skin in arciform strokes parallel to the direction of endpiece rotation.

Answer 42

F Perpendicular.

Question 43

To abrade, the hand engine in pushed over the skin surface.

Answer 43

F Pulled.

Question 44

For dermabrasion, the direction of rotation is only important when a wire brush is used.

Answer 44

T

Question 45

For deep surfacing of acne scarring on the mid cheek, traumatic or surgical scars, or debulking large nodules of rhinophyma, clockwise rotation is more efficient.

Answer 45

T

Question 46

For full-face procedures, it is best to start abrading along the jawline or preauricular area and progress toward the centre of the face and nose.

Answer 46

T This allows for bleeding from the abraded areas to flow away from the skin being abraded.

Question 47

Two-point retraction of skin should be used to stabilise the area being abraded.

Answer 47

F Three-point retraction.

Question 48

When using spray refrigerant during dermabrasion, the scar or rhytide should be frozen in its stretched position.

Answer 48

F Unstretched position.

Question 49

The depth of abrasion can be monitored by closely observing the abraded surface.

Answer 49

T Papillary dermis appears as glistening white surface. Points of bleeding with depth.

Question 50

Yellow globules of sebaceous glands are seen with deep dermabrasion of acne scars in the mid-cheek or rhinophyma of the nose.

Answer 50

T

Question 51

The dermal fibrosis of acne scars tends to be resistant to abrasion.

Answer 51

F It will crumble and become friable.

Question 52

The peripheral margin of the abraded regions should be feathered to create a natural-looking transition zone.

Answer 52

T

Question 53

Acriform strokes should be perpendicular to the border of the abraded areas

Answer 53

F Parallel.

Question 54

Upon completion of a full-face dermabrasion procedure, most of the abraded areas will still be bleeding.

Answer 54

F Most will have stopped.

Question 55

Post-operative oedema can be reduced with im kenacort A40 given immediately post-dermabrasion.

Answer 55

T

Question 56

The abraded surface should be dressed with a semipermeable dressing held in place with paper tape and backs with non-adherent pads and gauze.

Answer 56

T

Question 57

The patient should return to clinic for the full-face dressing to be changed every 7 days.

Answer 57

F Every 3-5 days.

Question 58

The development of pain with or without erosions generally indicates a postoperative herpetic infection.

Answer 58

T

Question 59

Superinfection by bacteria or fungi is not uncommon following dermabrasion.

Answer 59

F Much less common than HSV.

Question 60

The presence of bright erythema after the first 2-3 post-operative weeks is the first sign of early scar formation and should be treated with topical high-potency steroid ointment od-bd.

Answer 60

T

Question 61

Pulse dye laser should not be used following dermabrasion.

Answer 61

F Can decrease erythema and scar induration.

Question 62

Intralesional steroid injections can be given if any induration, elevation or hypertrophy develops after dermabrasion.

Answer 62

T

Question 63

After successful aggressive scar management following dermabrasion, the skin should be clear.

Answer 63

F Usually have small focal areas of hypopigmentation.

Question 64

Following 3-5 days of wearing a full-face mask after dermabrasion, an open wound care technique can be employed with topical petrolatum ointment.

Answer 64

T

Question 65

Petrolatum ointment should be applied sparingly after dermabrasion.

Answer 65

F Apply 3-4 times daily.

Question 66

The open wound produced by dermabrasion heals by the mechanism of second intention wound healing.

Answer 66

T

Question 67

Regions rich in sebaceous glands (eg. nose and mid-cheek) re-epithelialise more slowly than skin over the bony prominences of the forehead, malar cheek and mandible after dermabrasion.

Answer 67

F More quickly.

Question 68

In dermabrasive wound healing, the collagen fibres align perpendicular to lines of tension before intermolecular cross-linkages are complete.

Answer 68

F Parallel.

Question 69

Following dermabrasion, increased tenascin expression may promote cellular migration, while integrin mitigates the epithelial mesenchymal interaction of wound healing.

Answer 69

F Increased integrin expression may promote cellular migration, tenascin mitigates epithelial mesenchymal interaction of wound healing.

Question 70

As wound healing progresses following dermabrasion, intradermal oedema continues to dissipate for up to 3 months.

Answer 70

T

Question 71

Continuing improvement of the skin surface irregularities and depressions occur for up to 24 months following dermabrasion.

Answer 71

F 6-12 months.

Question 72

Re-epithelialisation is usually complete within 7-10 days following dermabrasion.

Answer 72

T

Question 73

The skin heals faster with open techniques of wound care compared to using a semi-permeable dressing.

Answer 73

F Faster with semi-permeable dressing.

Question 74

Normal skin tone tends to return within 2-3 months following dermabrasion.

Answer 74

T Need to avoid sun exposure during this time.

Question 75

Most patients will develop some degree of transient post-inflammatory hyperpigmentation over the malar prominences and jawline following dermabrasion.

Answer 75

T

Question 76

Bleaching regimens can be used from the 3rd-4th week after dermabrasion and continued for 4-8 weeks or until hyperpigmentation resolves.

Answer 76

T

Question 77

Permanent pigment alteration occurs in less than 5% of patient following dermabrasion.

Answer 77

F 20-30%.

Question 78

Skin types V-VI are more likely to develop post-inflammatory hyperpigmentation following dermabrasion.

Answer 78

F Skin types III and IV.

Question 79

Pseudohypopigmentation refers to the phenomenon of when normally repigmented abraded skin appears to have a different tone and appearance than adjacent non-abraded skin.

Answer 79

T Can correct non-abraded areas with chemical peels, IPL or non-abalative laser.

Question 80

Increased milia formation is an expected postoperative sequelae of dermabrasion.

Answer 80

T Treat with gentle extraction after 1 week.

Question 81

Acne flares following dermabrasion are due to the occlusive nature of postoperative wound care.

Answer 81

T Treat with routine acne regimens.