Treatment
Skin resurfacing, and how much injury is enough
Every resurfacing device works the same way underneath: measured injury, then repair. The art is in the dose — enough to remodel, not enough to pigment.
- Appointment
- 45 to 60 minutes including anaesthetic
- Anaesthetic
- Topical
- Onset
- Texture from 4 weeks; collagen remodels over 3 to 6 months
- Course
- Usually 3 to 4 sessions, 4 to 6 weeks apart
- Downtime
- Redness 2 to 4 days; light flaking for a few days after
What it is
Resurfacing means creating a controlled wound in the skin so that healing lays down new collagen and reorganises what is already there. Microneedling does it mechanically, with fine needles creating columns of injury at a set depth. Fractional energy devices do it thermally, treating a fraction of the surface and leaving untreated skin between the columns to drive repair. Radiofrequency microneedling combines the two.
What separates a good result from a bad one is depth and density rather than the name on the device. Too shallow and nothing remodels. Too deep or too dense, particularly in pigmented skin, and the inflammatory response produces exactly the discolouration the patient was trying to treat.
This is the single most important thing to understand about resurfacing in this part of the world. Protocols developed for lighter European skin are routinely applied unchanged to Fitzpatrick IV to VI, and post-inflammatory hyperpigmentation is the predictable result. Treating darker skin well means lower density, more conservative depth, more sessions, and priming beforehand — accepting a slower path in exchange for not causing the problem.
What is assessed
Different textural problems need different depths. Enlarged pores and fine surface irregularity sit shallow. Rolling acne scars are tethered by fibrous bands in the dermis and need depth, and often subcision, before any resurfacing will change them. Ice-pick scars have a narrow, deep tract that resurfacing across the surface will not reach, and are better addressed focally.
Sorting scars by type before treating them is therefore not academic. It is the difference between four sessions that achieve something and four sessions that achieve very little. Where a scar type will not respond, you will be told that rather than sold a course.
- Fitzpatrick type — sets density, depth and how much priming is required before the first session.
- Scar morphology — rolling, boxcar and ice-pick scars respond to different things and are separated before planning.
- Active acne — treated and stabilised before resurfacing, not during.
- Recent isotretinoin — resurfacing is deferred for six months.
- Pigmentation history — previous post-inflammatory hyperpigmentation changes the entire protocol.
- Keloid tendency — a contraindication to deeper resurfacing.
Where it applies
- Texture and pore appearance — the commonest indication, treated at shallow depth.
- Atrophic acne scarring — rolling and boxcar scars, often with subcision alongside.
- Fine lines — particularly perioral and periorbital.
- Photodamage — solar elastosis and surface irregularity from years of ultraviolet exposure.
- Neck, décolletage and hands — treated more conservatively, since healing is slower off the face.
The appointment
Assessment and priming
Skin type, scar morphology and pigmentation history established. Most people are primed with topical therapy and strict photoprotection for two to four weeks first.
Preparation
Topical anaesthetic for 30 to 45 minutes. The skin is cleansed and prepared.
Treatment
Depth and density are set for your skin type and adjusted by region across the face. Where indicated, PRP is delivered into the channels in the same session, or subcision is performed on tethered scars first.
Recovery and course
Redness for two to four days, then light flaking. Reviewed at four to six weeks before the next session. Collagen continues remodelling for three to six months after the final session, so the result is judged well after the course has finished.
Before and after
Photographs, unretouched
Each pair below shows the same person, photographed in the same position, under the same lighting and with the same lens. No retouching or filtering has been applied. Drag the handle to compare.
Before
After
/assets/before-after/skin-resurfacing-dubai-case-01-before.jpg
/assets/before-after/skin-resurfacing-dubai-case-01-after.jpg
- Treatment
- Skin resurfacing
- Interval
- Add the interval between the two photographs
- Note
- There is no guarantee that the result will be the same, as it might vary from one individual to another.
Before
After
/assets/before-after/skin-resurfacing-dubai-case-02-before.jpg
/assets/before-after/skin-resurfacing-dubai-case-02-after.jpg
- Treatment
- Skin resurfacing
- Interval
- Add the interval between the two photographs
- Note
- There is no guarantee that the result will be the same, as it might vary from one individual to another.
Before
After
/assets/before-after/skin-resurfacing-dubai-case-03-before.jpg
/assets/before-after/skin-resurfacing-dubai-case-03-after.jpg
- Treatment
- Skin resurfacing
- Interval
- Add the interval between the two photographs
- Note
- There is no guarantee that the result will be the same, as it might vary from one individual to another.
Please read. There is no guarantee that the result will be the same, as it might vary from one individual to another. These photographs record outcomes in specific individuals and are not a prediction of what any treatment will achieve for you. Anatomy, skin type, age, medical history and healing all differ between people.
Every procedure described on this page carries risks, which are set out in full below and are discussed with you in person before consent is taken. No result is guaranteed, and some people are advised at assessment that a treatment is not appropriate for them.
All photographs are published with the written consent of the individual concerned. Consent can be withdrawn at any time by contacting the clinic.
Risks and limits
These are discussed with you individually before consent is taken. The list is not exhaustive, and it is not a substitute for that conversation.
- Redness, warmth and swelling for two to four days.
- Light flaking and dryness for several days after that.
- Post-inflammatory hyperpigmentation, the principal risk in Fitzpatrick IV to VI, which is why depth and density are chosen conservatively.
- Prolonged erythema, more likely with deeper or denser treatment.
- Reactivation of herpes simplex, for which prophylaxis is prescribed if you have a history.
- Infection, and rarely tram-track marking or scarring if treatment is too aggressive.
- Incomplete response. Scarring improves in degrees; it is not erased, and any account of it that suggests otherwise is not accurate.
When this treatment is not appropriate
- Pregnancy and breastfeeding.
- Systemic isotretinoin within the previous six months.
- Active acne with inflammatory lesions in the treatment area, active infection or open skin.
- Keloid or hypertrophic scarring tendency.
- Active herpes simplex.
- Recent significant sun exposure.
- Anticoagulant therapy, requiring individual assessment.
- Unwillingness to maintain photoprotection during healing.
After treatment
- Bland emollient and gentle cleansing only for the first 48 hours. No active ingredients.
- Do not pick or exfoliate flaking skin.
- Broad-spectrum SPF 50 daily from day two, reapplied, plus shade. Ultraviolet exposure during healing is the main driver of post-inflammatory pigmentation.
- No make-up for 24 hours.
- No exercise, saunas, hammams, steam or swimming for 48 to 72 hours.
- Restart retinoids and acids only when instructed, usually at one week.
- Contact the clinic if you develop spreading redness, pustules, pain out of proportion, or crusting that is not settling.
Questions
Asked often
Is resurfacing safe in darker skin?
Yes, at appropriate settings and with proper priming. It is not safe at the settings commonly published for lighter skin. Conservative depth, lower density and more sessions is the trade this practice makes deliberately, because post-inflammatory hyperpigmentation is harder to treat than the texture it was meant to fix.
Will it remove my acne scars?
It improves them. Realistic expectation for a full course on suitable scar types is meaningful partial improvement, not erasure. Rolling scars respond best, usually with subcision. Ice-pick scars need focal treatment and respond least to resurfacing alone.
How many sessions?
Three to four spaced four to six weeks apart is typical for texture. Scarring often needs more. The plan is set from how your skin responds to the first session.
When will I see the result?
Surface texture improves from around four weeks. Collagen remodelling continues for three to six months after the last session, so the final assessment is made well after treatment finishes.
Does it hurt?
Topical anaesthetic makes it tolerable. Most people describe heat and a scratching sensation. The forehead and along the jaw are the more uncomfortable areas.
Can I combine it with PRP?
Yes, and it is often sensible. PRP delivered into the channels created during the session uses the same window of healing. Whether it suits you is decided at assessment.
Also relevant
Related treatments
Consultation
Every face is read before it is treated
A consultation establishes whether this treatment is the right one for you. Sometimes the answer is that it is not.