Dermabrasion is a type of surgical skin planing, typically performed in a professional medical setting by a dermatologist or plastic surgeon trained specifically in this procedure. Dermabrasion has been practiced for many years (before the advent of lasers) and involves the controlled deeper abrasion (wearing away) of the upper to mid layers of the skin with any variety of strong abrasive devices including a wire brush, diamond wheel or fraise, sterilized sandpaper, salt crystals, or other mechanical means. Dermabrasion should not be confused with microdermabrasion which is a newer and non-surgical cosmetic procedure performed by non-physician personnel, nurses, estheticians, medical assistants, and most recently untrained individuals in their homes. Dermabrasion procedures are surgical, invasive procedures that typically require a local anaesthetic. Often they are performed in surgical suites or in professional medical centers. Since the procedure can typically remove the top to deeper layers of the epidermis, and extend into the reticular dermis, there is always minor skin bleeding. The procedure carries risks of scarring, skin discoloration, infections, and facial herpes virus (cold sore) reactivation. In aggressive dermabrasion cases, there is often tremendous skin bleeding and spray during the procedure that has to be controlled with pressure. Afterward, the skin is normally very red and raw-looking. Depending on the level of skin removal with dermabrasion, it takes an average of 7–30 days for the skin to fully heal (re-epithelialize). Often this procedure was performed for deeper acne scarring and deep surgical scars. Dermabrasion is rarely practiced currently and there are very few doctors who are trained and still perform this surgery. Dermabrasion has largely been replaced all over the world by newer and somewhat simpler technologies including lasers, CO2 or Erbium: YAG laser. Laser technologies carry the advantage of little to no bleeding and are often less operator dependent than dermabrasion.