Acne is a common dermatological disease that occurs in adolescent men and women. After puberty, it tends to subside or diminish naturally, but often leaves behind depressed scarring, which seriously affects the appearance of the skin and makes patients desperate for treatment. Skin abrasion, also known as dermabrasion, is a surgical procedure that uses mechanical abrasion to remove superficial skin lesions so that the rough and uneven skin becomes flat and smooth after healing and normal color is restored. Dermabrasion began at the turn of the century when Kromayer, a German dermatologist, first reported the use of file abrasion to treat scarring, tattoos, and pigmented spots in 1905, and was later called the father of dermabrasion. In 1935, Jansen reported the removal of tattoos with wire brushes with relatively good results. In 1947, 1verson published a monograph on abrasion with woodworking sandpaper, and in 1953, kurtin reported on the experience of abrasion with an electric wire brush. The above work laid the foundation for the development of skin abrasion, and many scholars later improved the instruments and methods of surgery, so that the method of skin abrasion gradually matured and became a basic technique of plastic and cosmetic surgery. Skin abrasion is mainly suitable for depressed keloid scars, and the postoperative flatness is mainly due to two reasons, on the one hand, there is a natural tendency and characteristic of flatness in the healing process of skin wounds, on the other hand, the reason why depressed keloid scars are more obvious is because the scar edges are at an acute angle with the skin surface, resulting in light shadows, after abrasion removes the tissue from the scar edges and removes the acute angle, although the skin still has unevenness and After the scar edge is removed by abrasion, the sharp angle is removed, and although the skin is still uneven and undulating, it becomes smoother, thus giving the visual impression of flattening. The healing process after skin abrasion is similar to the healing process of skin abrasions or the healing process of the donor area of the skin fragment. Generally, the wound will heal after 7 to 10 days after surgery, and the healing time is related to the depth of abrasion, if the abrasion is too deep and the wound is not healed after more than 2 weeks, there is a possibility of long scar. Shallow depressed scars can become relatively flat after 1 to 2 surgeries, while deeper ones require 3 to 4 surgeries to achieve more desirable results (the interval between each surgery should preferably be more than half a year). Even so, one cannot expect all scarring to be eliminated without leaving a trace. In fact, complete elimination is difficult to achieve, but surgery can make the scarring less visible, thus improving the patient’s appearance. Abrasion is more effective for acne sequelae, especially for patients with dense and superficial scarring, but it is not ideal for deeper and larger scars, and these patients often need to be treated in combination with surgical plastic surgery. The most common complication of abrasion is hyperpigmentation, which occurs to varying degrees in about 70% of patients undergoing abrasion. The wound is light red when it first heals, then gradually turns brown or dark black, reaching a peak at 1 month, after which it slowly fades, mostly disappearing after 3 to 6 months, some may take longer, and even a very small number of patients with hyperpigmentation lasting several years. The prevention of hyperpigmentation includes: 1) avoiding the summer when UV rays are strong, and choosing autumn and winter for surgery; 2) using sunscreen topically for at least 3 months after surgery; 3) using oral and topical drugs that inhibit pigment metabolism, including vitamin C, dimercaptopropanol, thiouracil, cysteine and hydroquinone. Pigment loss can occur in a very small number of cases, mainly in those with deeper abrasions, and the healing time is usually longer. The key to prevention is to select the right indications and to master the depth of abrasion. A more serious complication of abrasion is scar growth, which is mainly caused by the long healing time of the tissue wound due to the deep dermal layer of the abrasion. Although the incidence is low, the consequences are serious, so the depth of abrasion must be controlled well, especially in the perioral area where the skin is thin and prone to scarring. Despite the shortcomings of skin abrasion, it is still a good method for treating post-acne depressed scarring. Strict control of indications and standardized operation will greatly reduce the occurrence of complications and improve treatment results.