A 20-year retrospective study of patients undergoing dermabrasion is reported. All patients included in this study met the strict criteria of a minimum of a 6-month follow-up examination, abstention from exposure to sun, and photographic documentation. Fifty-nine percent were seen at 1 year or more, and 41 percent were seen at 5 years or more. Unfavorable pigmentation as a result of dermabrasion was encountered in only eight patients. In seven, this receded with the passage of time. The eighth was lost to follow-up. Hypopigmentation was noted in three patients: two blacks and one Caucasian. Persistent redness occurred in three Caucasian patients. Recurring pigmentation with exposure to sun, continuing years after the procedure, was reported in two black patients and two Caucasian patients. Hispanic patients appear to be more aware of subtle pigmentary and textural changes. Adverse pigmentation does not appear to be an inevitable consequence of dermabrasion in patients who abstain from exposure to sun in the initial postoperative period. Dermabrasion is viewed as a valuable surgical procedure for improvement of acne and other scar deformities.