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Subcision for Acne Scars: What You Need to Know


Imagine waking up every morning, looking in the mirror, and seeing reminders of past acne battles in the form of scars. For many, acne scars are not just skin deep; they impact self-esteem, confidence, and social interactions.

But there's hope on the horizon with innovative dermatological treatments, and one such promising option is acne scar subcision.

This treatment is gaining traction for its effectiveness in smoothing out the skin and diminishing the appearance of scars, offering a beacon of hope for those who thought they had to live with their scars forever.


What is Subcision?

Subcision, a term that might sound complex at first, is actually a straightforward minor surgical procedure designed to combat acne scars.

In the simplest terms, it involves a specialized needle that dermatologists use to break up fibrous bands of scar tissue that pull down on the skin and create those indents we know as scars. The breaking of these bands allows the skin to lift, reducing the depth of the scars and improving the overall texture of the skin.

It's a beacon of hope for many, promising smoother skin where once there were only reminders of acne.


Types of Scars Treated by Subcision

Not all scars are created equal, and subcision particularly shines when treating specific types:

  • Rolling scars – characterized by their smooth edges and wave-like appearance on the skin.

  • Boxcar scars – these have sharper edges and resemble the shape of a box, hence the name.

  • Atrophic scars – a general term for scars that cause a depression in the skin.

Types of Atrophic Scars

Subcision excels in treating these types of scars due to its unique ability to target the underlying causes of scarring. By addressing the fibrous (underlying) tissues that tether the skin and create depressions, subcision encourages a natural healing process that results in a smoother, more even skin surface.


The Subcision Procedure Explained

Subcision might sound like a high-tech or daunting procedure, but in reality, it's a minimally invasive treatment that can be broken down into a few key steps. Here's what you can expect:

  1. Consultation: Everything starts with a consultation with a qualified dermatologist or cosmetic surgeon. During this meeting, they'll evaluate your scars to see if subcision is the right approach for you.

  2. Anesthesia: On the day of the procedure, the treatment area will be numbed using local anaesthesia. This ensures that you'll be comfortable and pain-free throughout the process.

  3. The Procedure: Using a special, needle-like instrument, the doctor carefully inserts it beneath the skin's surface to release the fibrous bands causing the scar depressions. This process not only helps lift the scar but also stimulates collagen production, aiding in the skin's natural healing process.

  4. Completion: The entire procedure can take anywhere from 30 minutes to an hour, depending on the number and extent of the scars being treated. And because it's minimally invasive, you can usually head home shortly after it's done.

Subcision Process

The role of a dermatologist or cosmetic surgeon is crucial in subcision. They not only perform the procedure but also ensure it's done safely and effectively, tailoring their approach to each individual's unique skin and scar types.


Before and After Care

Before the Procedure:

  • Avoid certain medications and supplements that can increase bleeding, such as aspirin or fish oil, for a week before your treatment.

  • Stay out of the sun to prevent any additional skin irritation.

  • Ensure your skin is clean and free of any products on the day of the procedure.

After the Procedure:

  • You can expect some swelling, bruising, and redness in the treated area, which typically subsides within a few days.

  • Ice packs and over-the-counter pain medication can help manage any discomfort.

  • It's important to follow your doctor's instructions on wound care to ensure proper healing. This might include avoiding strenuous activities or direct sun exposure for a certain period.

  • Recovery times vary, but most people see significant improvement as the skin heals and collagen remodels over the next few months.

Subcision is a journey from consultation to recovery, with every step carefully planned to ensure the best possible outcomes. By adhering to pre and post-procedure care, patients can maximize their results and experience a smoother, more even complexion that brings back confidence and leaves acne scars in the past.


Benefits of Subcision

The journey of treating acne scars with subcision is filled with numerous benefits, some of which extend beyond the skin’s surface:

  • Improvements in Texture and Appearance: Subcision offers a tangible transformation, smoothing out the scars and giving the skin a more even and refined appearance. This improvement in skin texture can make skincare products apply more smoothly and makeup look more natural.

  • Longevity of Results: One of the most compelling advantages of subcision is the durability of its outcomes. Unlike some cosmetic treatments that require frequent touch-ups, the results of subcision can last for years. This is because the procedure stimulates the body's natural collagen production, promoting long-term skin health and regeneration.

  • Psychological Benefits: The impact of acne scars can run deep, affecting individuals' self-esteem and confidence. The visible improvement in skin appearance can therefore offer significant psychological benefits, helping people feel more comfortable and confident in their own skin.


Potential Side Effects and Risks

As with any medical procedure, subcision comes with potential side effects and risks, though they are generally minimal:

  • Common Side Effects: After the procedure, it's typical to experience some swelling, bruising, and redness around the treated area. These side effects are usually mild and resolve within a few days to a week.

  • Rare Risks: Though less common, there are some risks associated with subcision, such as infection, significant bleeding, or uneven texture. The skill and experience of the practitioner play a crucial role in minimizing these risks.


How to Mitigate Risks

To ensure the best possible outcomes and minimize the risks of side effects:

  • Choose the Right Practitioner: Select a dermatologist or cosmetic surgeon who is experienced in performing subcision. Their expertise can significantly reduce the likelihood of complications.

  • Follow Pre- and Post-Care Instructions: Adhering to your doctor’s advice before and after the procedure can help prevent infection and promote healing. This includes avoiding certain medications, not wearing makeup immediately after the procedure, and protecting the skin from the sun.

  • Monitor the Healing Process: Keep an eye on your skin’s recovery and report any unusual symptoms to your practitioner immediately. Prompt attention to concerns such as unusual pain or signs of infection can prevent more serious complications.

Subcision offers a promising path to not only improving the physical appearance of acne scars but also enhancing overall well-being. By understanding and managing the potential side effects, patients can approach this treatment with confidence, looking forward to the significant and long-lasting benefits it provides.


Comparing Subcision with Other Acne Scar Treatments

When it comes to addressing acne scars, there is no one-size-fits-all solution. Different treatments offer varied benefits, targeting specific types of scars and skin concerns. Here’s how subcision stacks up against other popular acne scar treatments:

Fractional CO2 Laser

  • Mechanism: This laser treatment uses light energy to create micro-wounds in the skin, stimulating the body's natural healing process and encouraging new collagen production.

  • Best For: Surface scars and texture.

  • Consideration: While highly effective, especially for superficial scars, the recovery time can be longer, and it may require a series of treatments for optimal results. It can also be more painful and expensive than some other options.

CO2 Fractional Laser

Rejuran Healer, Rejuran S

  • Mechanism: These treatments involve the injection of polynucleotides or PN, which promote skin healing and rejuvenation at the cellular level.

  • Best For: Improving overall skin health, elasticity, and minor textural issues.

  • Consideration: Rejuran treatments are more about skin rejuvenation and less about targeted scar remodeling. They can improve the skin’s appearance but might not be as effective for deep scars without combination therapy.


Chemical Peels

  • Mechanism: Applying a chemical solution to the skin causes it to exfoliate and eventually peel off, making way for new, smoother skin.

  • Best For: Light scars, hyperpigmentation, and overall skin texture.

  • Consideration: Chemical peels vary in depth and intensity, with deeper peels offering more dramatic results but also requiring more downtime. They might not reach the deeper layers of the skin where some acne scars reside.

Chemical Peel


Why Subcision Might Be Recommended Over or Combining Subcision with Other Treatments

Subcision has unique advantages that make it an excellent choice for certain types of acne scars, particularly rolling, boxcar, and atrophic scars which have a tethered or indented appearance. Here’s why subcision might be recommended:

  • Directly Targets Scar Tissue: Subcision specifically targets the fibrous bands causing the scar’s depressed appearance, offering a targeted approach that some surface treatments can’t match.

  • Minimal Downtime: Compared to procedures like fractional CO2 laser, subcision generally offers a quicker recovery, allowing patients to return to their daily routines with minimal interruption.

  • Long-lasting Results: By stimulating collagen production beneath the scar, subcision can offer durable results that improve over time.

  • Complementary Nature: Subcision can be an excellent foundation for other treatments. For example, once subcision has released the deeper fibrous bands, treatments like lasers or Rejuran can further enhance skin texture and quality, making for a comprehensive approach to acne scar treatment.

In conclusion, subcision holds a unique place in the spectrum of acne scar treatments, offering benefits that are both specific to certain scar types and complementary to other treatments. For individuals with deep, tethered scars, subcision might be the key to unlocking a smoother, more even complexion, especially when used in combination with other therapies for a holistic approach to scar treatment.


Finding the Right Provider for Subcision

Embarking on the journey of subcision requires not just an understanding of the procedure but also the right medical professional to guide you through it. Here's how to ensure you're in capable hands:

Qualifications to Look For in a Provider:

  • Board Certification: Ensure the dermatologist or cosmetic surgeon is board-certified, indicating they have the necessary training, skills, and experience.

  • Specialization in Acne Scars: Look for a provider who specializes in treating acne scars, particularly with subcision. This specialization often means they are familiar with the nuances of different scar types and treatment strategies.

  • Before and After Gallery: Ask to see a portfolio of their work, specifically before and after photos of patients they've treated with subcision. This can give you an idea of their expertise and the results you might expect.

  • Positive Reviews: Look for testimonials or reviews from previous patients. While individual experiences can vary, a pattern of positive feedback can be a good indicator of the provider's quality.

Questions to Ask During Your Consultation:

  • "What results can I expect from subcision?": Setting realistic expectations is crucial. A reputable provider will give you an honest assessment of the possible outcomes.

  • "Is one session of subcision enough?": Depending on your specific case, you might require more than one session. Knowing this upfront can help you plan both logistically and financially.

  • "What is the recovery process like?": Whether one session of subcision is enough depends on the severity and type of acne scars, as well as the individual's skin healing response. Some people may see significant improvement after just one session, particularly if their scars are shallow or limited in number. However, more severe or extensive scarring often requires multiple sessions to achieve optimal results.

  • "Subcision how long to see results?": Results from subcision can begin to appear as early as one month post-procedure, with noticeable improvements in skin texture and scar appearance. However, the most significant results are typically seen between three to six months as the skin heals and collagen remodeling progresses. Individual healing times can vary, and some improvements may continue to develop up to a year after treatment.

  • "Can you show me before and after photos of previous patients?": Seeing actual results of the provider's work can help you gauge the potential effectiveness of your treatment.

  • "How do you handle complications or side effects?": An experienced provider should have clear protocols for managing any adverse reactions or complications.



Subcision is a powerful technique for treating certain types of acne scars, offering the promise of improved skin texture and appearance with minimal downtime. Its effectiveness, especially when combined with other treatments, can lead to significant cosmetic and psychological benefits.

However, the key to a successful subcision treatment lies not just in the procedure itself but in choosing the right provider. Board certification, specialization in acne scars, and a track record of positive patient outcomes are all critical factors to consider.

If you're exploring subcision as an option for acne scar treatment, we encourage you to consult with a professional who can provide personalized advice based on your unique skin type and scarring. This personalized approach ensures that you not only understand the potential benefits and risks but also embark on this journey with realistic expectations and a clear vision of the potential outcomes.

Taking the step towards treating your acne scars is a significant decision, but with the right information and the right provider, subcision can be a transformative experience, opening the door to not just smoother skin but renewed confidence.

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