Subcision Acne Scar Treatment

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Subcision Acne Scar Treatment

Treat Depressed Acne Scars with Subcision

Atrophic or depressed scars are very common on the face. Such scars are formed when a severe breakout penetrates deep into the skin and damages the tissues beneath it. Very often, superficial acne will heal quickly without leaving any scars. When deep inflammation happens, the dermis can be damaged to form depressed scars on the skin. This is cause by insufficient collage produced during the healing process.

I have some purplish, dark marks on my face. Are those permanent scars?

It is important to be clear on the difference between acne scars and post-inflammatory hyperpigmentation (PIH). These pink, red or purple marks you see on your face are PIH and these are not acne scars. It is perfectly normal for the affected area to take on a different color compared to the surrounding skin as the wound repairs itself after the inflammatory process. Such skin discoloration can be improved with Dual Yellow Laser and/or Retin-A.

Types of acne scars

The most common acne scars are depressed scars, also known as atrophic scars. They develop when there is a loss of tissue. Two common types of atrophic scars are rolling scars and boxcar scars.

Inflammation is usually a good gauge to determine how severe the scarring may be. The more serious the inflammation, the more likely scarring is to occur. Serious breakouts that take a long time to heal may also increase the chance of scarring. Blemishes and other skin conditions that do not cause any inflammation such as blackheads and whiteheads, typically don’t cause scarring as there is no trauma to the skin tissue.

How does subcision treatment reduce acne scars?

Acne scars are often very difficult to treat. While CO2 skin resurfacing laser is excellent for treating some acne scars, subcision acne scar treatment is a clinically-proven treatment that is specifically beneficial for people with rolling scars and boxcar scars.

This procedure is carried out by inserting a hypodermic needle into the skin directly beneath the scar. The doctor gently uses the needle to loosen and break down the fibers that connect the scar to the skin tissue underneath it. This manual process of breaking down the fibers not only helps to break the connecting fibers that pull your scar downwards, it also triggers the production of collagen at the treatment site to plump up the scar to give a smoother appearance.

Is subcision acne scar treatment painful? What is the procedure like?

Before starting the treatment, your doctor will clean the area and apply a topical anesthetic to numb the skin so that you will be comfortable during the treatment.

Your doctor will then insert the needle horizontally into the skin, beneath the scar. The doctor then moves the needle from side to side to gently break down fibers and release the tension in the underlying tissue. You may experience some tugging and resistance as the needle attempts to break down the fibers.

When the procedure is over, a cold compress may be applied to the wound to help reduce inflammation and stop the bleeding.

How often do you have to repeat subcision acne scar treatment?

You should be able to see good results after the first session. Depending on the type of scar and how deep it is, the doctor may advise you to repeat the treatment 3 to 4 more times with an interval of 4 weeks to achieve the best outcome.

Any post-treatment care I need to take note of?

Just like all other aesthetic treatments, you should avoid exposing the treated area to the sun. Should there be a need to go under the sun, ensure that you have applied sufficient sunscreen to avoid any possible complications.

Does subcision acne scar treatment have any downtime?

This treatment can cause a certain of trauma to the skin. After the procedure, you may experience some soreness and pain. The treated area may bruise and swell as well.

Although rare, some of the more serious side effects are:

  • Infection of the wound
  • Severe bruising caused by the injury to the blood vessels
  • Temporary nerve damage
  • Numbness and tingling sensation
  • Skin discoloration

Side effects should subside between 5 and 7 days. If your skin is sensitive, you may experience swelling for up to 2 weeks. Follow the doctor’s post-treatment care instructions carefully and you should be on your way to a speedy recovery.

Is subcision effective for treating acne scars?

There aren’t any large-scale studies to explore the effectiveness of subcision on acne scarring. However, there have been some studies to suggest that subcision can permanently reduce the appearance of depressed scars. In 2005, there was a small-scale study conducted in 40 patients. Subcision was administered and it was reported that 90 percent of treated patients noticed visible improvement in rolling scars. The study concluded that subcision appears to be a safe and effective treatment for rolling scars.


  • Improve appearance of depressed acne scars, especially rolling scars and boxcar scars
  • Achieve smoother appearance of the skin
  • Stimulate collagen production in the skin to reduce visible scarring
  • Effective adjunct therapy for other acne scar treatments, such as RF microneedling and skin resurfacing laser treatment

Best For

People who have moderate to severe acne scars particularly rolling scars and boxcar scars. Suitable for people who can take a longer downtime but with faster, more visible results.

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