Will Subcision Fix My Acne Scars?
Dr. Hazany compares acne scars to potholes in a street. When fixing a pothole, you wouldn’t level the entire street to match the depth of the pothole. Instead, you fill the pothole to match the surrounding road level.
This analogy applies to acne scar treatment. Unlike microneedling or laser treatments, subcision elevates depressed or rolling acne scars to the level of the surrounding skin. A hypodermic needle breaks the fibrotic strands tethering the scar tissue to the subdermal layer, using various needle sizes to target superficial, middle, or deep layers of the skin.
Subcision vs. Laser Resurfacing: Which Is Better?
Other acne scar treatments such as laser resurfacing, microneedling, and dermabrasion that flatten and thin the skin to the level of the acne scarring are like bringing the rest of the street down to the level of the pothole. However, laser treatment remains the go-to for dermatologists to improve the look and feel of acne scarring. While Dr. Hazany agrees that scar reconstruction lasers can be useful as a touch-up or for minor unevenness, for large areas of scarring (and even smaller areas), Dr. Hazany champions the subcision procedure. This medical acne scar treatment avoids unnecessary thinning of the skin, instead producing a healthier, more robust appearance. Additionally, while many lasers require multiple sessions to obtain any results, subcision is typically a one-time procedure.
What Does Subcision Involve?
Subcision is an outpatient procedure usually completed within a few hours. Patients receive local and tumescent anesthesia, along with anti-anxiety medication for comfort. The process begins with the insertion of a hypodermic needle into the skin which is moved laterally to break the fibrotic strands tethering the scar tissue. This releases the depressed scars, allowing them to rise to the level of normal skin. This form of “controlled trauma” also stimulates collagen production, providing support under the scarred areas.
The subcision procedure can be performed in several layers: superficial-layer, mid-layer, and deep-layer.
- Superficial-layer subcision: A needle is used to infiltrate the skin right below the epidermis.
- Middle-layer subcision: A blunt cannula is used to penetrate deeper into the dermis.
- Deep-layer subcision: A special metal tool is inserted into the deepest layer of the dermis to separate the toughest scars from underlying tissue.
Since middle-layer and deep-layer subcision treatment are more invasive than superficial-layer subcision, an “introducer”-needle is inserted into the skin to create a small opening for the cannula to be inserted.
Post-Treatment Guidelines
Following aftercare instructions is essential for optimal healing after subcision. It is normal to experience blood-tinged oozing and mild discomfort for the first 24-48 hours, with bruising and mild swelling possibly lasting up to a week. Keep the treated area makeup-free and dry for the first 24 hours. To reduce swelling and soreness, apply a cold, wet cloth for 10-15 minute intervals. After showering, use a thin layer of unscented Vaseline or petroleum jelly to moisturize the treatment areas. Leave any scabs that form undisturbed and minimize sun exposure to ensure smooth recovery and optimal results.
Pricing for the Subcision Procedure
The cost of subcision varies based on the depth (superficial, middle, and/or deep layer) and the number of treatment sites. Its long-lasting results mean you won’t need continuous maintenance payments. Additionally, since subcision doesn’t thin the skin, collagen-boosting formulas and dermal fillers might not be necessary.
Subcision is a leading acne scar treatment available in Ranchos Palos Verdes. Contact our scar specialists for more information and to create a personalized treatment plan!
