Is Subcision the Best for Acne Scar Removal?
Dr. Hazany describes acne scars as potholes in the street. When fixing a pothole, do you flatten and grind down the surrounding road to the level of the pothole? No! Flattening the rest of the street requires unnecessary work in areas that are not defective, and the street becomes unnecessarily thin, leading to other complications. The proper way to fix a pothole is to fill the pothole and lift it to the surrounding street level.
This analogy extends to acne scar treatment, where subcision raises depressed or rolling scars to align with the rest of the skin surface. Using a hypodermic needle, fibrotic strands tethering scar tissue to the subdermal layer are manually severed, with different needle sizes used based on scar depth.
Comparing Subcision vs. Laser Treatment
In the realm of acne scar treatment, procedures like laser resurfacing and microneedling aim to level skin to the depth of scarring, akin to lowering the entire street to the pothole’s level. Although laser treatments are a common choice among dermatologists for improving acne scarring, Dr. Hazany champions subcision. This medical acne scar treatment avoids unnecessary thinning of the skin and produces a healthier, more robust appearance. Additionally, while many lasers require multiple treatments in order to see results, subcision is typically a one-time procedure.
How Does Subcision Work?
Subcision is a minor surgical procedure typically accomplished in a few hours. The patient is administered a local anesthetic, tumescent anesthesia, as well as anti-anxiety medication to ensure comfort throughout. Next, a hypodermic needle is inserted under the skin and moved laterally to untether the scar tissue from the subcutaneous tissue underneath. This “controlled trauma” allows the depressed areas of acne scarring to raise back up to the level of normal skin while promoting collagen production and structural support.
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.
Aftercare Instructions
- After the first hour of treatment, you may experience blood-tinged oozing.
- In the first 24-48 hours, you will likely feel slightly sore and experience mild swelling that can last for up to one week
- Skin discoloration in treated areas is common, but does not always happen
- Keep the treatment sites completely make-up free and dry for the first 24 hours, then after you may use a cold and wet compress for swelling and soreness if needed
- Do NOT touch the treated site(s), as this may lead to infection and disrupt wound healing.
- Do NOT pick scabs that develop in the treated areas since they are important to heal scarring.
- Avoid sun exposure, but if necessary, apply minimum SPF 50+ sunscreen.
- After showering, apply a thin layer of unscented Vaseline or petroleum jelly.
Cost of Subcision for Acne Scarring
The cost of subcision varies depending on how many layers of subcision you require (e.g., deep layer, middle layer, or superficial layer) and the number of areas you plan on subcising. The long-lasting results of the subcision procedure mean you do not have to keep paying money for maintenance treatments. And, compared to laser resurfacing, it ensures you do not have to spend as much money on collagen-boosting formulas or dermal fillers to regain skin thickness in the treated areas.
Today, subcision is one of the foremost procedures available to patients in Agoura Hills for acne scar treatments. We encourage you to reach out to our scar specialists for more information and to create your personalized treatment plan!
