Is Subcision the Top Choice 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 same reasoning applies to addressing acne scars. Unlike alternative treatments such as microneedling or lasers, subcision is actually able to lift indented and atrophic acne scars back up to the level of the skin surface. This is achieved by inserting a hypodermic needle into the skin to destroy the tethers that are holding the scar tissue down to the subdermal layer. Different needles can be used to reach superficial, middle, and deep layers, depending on the unique profile of your acne scars.
Subcision vs. Laser Treatment for Acne Scars
Treatments that flatten all of the healthy skin down to the level of the depressed scars are equivalent to grinding down the street to the level of the pothole. Despite this, lasers and microneedling are still commonly used by dermatologists to treat atrophic acne scarring. Dr. Hazany does value scar reconstruction lasers for touch-ups and other minor details, but otherwise, the subcision procedure is much preferred since it avoids unnecessary thinning of the skin. In addition, subcision is usually only performed once to see results, while other treatment methods require multiple tedious sessions.
How Does Subcision Work?
As an outpatient procedure, subcision only takes around a few hours. Before the treatment begins, patients are given a local anesthetic, tumescent anesthesia, and anti-anxiety medication to ensure their comfort. Then, the hypodermic needle is inserted into the skin and moved laterally to detach the scar tissue from the subcutaneous layer beneath. This “controlled trauma” allows the atrophic scars to rise back to the level of normal skin and it also promotes collagen production, thus providing even more support underneath 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 Care
- Swelling, soreness, and skin discoloration are normal in the first 48 hours and may last for up to one week.
- Keep the treated site(s) completely dry and free from all cosmetic products for the first 24 hours after the procedure .
- After the first 24 hours, you may apply a cold and damp compress to the treatment areas in rounds of 10-15 minutes to alleviate pain and swelling.
- After showering, you may apply unscented Vaseline/petroleum jelly to the treated areas to aid in moisturizing.
- Do not touch the treated site(s) and any scabs that form on them, as this disrupts the healing process and could lead to infection.
- Throughout the entire healing process, you should avoid sun exposure as much as possible, but if truly necessary, you should apply minimum SPF 50+ sunscreen.
How Much Is Subcision?
The pricing for subcision strongly depends on your individual scarring profile. It can vary based on how many layers you need (e.g., superficial, middle, and/or deep layer) as well as the amount of areas to be treated. However, since subcision creates long-lasting results, this saves you from having to spend more money on maintenance treatments. And, compared to laser resurfacing, it ensures you do not need to invest in 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 Redondo Beach for acne scar treatments. We encourage you to reach out to our scar specialists for more information and to create your personalized treatment plan!
