Does Subcision Work 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.
The same principle applies when treating acne scars. Subcision, unlike microneedling or laser treatments, raises depressed scars or rolling acne scars to match the surrounding skin surface. This procedure involves inserting a hypodermic needle into the skin to manually sever fibrotic bands that anchor scar tissue to the underlying layers. Different-sized needles are used depending on the depth of the scar tissue within the skin layers.
Subcision vs. Laser Treatment: Which is Better?
Laser resurfacing, microneedling, and other medical treatments that involve vertical movements to smooth and thin the skin to the level of acne scarring can be likened to leveling the entire street to fix a single pothole. Despite this, laser treatments are still widely performed by dermatologists to enhance the appearance of acne scars and atrophic scars. While Dr. Hazany acknowledges the effectiveness of scar reconstruction lasers for minor imperfections and touch-ups, he advocates for subcision for larger areas of scarring and even smaller cases. This medical treatment for acne scars avoids unnecessary thinning of the skin and promotes a healthier, more resilient appearance. Unlike many laser treatments that require multiple sessions to achieve noticeable results, subcision usually requires only one procedure.
How Does Subcision Work?
Subcision is a minor surgical procedure performed within a few hours. To ensure comfort, the patient is given local anesthetic, tumescent anesthesia, and anti-anxiety medication. Then, a hypodermic needle is inserted into the skin and methodically moved back-and-forth in order to break up the fibrotic bands that tether the scar tissue to the underlying basement layer. This allows depressed areas of scarring to lift to the level of normal skin. This form of “controlled trauma” also stimulates collagen production, which provides additional support underneath the scarred areas.
The subcision procedure can be performed in different layers, depending on the nature of your scars: 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 Recommendations
- It is typical to experience soreness in the treated site(s) during the first 24-48 hours.
- Skin discoloration may occur on the treated site(s)
- Mild swelling in the treated site(s) usually subsides within 48 hours, but in some cases, it may persist for up to a week
- Blood-tinged oozing is normal immediately after the procedure
- To prevent infection and support proper wound healing, refrain from touching the treated site(s).
- Refrain from applying makeup or other cosmetic products to the treated area for at least 24 hours.
- Keep the treated site(s) completely dry for the initial 24 hours following the procedure.
- For relief from swelling and soreness, apply a cold, wet cloth to the treatment site(s) every 10-15 minutes.
- Normal activities can typically be resumed within 48 hours.
- It is important not to pick at scabs that form in the treated areas, as they aid in healing and prevent scarring.
- Avoid sun exposure; if necessary, apply SPF 50 sunscreen to the treatment areas.
- After showering, apply a thin layer of Vaseline or petroleum jelly.
Subcision Pricing
Depending on how many layers (superficial, middle, and/or deep) and how many sites, the cost of subcision can vary. However, subcision yields lasting results, meaning you will not need to repeatedly pay for maintenance treatments. Furthermore, unlike laser resurfacing, subcision does not thin the skin, so you do not have to worry about paying for collagen-boosting products or dermal fillers.
Today, subcision is one of the foremost procedures available to patients in Tustin for acne scar treatments. We encourage you to reach out to our scar specialists for more information and to create your personalized treatment plan!
