Subcision For Acne Scar Treatment

Which acne scar types respond best to subcision?

Subcision treatment is most suitable for rolling-type acne scars. Rolling scars appear as broad-based, wavy depressions on the skin surface. The main cause of these scars is the fibrotic bands beneath the skin that pull the surface downward. Subcision mechanically releases these bands and helps the skin return to a smoother position.

Subcision alone may not be sufficient for ice pick scars or very narrow and deep scars. In such cases, a combination of different treatment methods may be planned. Therefore, correct patient selection and accurate scar analysis are critical for successful acne scar treatment outcomes.

For Which Acne Scar Types Is Subcision Used?

Subcision treatment is particularly preferred for depressed acne scars caused by fibrotic bands beneath the skin. However, it may not be suitable for every acne scar type. The table below summarizes different acne scar types and the suitability of subcision treatment.

In summary, subcision is considered an effective treatment method particularly for rolling-type acne scars. Correct identification of the scar type plays an important role in treatment planning.

How is the subcision procedure performed?

Subcision is a minimally invasive procedure performed under local anesthesia. A special fine-tipped needle or cannula is inserted beneath the skin to cut the fibrotic connective tissue bands that pull the scar downward. During this process, a small controlled bleeding area is also created in the region, which stimulates new collagen production.

The procedure usually takes 20–40 minutes, and patients can return to their daily activities on the same day. Mild bruising and swelling may occur after the procedure, but these effects typically subside within a few days. The collagen production that follows subcision helps further improve the appearance of scars over time.

When Is Subcision Preferred?

Subcision treatment is preferred especially for depressed acne scars caused by fibrotic bands beneath the skin. These bands pull the skin surface downward and create a wavy or sunken appearance. The subcision procedure aims to release these bands and help the skin surface appear smoother.

It is most commonly preferred in the following situations:

• Rolling-type acne scars
• Depressed scars caused by fibrotic bands beneath the skin
• As part of combined acne scar treatment protocols

Subcision treatment is particularly used for rolling-type acne scars, depressed scars caused by fibrotic bands beneath the skin, and often as part of combined acne scar treatment protocols. This approach aims to release the connective tissue responsible for the depressed appearance and helps the skin surface appear more balanced.

What is the recovery process after subcision?

The most common effects after subcision are bruising and mild swelling. These effects usually decrease significantly within 5–7 days. Temporary sensitivity may occur in the treated area, but most patients can return to their social lives shortly after the procedure.

During the recovery process, sun protection and following the doctor’s care recommendations are important. Subcision not only provides mechanical release but also aims for long-term improvement through the formation of new collagen tissue during healing. Final results usually become more noticeable within a few weeks.

Is subcision treatment permanent?

The mechanical release achieved through subcision in acne scar treatment is permanent. Once the fibrotic bands are cut, they no longer pull the skin downward in the same way. In addition, the new collagen production that occurs after the procedure supports a smoother skin surface.

However, a single session may not be sufficient for deep and widespread acne scars. In some patients, several sessions or combined treatment planning may be required. When performed with the correct technique and proper patient selection, subcision is a powerful treatment option that can provide effective and long-lasting improvement in rolling-type acne scars.