Subcision for Acne Scars

How it works

After numbing, the doctor inserts a fine needle or blade beneath the scar and moves it to free the band pulling the skin down. The released area may lift as it fills with blood and later healing tissue. Some doctors add filler or another treatment after. Effects vary by person and scar type, and further sessions may be advised.

Who it may suit

• Rolling or tethered acne scars
• Depressions that flatten when the skin is stretched
• People who can accept bruising for a week or two
• Those who want to combine it with resurfacing later

The treatment day

1. Consultation. The doctor stretches the skin to see which scars suit this approach. Ask which scars will be treated.
2. Local anesthesia. A numbing injection is given. Mention past reactions to anesthetic.
3. Release. A needle moves beneath the scar. You may feel pressure and tugging.
4. Aftercare. Pressure is applied to limit bruising. Ask for instructions in English.

Aftercare

• Apply cold packs or pressure only as instructed
• Avoid blood-thinning supplements unless your own doctor says otherwise
• Keep the area clean and avoid makeup for the period advised
• Use sunscreen once the skin allows
• Report expanding swelling, severe pain, fever or signs of infection

Things to know first

• Bruising, swelling, tenderness and small lumps are common
• Infection, bleeding under the skin and uneven results can occur
• Not all scars improve, and ice-pick scars usually need other methods
• Blood thinners, bleeding disorders and active acne call for caution
• Pregnancy and active infection are reasons to wait

Talking through subcision in English

Because this is a procedure with a needle and local anesthetic, list everything you take: aspirin, ibuprofen, fish oil, vitamin E and herbal products. Tell the doctor about bleeding history and keloids. Give dates for past scar treatments.

Ask which scars are likely to respond and which are not. Ask how much bruising is typical and how long it lasts. Ask whether a second session is likely and when it should be.

Words such as tethered, rolling scar and hematoma may come up. A hematoma means a collection of blood under the skin. Ask for aftercare instructions in English and a clear way to reach the clinic.