Subcision for Acne Scars

Subcision can be one of the best treatments for rolling acne scars and chicken pox scars. A rolling scar is a shallow, indented scar with no sharp edges. They primarily occur on the cheeks. Other treatments for rolling scars are microneedling and injectable fillers. Subcision is the least expensive. Twelve treatments of microneedling may be needed to treat rolling scars at a cost of $3600. Injectable fillers range in price from $665-$680 but may need repeating every 9-12 months. Not all rolling scars can be treated with filler. Subcision is $400 per treatment. The treatment number is variable, but is done every 3 weeks to 3 months. So, if you have 4 per year it is $1600, making it the least expensive and more permanent solution.

Subcision is done in the office. The scars are numbed with lidocaine and nitrous oxide (laughing gas) can be administered to make this more comfortable. Then a special needle is inserted into the skin at an angle, targeting the scar bands. This breaks up the fibrotic strands that are tethering the scar to the underlying tissue. This causes bleeding , which forms a clot. The clot plus the release of the bands raises up the scar. As the clot is absorbed it leaves scar tissue that continues to support the skin.

Subcision causes bleeding, swelling, pain and bruising. Occasionally, the patient may experience nodules under the skin while the area is healing. All these things will begin to subside in 5 days. Several subcision treatments may be needed. It works for 60% of patients. Improvement can be seen over 6 months but sometimes it takes longer. It is not 100% predictable.