Subcision for Acne Scars

Targeting Acne Scars at Their Structural Root

Subcision is a minor surgical procedure designed to treat depressed acne scars — specifically rolling scars caused by fibrous bands that tether the skin downward. By mechanically releasing these bands, the skin is freed to lift and recontour. It also triggers a controlled wound-healing response that stimulates new collagen formation over time.

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Who is This For?

Subcision is most effective for rolling acne scars — broad depressions with soft edges, tethered or bound-down scars, and uneven skin texture not responding to surface-level treatments.

It is less effective for ice pick scars, raised hypertrophic or keloid scars, or very superficial textural changes. Accurate scar assessment is essential before treatment.

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How it Works

A fine needle or blunt cannula is inserted beneath the skin. The practitioner moves it in a controlled pattern to break the fibrous bands anchoring the scar downward. This creates a small, controlled injury beneath the surface — triggering the body's natural collagen-building response. Improvement is therefore both immediate (release of tethering) and progressive (collagen remodelling over weeks to months).

Clinically Proven Benefits

• Targets the underlying structural cause of rolling scars
• Immediate visible lifting of tethered tissue
• Stimulates natural collagen production
• Can be combined with fillers, microneedling, or laser for enhanced results
• Minimally invasive with relatively short recovery

What to Expect

1. Pain level: Local anaesthetic is used. Pressure or movement is felt, but pain is usually minimal.
2. Downtime: Bruising and swelling typically 5 to 10 days. Normal activities resume within a few days.
3. Sessions: Usually 1 to 3 sessions depending on scar severity, spaced 4 to 8 weeks apart to allow full healing.
4. Session length: Approximately 20 to 45 minutes.
5. First results: Some improvement is immediate; optimal results over 4 to 12 weeks as collagen develops.

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Preparation and Aftercare

Before treatment:

• Avoid blood-thinning medications if medically appropriate
• Ensure no active infections or inflammation in the area
• Follow pre-procedure advice from your dermatologist

After treatment:

• Expect bruising — it is part of the healing process
• Avoid strenuous activity for 24 to 48 hours
• Do not massage the area unless instructed
• Use sun protection to reduce pigmentation risk

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Clinical Insight

Not all acne scars are surface problems — many are structural. Subcision directly targets the mechanical component of scarring, which is why it is often the essential first step in a comprehensive scar treatment plan, before resurfacing procedures are introduced.