Subcision Of Acne Scars: Cost, Results, Complications

Skin Conditions, Treatments

Subcision is an acronym for Subcutaneous Incisionless Surgery. Subcision of acne scars makes use of a needle that is inserted into the skin below an atrophic acne scar. The needle tip is maneuvered so as to disrupt fibrous tissue bands below the scar that give atrophic scars their characteristic indented look.

How Subcision Of Acne Scars Works:

By breaking up fibrous bands that are pulling atrophic scars downwards, the scar is released. This allows the scar to lift up to a level closer to the surrounding, normal skin. Additionally, the controlled trauma caused by the needle provokes collagen build-up beneath the scar. This provides the scar with a “pillow” of support from below, keeping the skin at a more optimal level.

Subcision Of Acne Scars Cost:

Fees for subcision vary from one clinic to the other. An average fee is about $300 per session. As multiple sessions are generally required to obtain the best outcomes, expect to pay up to $2000 or more in total.

Which Scars Work Best?

Atrophic scars can be improved using subcision. Hypertrophic scars and keloids are not treated with subcision. Amongst atrophic acne scars, rolling scars respond best to subcision. But, boxcar and ice pick scars can be treated by this technique as well.

Who Shouldn’t Have Subcision Of Acne Scars:

People with medical conditions that prevent normal blood clotting shouldn’t have subcision treatments. Also, if you’re on medications such as Aspirin, Warfarin, or Xarelto, Subcision is likely not a good choice. Blood collections (hematomas) can form beneath the skin in these cases that cause severe bruising and also form visible lumpy nodules.

Complications Of Subcision:

  • pain
  • bruising
  • hematoma
  • swelling
  • lumpy nodules
  • hyperpigmentation (dark blemishing of skin) 

Results:

Subcision is a proven technique. One study confirmed around a 50% improvement in atrophic acne scars. The procedure is generally repeated every 2-4 weeks until results seem to plateau. Subcision is often combined with other procedures such as laser, and micro needling in order to optimize the results.

Subcision of acne scars
Subcision of acne scars (Credit: Dr. Davin Lim)
Subcision of acne scars
Subcision of acne scars (Credit: Dr. Davin Lim)

Medical References:

Gupta A, Kaur M, Patra S, Khunger N, Gupta S. Evidence-based Surgical Management of Post-acne Scarring in Skin of Color. J Cutan Aesthet Surg. 2020 Apr-Jun;13(2):124-141. doi: 10.4103/JCAS.JCAS_154_19. PMID: 32792773; PMCID: PMC7394107.

Alam M, Omura N, Kaminer MS. Subcision for acne scarring: Technique and outcomes in 40 patients. Dermatol Surg. 2005;31:310–7.

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