Acne Scar Subcision

Acne scar subcision is most appropriate for treating specific types of acne scars, particularly rolling scars and some boxcar scars. These scars are caused by a loss of collagen and underlying support, resulting in a sunken or uneven texture. Subcision is generally recommended for individuals who have:

• Depressed scars that are tethered to deeper layers of skin.
• Good skin elasticity and no significant active acne or skin infections.
• Realistic expectations for gradual improvement over time.

Subcision is typically not suitable for treating raised scars, also known as hypertrophic or keloid scars, as these require entirely different approaches.

This treatment is ideal for those looking to achieve noticeable, long-lasting improvements in their skin’s texture without resorting to more invasive surgical methods.

Dr. Knackstedt and the team at Apex Skin Center perform acne scar subcision under local anesthesia to minimize discomfort. The procedure typically involves the following steps:

1. Preparation: The treatment area is cleaned and marked to identify the target scars. Local anesthesia is then injected into the area to numb the skin and ensure the patient’s comfort during the procedure.
2. Needle Insertion: A fine, sterile needle or blunt-tipped cannula is carefully inserted into the skin through a small puncture. The needle is moved in a controlled fanning or sweeping motion to break up the fibrous bands tethering the scar to the underlying tissue.
3. Collagen Stimulation: Once the bands are released, the skin begins to lift and even out. The minor trauma caused by the needle also stimulates the body’s natural collagen production, which helps to improve skin texture and elasticity over time.
4. Finishing Touches: After the procedure, the treatment area is cleaned, and an ointment or dressing is applied.

The entire process typically takes 30-60 minutes, depending on the number and severity of scars being treated.

Healing after acne scar subcision varies from person to person but generally involves minimal downtime. Patients can expect the following stages of healing:

1. Immediate Post-Procedure Effects:
   • Mild redness, swelling, and bruising are common and usually resolve within 7-10 days.
   • Tiny puncture marks from the needle may be visible but will heal quickly with proper care.
2. Collagen Remodeling:
   • Over the following weeks to months, the body produces new collagen in the treated area, further improving the skin’s texture and firmness.
   • Subcision often results in progressive improvement as the skin regenerates.
3. Aftercare Instructions:
   • Patients are typically advised to avoid strenuous activities and direct sun exposure for a few days after the procedure.
   • Gentle skincare, including the use of sunscreen and a non-comedogenic moisturizer, can promote healing and protect the skin.
   • Avoid picking at or irritating the treated area to prevent complications.
4. Follow-Up Treatments:
   • While some patients see significant improvement after one session, multiple sessions spaced 4-6 weeks apart may be necessary for optimal results, especially for more severe scarring.
5. Potential Side Effects:
   • Though rare, risks include prolonged redness, infection, or hyperpigmentation, especially for individuals with darker skin tones. These side effects are typically mild and can be managed with proper care and follow-up with the dermatologist.