Subcision is a minimally invasive treatment for depressed acne scars. Learn how it works, who it’s for, and what to expect.
If you’ve been researching treatments for acne scars, you may have come across the term subcision. It’s not as widely discussed as microneedling or laser resurfacing, but for the right candidate, it can be one of the more effective tools available for a specific type of scarring. This post explains what subcision is, how it works, and whether it might be worth discussing at a consultation.
What Subcision Actually Is
Subcision is a minimally invasive procedure used to treat depressed acne scars — the kind that sit below the surrounding skin surface rather than raised above it. Rolling scars and certain boxcar scars are the most common types addressed with this technique.
During the procedure, a small needle or cannula is inserted beneath the surface of the scar. The instrument is used to break up the fibrous bands of tissue that tether the scar downward, pulling the skin into that characteristic indented appearance. Once those bands are released, the skin is better able to sit at a more even level with the surrounding tissue. The process also stimulates the body’s natural healing response, which can encourage the production of new collagen in the treated area over time.
Subcision is performed in-office under local anesthesia. Most patients describe the sensation as pressure rather than pain, and the procedure itself is typically brief, depending on the number of scars being treated.
Who Is a Good Candidate?
Subcision is most effective for patients with tethered depressed scars — scars where the underlying fibrous attachment is the primary reason for the indentation. The best way to determine whether your scarring fits that profile is through an in-person evaluation. Patients who may benefit from subcision include those with:
- Rolling acne scars with a soft, undulating appearance
- Certain boxcar scars with defined edges and visible depth
- Scarring that has been present long enough to be considered stable
- Skin that is not actively breaking out in the treatment area
Subcision is generally not the right approach for ice pick scars, raised (hypertrophic) scars, or post-inflammatory hyperpigmentation — the dark marks left behind after acne that are often confused with true scarring. Those conditions respond better to different treatments.
It’s also worth noting that subcision is frequently combined with other procedures. Depending on the patient’s scar type and skin, a provider may recommend pairing subcision with microneedling, laser treatment, or filler to achieve a more complete result. Treatment plans are individualized, and results vary.
What to Expect After the Procedure
Some bruising, swelling, and tenderness in the treated area are normal and expected following subcision. Most patients see these side effects resolve within one to two weeks. The skin may feel slightly firm or uneven during the initial healing period as collagen remodeling begins.
Results from subcision typically develop gradually over several weeks to months. Most patients require more than one session to achieve their desired outcome, and the number of treatments depends on the severity and distribution of the scarring. A consultation is required to establish realistic expectations for your specific situation.
Is Subcision Available in Troy, MO?
Yes. Subcision and other acne scar treatments are offered at St. Louis Dermatology & Cosmetic Surgery in Troy, Missouri. Dr. Brandon T. Beal is a double board-certified dermatologist and fellowship-trained cosmetic surgeon with advanced training in procedural dermatology and minimally invasive facial procedures — including scar revision techniques.
Contact St. Louis Dermatology & Cosmetic Surgery Today
Patients from Troy and surrounding communities, including Warrenton, Wright City, and Lake St. Louis, are welcome to request a consultation to discuss whether subcision or another scar treatment approach may be appropriate.
Call (314) 834-1400 or fill out our online contact form to schedule an appointment.
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