7 Pros and Cons of Subcision for Acne Scar Removal

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Author: Natalie Ng|21 April 2025

Thinking about subcision for acne scars? Subcision is a simple, minimally invasive treatment that helps with depressed scars like rolling scars and boxcar scars by releasing the fibrous tissue pulling the skin down. This can smooth out the surface and boost collagen production. Subcision works well for deep acne scars, especially when combined with other acne scar treatments like fillers or fractional laser. It doesn’t need much downtime, but it can cause swelling or bruising, and it’s not ideal for ice pick or keloid scars. If you’re looking for ways to treat acne scars, this could be an option. Keep reading to see the full list of pros and cons, and find out if subcision for acne scars makes sense for you.

Subcision Is Effective for Deep Rolling and Boxcar Scars

Subcision works best for depressed acne scars, especially rolling scars and some boxcar scars. These types of atrophic scars are often caused by scar tissue pulling the skin downward, which is exactly what subcision targets.

How Subcision Helps Rolling Scars

Rolling scars are shallow and wide, creating a wave-like texture on the skin surface. These are often caused by fibrotic strands under the skin. A subcision procedure breaks these strands, which helps release the tension and smooth out the skin. For deeper rolling acne scars, combining subcision with dermal fillers can give better results. The filler helps lift the skin further after the fibrous bands are cut.

What to Know About Boxcar Scars

Boxcar scars have sharper edges and go deeper into the skin. Subcision can help, but these often need more than one method. Many treated patients see better improvement when subcision acne scar treatment is followed by fractional laser or dermabrasion, especially if the scar depth is severe.

Combine With Other Treatments

Subcision works on the underlying tissue, but the full result depends on things like scar severity, skin type, and how well your body produces collagen during the healing process. Many doctors suggest adding treatments like PRP, fractional CO2 laser, or rejuran scar treatment to improve results. If you’ve got deep scars or atrophic acne, subcision could be a helpful first step. But combining it with other acne scar treatments often makes a bigger difference.

Subcision Requires Minimal Downtime and Recovery

Subcision is a minimally invasive procedure, but recovery still takes time. Most people need about 1 to 2 weeks before their skin starts to feel and look normal again.

Results After Treatment

In the first 48 to 72 hours, you’ll likely see swelling and bruising in the treated area. This is normal and part of the healing process, but it can make daily activities uncomfortable. Some people may also notice mild bleeding or tenderness.

Aftercare

Since subcision involves breaking fibrous tissue below the skin surface, it’s important to follow aftercare steps closely. Your provider may recommend a topical antibiotic ointment to prevent infection. You’ll also need to avoid strenuous activities and sun exposure for at least a week. Using sunscreen daily helps protect the skin as it heals.

Gradual Skin Texture Improvement

Your skin texture may not improve right away. It takes time for the skin to heal and for collagen growth to begin. For most people, full healing takes 2 to 3 weeks, though this can vary based on skin type, scar depth, and overall health. While subcision acne scar treatment doesn’t involve a long recovery, it still requires planning. You might not feel comfortable jumping back into work or social events right away.

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Subcision Leads To Long-Lasting Results After Healing

Subcision acne scar treatment often leads to results that last for years. It works by cutting the fibrous bands beneath depressed acne scars, which helps lift the skin. Once those bands are released, they usually don’t grow back in the same way—so the scar tissue doesn’t pull the skin down again.

How Subcision Creates Long-Term Change

The effects of subcision are partly mechanical and partly biological. First, the tethered scars are released. Then, as your skin heals, collagen production increases in the treated area. This supports the skin from underneath, helping with long-term improvement in skin texture. In some cases, especially with deep atrophic scars, the scar tissue beneath the skin can reattach over time. That’s why many people need more than one session. Multiple treatments help keep the scar from returning and make the results more stable. Your skin’s response to the subcision procedure, along with the severity of the scars, plays a big role in how long the results last. Some people may need occasional follow-ups, especially if they have deep scars or moderate scarring.

Duration Of Results

Most people see noticeable acne scar improvement for 2 to 5 years after subcision. In some cases, results last even longer. That’s because of the lasting effect of collagen growth in the underlying tissue. To get the best results, many providers recommend combining subcision for acne scars with other acne scar treatments, like fractional laser or dermal fillers. These combinations help prevent the scar from reforming and reduce the chance of needing repeat sessions.

Risk of Post-Treatment Bruising and Swelling

Although subcision is a minimally invasive procedure, it still involves a hypodermic needle moving under the skin surface to cut through fibrotic tissue. This can temporarily affect blood vessels and cause bruising or swelling in the treated area. Most patients see bruising that lasts about 7 to 14 days. Swelling usually peaks in the first 48 hours and fades within a week. These are expected parts of the healing process and usually don’t require medical treatment. If you take blood-thinning medications or have a bleeding disorder, you may be at higher risk for more visible or longer-lasting bruising. It's important to let your provider know in advance.

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Potential for Uneven Texture and Scarring

Subcision is meant to smooth out depressed cutaneous scars, especially rolling scars and atrophic acne. But if not done properly, it can sometimes lead to new issues with skin texture.

Risks

Because the procedure involves moving a needle under the skin surface, there’s a risk of creating uneven or raised areas. This can happen if the technique is off or the treatment doesn’t match the scar depth or scar type. - The needle may leave irregular marks beneath the skin if not carefully controlled - Some areas might develop excess scar tissue, leading to raised bumps - Ice pick scars can appear more noticeable if nearby skin becomes uneven - Uneven collagen growth can cause a bumpy or lumpy texture in the treated area

Limited Effectiveness on Ice Pick Scars

Subcision isn’t the best option for treating ice pick scars. These scars are deep, narrow, and sharply defined, which makes it hard for the subcision needle to reach the base and release the fibrotic tissue that causes the depression.

Why Subcision Struggles with Ice Pick Scars

- Ice pick scars are too narrow for effective access with a standard hypodermic needle - The fibrous bands anchoring the scar are often too deep and tight to fully release through subcision - Even if some improvement happens, results are usually minimal compared to how well subcision works on rolling scars or boxcar scars

Better Treatment Options for Ice Pick Scarring

To treat ice pick scars more effectively, doctors often use TCA CROSS, punch excision, or a combination approach. While subcision for acne scars can still be part of the plan, it usually plays a supporting role rather than being the main treatment. If you’re dealing with multiple scar types—including atrophic acne scars like ice pick, rolling, or boxcar scars—your provider will likely recommend different techniques for each one.

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Subcision Works Well With Fillers, Lasers, and Other Acne Scar Treatments

Subcision can be effective on its own, but it often works better when combined with other acne scar treatments. This is especially helpful if you have different types of acne scars, like rolling scars, boxcar scars, or hypertrophic scars, each needing a different approach.

Common Treatment Combinations

- Subcision + Dermal Fillers: After cutting the fibrotic strands, fillers can be injected to lift the depressed scars and improve skin texture right away. This is useful for atrophic acne scars that need extra volume. - Subcision + Laser Treatments: Once the scar tissue beneath the skin is released, fractional laser or fractional CO2 laser can reach deeper layers more effectively. This boosts collagen production and smooths the skin surface over time. - Subcision + Injections for Keloid or Hypertrophic Scars: While subcision isn’t a primary treatment for keloid scars, combining it with corticosteroid injections or topical treatments may help reduce scar tissue buildup in some cases.

A Flexible Treatment Strategy

Subcision acne scar treatment is often just one part of a full acne scar management plan. By combining methods based on your scar type, scar severity, and skin type, you’re more likely to see long-term improvement with fewer repeat sessions.

Clear Breakouts and Support Scar Healing With the Acne Treatment

Acne and acne scars often overlap, but they form differently — and need different types of treatment. While subcision is effective for atrophic acne scars like rolling scars and boxcar scars, it doesn’t treat active acne or surface buildup. In fact, performing subcision on inflamed skin can slow healing and increase the chance of complications. The Acne Treatment works at the skin surface, helping clear pores, calm inflammation, and reduce excess sebum—creating the ideal environment for subcision acne scar treatment to work better and heal faster.

What Is the Acne Treatment?

The Acne Treatment is a non-invasive skin therapy developed for individuals with acne-prone skin, including those dealing with acne scars, whiteheads, blackheads, and ongoing breakouts. It uses a dual spiral suction plus drainage system to remove dead skin cells, oil, and impurities from clogged pores. This step is followed by the infusion of a medical-grade hydrating serum that penetrates the deeper layers of skin. The serum is formulated to: - Soothe inflamed sebaceous glands - Rebalance the oil-water ratio - Support collagen production to restore and strengthen the skin barrier By clearing the skin and promoting healing from the surface down, the Acne Treatment prepares the skin to respond better to deeper scar treatments, including subcision.

How the Acne Treatment Enhances Subcision Results

Subcision treats depressed scars by breaking the fibrous bands below the skin surface that cause tethering. While this works well for atrophic scars, it doesn’t address surface problems like blocked pores, active breakouts, or oily skin—which can interfere with healing and reduce the visible benefits of subcision. Here’s how the Acne Treatment supports and complements subcision: - Pre-treatment: Clears congested pores before subcision, reducing inflammation and minimizing the risk of complications like swelling, irritation, or post-procedure breakouts - Post-treatment: Keeps pores clear and balanced after subcision, which supports collagen remodeling and scar healing - Breakout prevention: Reduces future acne flare-ups, which lowers the risk of new post-acne scarring - Skin health: Hydrates and calms the skin during the healing process, preventing dryness or excess oil production - Scar texture support: By boosting collagen growth at the surface level, it enhances the overall effect of the subcision underneath This combination is ideal for people with moderate scarring, ongoing acne, or oily, congested skin that needs more than one type of care.

Key Benefits of the Acne Treatment

- Non-invasive: No incisions, needles, or medications - Safe for active acne and sensitive skin types - No downtime: Return to daily activities immediately after the session - Supports scar healing by promoting hydration and reducing surface inflammation - Targets acne and scar risk at the same time, improving both appearance and skin health

The Acne Treatment is most effective when done regularly—often once a month—as part of a full acne scar management plan. If you’re planning a subcision acne scar treatment, or recovering from one, combining both approaches can help reduce breakouts, improve healing, and lead to better long-term results. If you're currently dealing with deep acne scars, active breakouts, or both, combining subcision with the Acne Treatment can help you get clearer skin faster — and maintain the results longer. Book a consultation today to find out how these treatments can work together for your skin.

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FAQ

Is Subcision Treatment Painful Even With Local Anesthesia?

With local anesthesia, you'll feel minimal to no pain during the subcision procedure itself. You might experience a slight pinching sensation when receiving the anesthetic injection, but once it takes effect, the treatment area becomes numb. After the anesthesia wears off, you can expect some discomfort, tenderness, and bruising for 3-7 days, which you can manage with over-the-counter pain medications.

How Long Should I Wait Between Subcision Sessions?

Like a garden needs time between plantings to regenerate its soil, your skin requires adequate healing periods between subcision treatments. You'll need to wait 4-6 weeks between sessions to allow proper collagen formation and tissue healing. If you're combining subcision with other treatments, your doctor might recommend 8-12 weeks between sessions. Your specific healing time depends on your skin's response and the treatment's depth.

Can I Wear Makeup Immediately After the Procedure?

You shouldn't wear makeup immediately after subcision, as it can increase your risk of infection and interfere with proper healing. Wait at least 24-48 hours before applying any cosmetics to the treated area. When you do resume wearing makeup, guarantee your brushes and products are clean, and use only non-comedogenic products. If you need coverage during the initial healing period, ask your doctor about special post-procedure mineral makeup options.

What Age Is Considered Ideal for Getting Subcision Treatment?

Just as a fruit must reach full ripeness before harvest, you'll get the best results from subcision when your skin has fully matured. The ideal age typically ranges from 20-45, when your skin's healing capabilities are prime. You'll want to guarantee your acne is under control for at least 6-12 months before treatment, and your scars should be fully mature, which usually takes 1-2 years after active breakouts have stopped.

Are the Results of Subcision Permanent if I Continue to Get Acne?

Subcision results can be affected if you continue to develop active acne. While the treatment permanently breaks up existing scar tissue, new acne breakouts can create additional scarring. To maintain your results, you'll need to: 1. Control active acne through proper skincare and medication. 2. Treat new breakouts promptly. 3. Consider follow-up subcision treatments for any new scars that develop. Think of subcision as one part of your overall acne management strategy.

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7 Pros and Cons of Subcision for Acne Scar Removal

Subcision Is Effective for Deep Rolling and Boxcar Scars

How Subcision Helps Rolling Scars

What to Know About Boxcar Scars

Combine With Other Treatments

Subcision Requires Minimal Downtime and Recovery

Results After Treatment

Aftercare

Gradual Skin Texture Improvement

Read More

Subcision Leads To Long-Lasting Results After Healing

How Subcision Creates Long-Term Change

Duration Of Results

Risk of Post-Treatment Bruising and Swelling

Potential for Uneven Texture and Scarring

Risks

Limited Effectiveness on Ice Pick Scars

Why Subcision Struggles with Ice Pick Scars

Better Treatment Options for Ice Pick Scarring

Read More

Subcision Works Well With Fillers, Lasers, and Other Acne Scar Treatments

Common Treatment Combinations

A Flexible Treatment Strategy

Clear Breakouts and Support Scar Healing With the Acne Treatment

What Is the Acne Treatment?

How the Acne Treatment Enhances Subcision Results

Key Benefits of the Acne Treatment

FAQ

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