Rolling acne scars, also known as atrophic scars, are wavy depressions in the skin with gentle, sloping edges. These scars occur when fibrotic strands of scar tissue form under the skin, causing uneven skin texture, especially in certain angles of lighting.

During a subcision treatment, a cannula is gently inserted into the skin and used to break the fibrotic bands that connect the scar to the underlying tissue. This lifts the depressed scar and helps correct the deficiency in volume. The process also triggers the body’s natural healing process where the needle was inserted, prompting the development of new collagen and further improving the appearance of the scar.

Before your subcision treatment begins, your skin will be prepped and cleansed. Then, one of our physicians will inject a local anesthetic to make the procedure as comfortable as possible. You may also request the use of nitrous oxide or Pronox to further improve your patient experience.

Once the area is numb, your physician will insert a hypodermic needle horizontally under the surface of the skin. They will then gently move the needle in a fan-like motion to break the fibrous bands and release the scar.

Once the procedure is complete, your physician will apply pressure and ice to the treated area to help soothe the skin. The length of the procedure is determined by the extent of the scarring, but most treatments will take around 30 minutes.

After a subcision procedure, you may experience some pain, swelling, or bruising in the treated area, which typically resolves after one to two weeks. You may take over-the-counter anti-inflammatory drugs to decrease any pain or swelling.

You will be able to apply makeup to conceal bruised areas, but we recommend that you allow 1-2 weeks for complete resolution of swelling and bruising to ensure adequate social downtime. After a subcision treatment, most patients note having swelling and some bruising, and report that they are back to their normal social activities within one week.

After subcision, the appearance of acne scars is visibly reduced, improving the texture and volume of the skin. According to a study published in the Journal of Cutaneous and Aesthetic Surgery, “Subcision is a safe, simple technique that provides significant long-term improvement in the ‘rolling scars’ of selected patients. It can be safely and easily combined with other treatments for acne scars.”

For best results, multiple subcision treatments are recommended. Depending on the severity of the scarring and each individual’s healing experience, most patients will require three to six treatments. Subsequent procedures can be performed after at least four weeks.

While subcision can greatly improve the appearance of acne scars, it cannot eliminate them completely. Subcision treatments can be combined with platelet-rich plasma for improved results. Subcision can also be performed in conjunction with other acne scar treatments, including microneedling and laser therapy. To learn more about our acne scar treatments, visit our Acne Clinic.

You may be a good candidate for subcision if you have rolling acne scars that disrupt the texture of your skin. We do not recommend subcision for patients who have active acne or a history of keloids. Subcision is not suitable for all types of acne scars, and a consultation with one of our trained physicians is necessary to determine if subcision is the best option for you.