Subcision for Acne Scars | Board-Certified Dermatologist
Subcision is a minimally invasive scar treatment used to improve the appearance of certain depressed or tethered acne scars. The procedure involves releasing fibrous bands beneath the skin that pull a scar downward, allowing the treated area to lift and heal more evenly.
At Yolanda C. Holmes, M.D., P.C., Dr. Holmes provides personalized evaluation for patients considering subcision in Washington, DC. As a board-certified dermatologist with more than 34 years of experience, Dr. Holmes evaluates your acne scars, skin type, scar pattern, medical history, and treatment goals to determine whether subcision may be appropriate for you.
Subcision is a minor dermatologic procedure used to treat certain depressed scars that are attached to deeper layers of the skin by fibrous bands.
These bands can pull the surface of the skin downward, creating a depressed or uneven appearance.
During subcision, a specialized needle or instrument is inserted beneath the skin and used to release the fibrous attachments underneath the scar.
Once these attachments are released, the scar may be able to rise and become less noticeable.
Subcision is most commonly associated with the treatment of certain types of acne scars.
Subcision is particularly useful for certain depressed or rolling acne scars that are tethered to the underlying tissue.
These scars may appear as:
Not every acne scar responds to subcision.
For example, deeper ice-pick scars and some sharply defined boxcar scars may require different treatment approaches.
Because acne scars often include several different scar types, Dr. Holmes evaluates the individual scars before recommending treatment.
Acne scars can form when inflammation and tissue damage during acne healing cause abnormal scar formation beneath the skin.
In some depressed scars, fibrous strands form underneath the skin and tether the scar downward.
Subcision works by mechanically releasing these attachments.
The process can:
The degree of improvement depends on the type, depth, and severity of the scar and your individual healing response.
Rolling acne scars are often characterized by broad, shallow depressions that create an uneven or wavy appearance.
These scars may be caused in part by fibrous bands pulling the skin downward.
Because subcision specifically addresses these underlying attachments, it may be particularly useful for appropriately selected rolling scars.
Dr. Holmes can evaluate whether the appearance of your scars is consistent with tethering and whether subcision may be beneficial.
Depressed acne scars occur when scar tissue pulls or replaces normal skin structure, creating an indentation.
Subcision may help elevate certain depressed scars by releasing the tissue responsible for the tethering.
However, the procedure does not automatically correct every type of depressed scar.
Some patients may benefit from a combination of treatments to address different components of their scarring.
Acne scars are not all the same.
A patient may have a combination of:
Because each type of scar behaves differently, treatment needs to be individualized.
Subcision may be appropriate for some scars but not others.
A dermatologist can determine which treatment or combination of treatments is most appropriate for your particular scar pattern.
Subcision and microneedling work in different ways.
Subcision addresses fibrous attachments beneath the skin that tether certain depressed scars.
Microneedling creates controlled micro-injuries in the skin to stimulate the body's healing response and may improve overall skin texture and certain scars.
Because they address different aspects of acne scarring, the treatments may sometimes be incorporated into a broader acne scar treatment plan.
Dr. Holmes can determine whether one treatment or a combination approach is appropriate for your scars.
Learn more about Microneedling →
PRP, or platelet-rich plasma, may sometimes be incorporated into a cosmetic treatment plan for acne scars.
PRP uses a concentrated platelet-containing preparation made from the patient's own blood and may be used to support the body's natural healing processes.
Whether PRP is appropriate in combination with subcision depends on the patient's skin, scar characteristics, and treatment goals.
Learn more about Platelet-Rich Plasma (PRP) →
Before treatment, Dr. Holmes evaluates your acne scars and discusses your medical history, previous acne treatments, and cosmetic goals.
The treatment area is cleaned and prepared.
A local anesthetic is typically used to numb the treatment area and improve comfort during the procedure.
Once the area is numb, a small instrument or needle is inserted beneath the skin near the scar.
The instrument is carefully moved beneath the scar to release the fibrous bands responsible for tethering the skin.
The technique and treatment pattern depend on the location and characteristics of the scars being treated.
The procedure length varies depending on the number and size of the areas being addressed.
Subcision is typically performed using local anesthesia to minimize discomfort during treatment.
You may feel pressure, movement, or pulling while the scar tissue is being released, but the treatment area should be adequately numbed.
After the procedure, some soreness or tenderness is expected as the skin heals.
Individual experiences vary depending on the number and location of scars being treated.
Some improvement may be noticeable after the initial swelling begins to resolve.
However, the skin continues to heal and remodel following treatment, so the final appearance develops gradually.
The amount of improvement varies based on:
Some patients may require more than one treatment session to achieve their desired improvement.
The number of treatments varies depending on the severity and characteristics of your acne scars.
Some patients may see meaningful improvement after one treatment, while others may benefit from multiple sessions.
Treatment may be performed in stages, allowing the skin to heal between procedures.
Dr. Holmes will determine whether additional treatment is appropriate based on your response and treatment goals.
Subcision is designed to release the underlying scar attachments rather than simply temporarily change the appearance of the skin.
Once the fibrous bands have been appropriately released and the area has healed, improvement may be long-lasting.
However, results vary.
New acne can create additional scars, and existing scars may continue to change with aging and other factors.
Maintaining control of active acne is therefore an important part of preventing new acne scars.
Learn more about Acne Treatment →
Subcision may be appropriate for adults with certain depressed or tethered acne scars, particularly rolling scars.
You may be a candidate if you are concerned about:
A consultation is important because subcision is not appropriate for every type of acne scar.
Dr. Holmes will examine your scars and determine whether subcision, another treatment, or a combination approach is most appropriate.
Subcision may need to be postponed or avoided in certain circumstances.
Factors that may affect candidacy include:
Pregnancy and breastfeeding should also be discussed with your physician before elective procedures.
Your medical history and current medications will be reviewed before treatment.
Subcision involves creating a controlled injury beneath the skin, so temporary side effects are expected.
Possible effects may include:
Less common complications can include infection, prolonged swelling, hematoma, nerve injury, changes in pigmentation, or additional scarring.
Dr. Holmes can discuss the potential benefits, risks, and limitations of treatment during your consultation.
Subcision generally involves more recovery than non-invasive cosmetic treatments because the procedure works beneath the surface of the skin.
Temporary swelling and bruising can occur and may be noticeable for several days.
The length of recovery varies depending on the number of scars treated, treatment intensity, and individual healing response.
Dr. Holmes will provide specific aftercare instructions and let you know when you can safely return to your normal activities.
After treatment, you will receive individualized instructions for caring for the treated area.
General recommendations may include:
Do not stop prescribed medications, including blood-thinning medications, unless your physician specifically instructs you to do so.
Your individual aftercare instructions should take priority over general information found online.
Subcision can be performed in patients with a wide range of skin tones.
However, patients with darker skin tones may be more prone to post-inflammatory hyperpigmentation after procedures that cause inflammation or injury to the skin.
Careful treatment planning is therefore important.
Dr. Holmes has a focus on dermatology for skin of color and considers individual skin characteristics, pigmentation concerns, and scar type when developing an acne scar treatment plan.
Learn more about Dermatology for Skin of Color in Washington, DC →
Subcision is only one option for treating acne scars.
Depending on your scar type, Dr. Holmes may recommend:
The most effective treatment depends on the specific characteristics of your scars.
For patients with multiple scar types, combining treatments may provide a more comprehensive approach than using a single procedure.
Subcision may be performed on selected areas where depressed or tethered scars are present.
Common treatment areas can include:
The treatment area depends on the location and characteristics of the scars.
The face contains important blood vessels, nerves, and other structures, making appropriate anatomical knowledge and medical evaluation important when performing subcision.
Subcision may be considered for selected depressed scars on areas of the body.
However, treatment is highly dependent on the scar type, location, depth, and underlying tissue.
If you have acne scars on the chest, back, or another area, Dr. Holmes can evaluate the scars and determine whether subcision or another treatment would be appropriate.
Subcision is intended to improve the appearance of acne scars, not completely erase them.
Acne scars are structural changes in the skin, and no single treatment can guarantee complete removal.
The goal is to make scars less noticeable and improve the overall texture and appearance of the skin.
Realistic expectations are an important part of treatment planning.
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Board-Certified Dermatologist
with 34+ years of experience
Personalized Acne Scar Evaluation
based on your scar type, skin characteristics, medical history, and treatment goals
Medical & Cosmetic Dermatology Expertise
with an understanding of both skin health and cosmetic scar treatment
Experience With Skin of Color
with individualized consideration of pigmentation and skin characteristics
Individualized Acne Scar Treatment
with treatment recommendations based on your specific scar pattern
Convenient Washington, DC Location
1737 20th Street NW, Washington, DC
Dr. Yolanda C. Holmes is a board-certified dermatologist with more than 34 years of experience serving patients in Washington, DC.
She provides personalized medical, surgical, and cosmetic dermatology care for patients with a wide range of skin concerns.
Dr. Holmes evaluates each patient's skin characteristics, scar type, medical history, and treatment goals when determining whether subcision or another acne scar treatment may be appropriate.
Learn more about Dr. Holmes →
If depressed or tethered acne scars continue to affect the appearance of your skin, a personalized dermatologic consultation can help determine whether subcision may be appropriate. Dr. Holmes can evaluate your acne scars and discuss whether subcision, microneedling, PRP, or another treatment approach may best address your goals.
Schedule a Subcision Consultation in Washington, DC
