Acne Scar Subcision

Acne Scar Subcision

What are the different types of acne scars?

Acne scars can be broadly categorized into acne erythema (red discoloration from early stage acne scarring), hypertrophic scars (firm, pink, “bumpy” scars), rolling scars (scars with a sweeping, depressed contour), boxcar scars (scars with an abrupt drop-off depression), and ice pick scars (scars with deep, punctate, or “icepick” depression).  These clinical categories are only important because they direct the treatment methods.

What is Acne Scar Subcision?

Many treatment methods can be utilized to treat acne scarring, depending on the type of acne scar targeted. Subcision is a specific treatment that addresses the depressed categories of acne scarring. It is most effectively used to treat rolling scars, but can also moderately improve the appearance of boxcar scars, and minimally (if at all) improve the appearance of ice pick scars.

Acne scar subcision is a technique in which a sharp instrument is used to “subcise”, or break apart, the firm scar tissue that tethers the upper layer of the skin to its underlying layers.  This technique involves precise sweeping motions of a sharp instrument to free the upper skin from being bound down below. Filler material, known as hyaluronic acid, can also be injected at the same time to temporarily fill in the opened spaces, while waiting for the body to eventually create its own collagen to fill in the gaps.  The injected hyaluronic acid aids in stimulating the body to produce more collagen.

Does Acne Scar Subcision Hurt?

A topical numbing cream is applied before the procedure.  With appropriate numbing, the procedure is painless. There may be some mild discomfort and swelling in the several days after the procedure, but this can be easily controlled with over the counter pain medication, if needed.

How Many Sessions are Needed for Acne Scar Subcision?

While individual results vary, an average of 3 treatment sessions are recommended for optimal results.  Visible improvement can be seen as soon as after one treatment session.

What is the Downtime Involved?

Most of the swelling and bruising occur during the first week of the procedure, while some residual effects may run into the second week.  Most people wish to avoid working the first two days after the procedure due to the postprocedural bruising that can occur.  We recommend avoidance of any medically unnecessary blood-thinning medications or supplements (aspirin, advil, fish oil, etc)  two weeks prior to the procedure to decrease the amount of post-procedural bruising. Exercise, saunas, and intense physical activity should be avoided in the two weeks after the procedure.

Is Acne Scar Subcision Right for Me?

Acne scar subcision may not be the most appropriate procedure for every patient with acne scarring. There are also other procedures that can help minimize the appearance of acne scars such as laser treatments, and microneedling.  Sometimes, a combination approach is utilized for the best outcome.  During your consultation, Dr. Tzu will review your medical history, explore the individual characteristics of your acne scars, and develop a customized treatment plan to target your acne scarring.

Call Wall Street Dermatology to schedule a consultation with us today.

Dr. Julia Tzu

Dr. Julia Tzu is a double board certified dermatologist who specializes in Mohs and reconstructive skin surgery, laser surgery, and cosmetic dermatology. She is one very few dermatologists in the world who has devoted additional years of formalized fellowship training in both Mohs surgery as well as dermatopathology, making her amongst the most highly trained and elite dermatologists.


Wall Street Dermatology: Julia Tzu, MD
Phone: 212-931-0538
65 Broadway, Ste 904
New York, NY 10006


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