subcision

Subcision is a well established in-office treatment performed by a dermatologist. The most common effects are temporary and include bruising, swelling, soreness, and a firm or full feeling under the skin that settles over several days to a few weeks. Your provider will review what to expect and how to care for your skin before you leave.

Most people have bruising and swelling that are most noticeable in the first couple of days and ease over about 1 to 2 weeks. You can usually return to everyday activities right away, though it is best to avoid heavy exercise, heat, and sweating for a few days. Makeup can go back on once the skin is no longer tender.

Most patients have 3 to 4 sessions spaced 6 to 8 weeks apart. The exact number depends on how many scars are being treated and how deeply they are tethered, which your dermatologist will assess at your consultation.

The bands tethering a scar down are released permanently, so that part of the result does not reverse. The smoothing continues to build for several months as new collagen forms, and most patients see the fullest result 3 to 6 months after their final session.

Subcision works best on rolling, depressed, and tethered acne scars, and it can help shallower boxcar scars and some scars left by injury. It is not the right choice for narrow ice pick scars, which usually need a different approach. A consultation is the best way to confirm your scar type.

To prepare, avoid blood thinning medicines and supplements such as aspirin, ibuprofen, fish oil, and vitamin E for about a week unless your provider advises otherwise, stop retinoids and exfoliants 3 to 5 days before, and avoid tanning for 2 weeks. Arrive with clean skin. Afterward, use cold compresses for swelling, keep your head elevated the first night if your face was treated, protect the area from the sun, and hold off on strenuous exercise for a few days. Your provider will give you full instructions.

Neither is better, because they work in different layers of the skin. Microneedling builds collagen at the surface, while subcision releases scars that are anchored from below. For rolling and tethered scars, the two are often combined rather than chosen between.

Subcision has a well established safety record when performed by a board-certified dermatologist. The most common effects are bruising and swelling for 1 to 2 weeks. Less common effects include temporary firmness or a small nodule at the treatment site, which your dermatologist will discuss with you beforehand.