Written by: Anna Chacon, M.D. • June 9, 2025• Dermatology

Subcision: Releasing the Scars for Smoother Skin

Tired of acne scars that seem etched in time? Frustrated by the uneven texture of your skin? You’re not alone. Millions seek solutions to minimize the appearance of these reminders of past breakouts. While various treatments exist, one often-overlooked yet highly effective option is subcision.

So, what exactly is subcision? Imagine the tethered roots of a stubborn weed. Similarly, some types of scars, particularly depressed or rolling acne scars, are anchored beneath the skin’s surface by fibrous bands. These bands pull down on the epidermis, creating that characteristic pitted or undulating appearance.

Subcision is a minimally invasive surgical technique that directly addresses this underlying issue. Using a small needle, a dermatologist or cosmetic surgeon meticulously releases these fibrous bands. Think of it as carefully snipping those stubborn roots. This release allows the skin to lift and regain its natural contour, resulting in a smoother, more even complexion.

How Does It Work Its Magic?

The benefits of subcision are twofold:

Physical Release: By severing the tethering bands, the depressed scar tissue is freed, allowing it to rise to the level of the surrounding skin.
Stimulation of Collagen: The micro-trauma caused by the needle stimulates the body’s natural healing response. This triggers the production of new collagen, a vital protein that provides structural support and elasticity to the skin. Over time, this new collagen further improves the texture and appearance of the treated area.

What Types of Scars Benefit from Subcision?

Subcision is particularly effective for treating:

Rolling scars: These are characterized by gentle, wavelike depressions across the skin.
Boxcar scars: These are wider, sharply defined depressions with vertical edges.
Some depressed surgical or traumatic scars: As long as the underlying tethering is present.

It’s generally less effective for ice pick scars, which are narrow, deep and pit-like.

What to Expect during and after the Procedure

Typically performed under local anesthesia, subcision involves the insertion of a small needle through a tiny entry point in the skin. The practitioner then manipulates the needle beneath the scar to break the fibrous bands. You might feel a mild pressure or a “scratching” sensation. The number of entry points and the duration of the procedure depend on the extent and location of the scarring.

Immediately after subcision, it’s common to experience some swelling, bruising and tenderness in the treated area. These side effects usually subside within a few days to a couple of weeks. Your practitioner will provide specific aftercare instructions, which may include applying ice packs, avoiding strenuous activity and protecting the area from sun exposure.

The Results and the Journey

While some improvement may be noticeable shortly after the swelling subsides, the full benefits of subcision often become apparent over several weeks to months as new collagen forms. Multiple treatment sessions may be recommended for optimal results, especially for more severe scarring.

Is Subcision Right for You?

If you’re bothered by depressed acne scars and are looking for a treatment that addresses the underlying structural issues, subcision could be a game-changer. However, it’s crucial to consult with a qualified dermatologist or cosmetic surgeon to determine if it’s the most appropriate option for your specific skin type and scar characteristics. They can assess your scars, discuss your goals and explain the potential risks and benefits of the procedure.

Subcision offers a promising approach to achieving smoother, more confident skin by tackling the root cause of depressed scars. By releasing the tethering bands and stimulating collagen production, it can help you finally break free from the visible reminders of past breakouts.

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