Subcision Treatment – A Solution for Acne Scars

If you find yourself slathering your face with honey and lemon juice in an attempt to get rid of your acne, it may be time to wash off and look into treatments that will actually improve your skin. 

Acne happens to everyone, whether you are a teenager or an adult, and it does not discriminate by gender. Everyone gets acne. But even when your acne “goes away,” it can leave scarring behind that makes your skin look dimpled, uneven, and blemished. 

This is where subcision treatment can help! Unlike your Pinterest board featuring DIY acne treatments, subcision is a clinically proven, non-invasive treatment that improves the appearance of acne scars instantly. 

What is Subcision Treatment and How Does it Work? 

Subcision treatment is a procedure that treats depressed acne scars using small needles to correct the depressed volume in the skin. Depressed acne scars are caused by bands that connect the top layer of skin to layers beneath it and pull the skin downward, creating uneven skin texture. Subcision addresses this by cutting that band in order to allow the skin to return to its natural texture. 

When you undergo this treatment, a board-certified cosmetic physician like Dr. Nadir Qazi will insert a small needle into the scar and make a sweeping motion in order to sever the underlying band. 

This will need to be repeated for all your acne scars. 

Because the procedure mimics damage to the skin, it triggers increased collagen production, which will improve your skin’s overall texture and appearance over time. 

While subcision will not remove your acne scars entirely, it will certainly improve the appearance of them and give you healthier, smoother skin. In some cases, multiple treatments may be required to achieve your desired results.  

Frequently Asked Questions About Subcision Treatment 

How do I know if subcision treatment will work for me and my acne scars?

This treatment is only ideal for certain types of acne scars, namely “boxcar” scars and “icepick” scars. These are types of acne scars that are indented. Other types of acne scarring like pigmentation and raised scars can not be treated with subcision. 

The best way to find out if subcision is the right treatment for you is to schedule a consultation at Qazi Cosmetic Clinic. Dr. Qazi can examine your acne scarring, identify what type you have, and recommend a customized treatment that will reduce the appearance of your acne scars. 

How much downtime is there after the treatment? How soon after can I book a special event? 

As a general rule, you should always give it at least 2 weeks after a cosmetic procedure before you book a special event. 

Certain procedures may require more time. If you want to look your best for a party, special gathering, ceremony, photoshoot, or another important event, you will need to schedule your subcision appointment 7-10 days before it. 

Immediately after treatment, your skin will be swollen and some bruising may occur. It is perfectly safe to return to work or school after the treatment, but many people opt to take the day off due to the appearance of their healing skin. The swelling will gradually heal over the next 2-3 days. If bruising occurs, it will heal over the next 7-10 days. Once your skin heals over, you will be able to see the results of the treatment. 

Because subcision also promotes collagen production, the texture of your skin will continue to improve in the weeks after the procedure. For patients with extensive scarring, they normally opt to treat one area of skin at a time in order to limit the amount of facial swelling at once. 

If you require multiple treatments, it is safest to space them out about one month apart over the course of several months. 

What are the side effects? Is subcision risky? 

Subcision is perfectly safe. There are few risks and bad reactions to the procedure are exceedingly rare. Some side effects have been reported, these include: hematoma, pain and tenderness at the site, temporary inflammatory hyperpigmentation, infection, hypertrophic scarring, and – in rare cases – injury to nerves or blood vessels. 

Don’t worry, negative side effects are extremely rare. The best way to avoid side effects is to only get cosmetic procedures from a qualified, board-certified cosmetic physician. A medical expert will ensure your safety during the procedure and use the best practices to make the procedure and your recovery go as smoothly as possible. Additionally, you can avoid side effects like infection by taking a prescribed antibiotic or anti-inflammatory medication if directed. 

Can men get subcision treatment for acne scars?

Yes! Cosmetic treatments are for everyone, not just women. 

In fact, Dr. Qazi sees many male patients who want to improve their appearance with non-invasive, natural-looking cosmetic procedures. Men who undergo treatment for acne scars overwhelmingly report greater confidence, both in the workplace and at parties. Acne scars happen to everyone and subcision treatment can help! 

Learn more about cosmetic treatments for men. 

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    What You Need to Know About Acne and Scarring

    While subcision is highly effective for certain people and certain types of acne scars, it isn’t right for everyone. For example, if you are terrified of needles, you should not undergo subcision. Additionally, your acne scars may be treated more effectively with another method depending on what type of scarring you have. 

    When you have acne, it may or may not lead to scaring. 

    This depends on your genetics and other factors related to your skin type. Acne occurs when small holes in the skin become clogged with excess oil and dead skin cells, resulting in raised bumps that may or may not have a head. It is very tempting to pop whiteheads and blackheads, but this causes greater damage to the skin. 

    When you pop or pick at acne, it is like a small wound to your skin. When your body tries to repair the damage, the skin creates collagen. Acne scarring occurs when the body produces too much or too little collagen. Too much collagen results in raised acne scars, also called hypertrophic or keloid scars. Too little collagen results in depressed acne scars that cause indents in the skin. 

    This is a before and after result of an acne subcision treatment that was performed at Qazi Cosmetic Center in Newport Beach, California.

    What Are the Types of Acne Scars and How Can They Be Treated?

    1. Hyperpigmentation: Discoloration of the skin can be caused by many factors, including melasma during pregnancy. When the skin is damaged by acne, discoloration can occur as a result of post-inflammatory hyperpigmentation. In this situation, the skin heals a little darker typically from sun exposure and this is especially common for people who have darker skin tone because they have more melanin. For most people, their discoloration will go away on its own, but if it doesn’t, medical-grade chemical peels are a very effective treatment for evening out your skin tone. 
    1. Keloids: When your skin produces too many cells as it heals from acne, the result are these raised, reddish bumps on the skin. Keloids can be hard to treat, even with surgery because they will often return even after being removed. Retinol topicals, laser treatment, and a cortisone shot are often effective at flattening or shrinking keloids. 
    1. Icepick Scars: These are named because they look like small holes in the skin. When your skin heals after acne damage and does not produce enough collagen, it causes depressions in the skin like icepick scars. In some cases, subcision treatment will work great on icepick scars. Another option is a chemical peel or laser resurfacing; these treatments work by damaging the skin in order to promote proper healing so that your skin will close up these holes on its own. 
    1. Rolling Scars: These are scars that have a stretched, wave-like appearance. Rolling scars are almost always caused by long-term inflammatory acne. If you have them when you are young, they will only get worse as you age and your skin loses its elasticity. Laser treatments are a common way to treat rolling scars; however, it can often require multiple treatments to achieve the desired results. Another option is using dermal fillers to restore volume to your skin. 
    1. Boxcar Scars: Inflammatory acne is nearly always the cause of boxcar scars. These are shallow indents in the skin with sharp edges. The appearance of boxcar scars can be reduced greatly with subcision treatment, either alone or in conjunction with laser treatment. 

    Laser Treatment: An Effective Complement to Subcision 

    If you are afraid of needles or have a type of acne that subcision will not treat, then acne laser treatment may be the solution for your acne scars. At Qazi Cosmetic Clinic in Orange County, we like to combine acne laser treatment with other acne solutions in order to give you the best results possible. Cortisone is a diluted steroid that reduces inflammation instantly and fades blemishes within hours of injection. After a cortisone shot, Dr. Qazi normally utilizes laser treatment in order to repair and restore large areas of damaged skin. 

    There are several types of lasers that can be used to heal your acne scars including: 

    • Aerolase Lightpod Neo Laser is FDA-approved to treat acne scars as well as many other cosmetic issues, including wrinkles, skin discoloration, cystic acne, and unwanted hair. 
    • Sciton Halo: this cutting-edge laser has dual wavelengths for ablative and non-ablative treatments. With this particular laser, we can resurface the skin and smooth acne scars with minimal discomfort or social downtime.
    • Lutronic LaseMD Ultra: 1972nm wavelength lasers are fantastic for even darker skin patients, but this particular device is one of our favorites since we can put out much more energy than almost anything else on the market. It also creates tiny microchannels that can be used to infuse medications such as tranexemic acid which can help with hyperpigmentation.
    • Fraxel Dual Laser: is primarily used to restore a youthful glow to your skin and is ideal because it requires little downtime. This laser also works on wrinkles, sun damage, discoloration, actinic keratosis, and most kinds of scarring – including acne scarring. Like most lasers, it works by shooting microscopic laser columns deep into the skin in order to expedite collagen production. Because it only treats small areas of the skin at a time, it leaves the surrounding skin intact to allow for faster healing. 
    • ND:YAG 1064 Laser: is designed using a crystal to emit high energy light with a wavelength of 1064 nm in order to reach the deepest layers of the skin. When the laser is focused on certain areas of the skin, the heat produced will destroy damaged skin cells. This laser can be used to treat everything from spidery veins to birth marks to acne scars and active acne. 
    • Erbium Laser: This powerful laser is sometimes known as “Cool laser” since it can actually have a cooling sensation on the skin with little to no pain. On higher settings, it can actually resurface the skin and can be fantastic for certain types of scars. There can certainly be more downtime with Erbium lasers when done for resurfacing purposes.
    • CO2 Laser: An ablative laser that can be used to treat deeper lines, wrinkles, and acne scars. Depending on the treatment, recovery can be a matter of a few days to up to two weeks.

    When you make an appointment with Dr. Qazi, he will determine which laser and which treatment is right for you. Dr Qazi is an expert in combining multiple different treatment options for optimal results.

    Frequently Asked Questions About Laser Treatment

    Will my treatment be painful? 

    Typically laser treatments are not painful; you may feel some pressure and heat on your skin, but you will likely not experience pain. For some cosmetic issues, it is necessary that the laser penetrates deep into the skin. In some cases, this can cause a little discomfort. In order to keep you comfortable, Dr. Qazi can apply a topical numbing cream. 

    How can I prepare for my treatment? 

    The most important thing you can do prior to your treatment is avoid excessive sun damage and tanning. When you are in the sun, it is important that you wear sunscreen and use a hat or parasol to block the sun’s harmful rays. Before the procedure, make sure to tell Dr. Qazi if you are on accutane or certain oral antibiotics as these can make your skin more sensitive. 

    What is the recovery process like?

    Like subcision treatment and many other acne treatments, lasers are non-invasive and non-surgical.

    This means that you may have some downtime to heal, but there is very little in the way of recovery. After your procedure, you will have some redness and dryness. It is very important that you follow Dr. Qazi’s instructions on moisturizing properly. Additionally, your skin may feel tender. Immediately after the procedure you are safe to drive and go back to school or work. Over the course of the next week, your skin will heal. Over the next 2 weeks, your results will begin to show as your body produces more collagen. 

    What other cosmetic concerns can be treated with lasers?

    In addition to treating your acne scars, lasers can also be used to treat wrinkles, sun damage, and melasma.

    These laser treatments work by penetrating deep into the skin to boost collagen production. Because collagen is responsible for skin texture and elasticity, more collagen means tighter skin. When the laser treatment mimics damage to the skin, it promotes your body to naturally heal sun damage and discoloration. While it can take repeated treatments to see the desired results, laser treatments are ideal for overall skin improvement.

    With one procedure, you can see a dramatic decrease in your wrinkles, scars, and sun damaged skin. 

    Learn More About Subcision Treatment and Lasers for Acne Scars

    If you are ready to treat your acne scars, please contact Qazi Cosmetic Clinic to schedule a consultation. Dr. Nadir Qazi will determine the best treatment for your specific needs and customize a treatment plan to give you the glowing skin you’ve always wanted. 

    By: Dr. Nadir Qazi

    Dr. Nadir Qazi is a board certified physician specializing in minimally invasive cosmetic procedures. He is a fellow of the American Academy of Cosmetic Surgery and an instructor for advanced injections and laser techniques.

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