Subcision is a minimally invasive procedure used to treat certain types of depressed acne scars, particularly those caused by fibrous bands (fibrotic adhesions) beneath the skin. These fibrous bands tether the skin downward, causing the surface to become depressed and creating the appearance of deep acne scars.

Subcision addresses the underlying cause of specific acne scar types rather than treating only the skin's surface. It is especially effective for acne scars associated with subdermal tethering. However, treatment outcomes vary depending on the type and severity of the acne scars, and Subcision is often incorporated into a personalised treatment plan that may include other procedures to optimise overall results.



Because acne scar remodelling takes time, multiple Subcision sessions may be recommended. Treatment should always be performed following a comprehensive assessment by a qualified physician to ensure the most appropriate approach for each individual's skin condition.

Subcision is considered the most effective treatment option for Rolling scars, as these scars are typically caused by fibrous bands beneath the skin that tether the underlying tissue and pull the skin surface downward. This results in broad, shallow depressions and an uneven skin texture.

By releasing these fibrous bands, Subcision reduces the downward tension on the skin, allowing the depressed area to gradually elevate as the skin undergoes its natural healing process. Over time, this can improve the appearance of acne scars and create a smoother skin surface.


Characteristics of Rolling Scars

• Broad, shallow depressions
• Poorly defined or sloping edges
• Uneven or wavy skin texture
• More noticeable when viewed from the side or under directional lighting
• Caused by fibrous bands (fibrotic adhesions) tethering the skin beneath the surface

In contrast, Boxcar scars and Ice pick scars are primarily associated with loss of collagen and underlying tissue, rather than fibrous tethering. As a result, these scar types often require different treatment modalities or combination therapies based on the physician's assessment.



In clinical practice, most patients present with a combination of different acne scar types rather than a single scar pattern. Therefore, a thorough skin assessment is essential to accurately classify the scars and develop a personalised treatment plan that addresses each scar type appropriately.

The principle of Subcision involves inserting a specialised medical needle or blunt cannula beneath the skin to carefully release or divide the fibrous bands (fibrotic adhesions) that tether the scar to the underlying tissue. Once these adhesions are released, the downward tension is reduced, allowing the depressed skin to elevate more naturally.

In addition to mechanically releasing the scar, the controlled tissue injury created during the procedure stimulates the body's natural wound-healing response. This process promotes new collagen formation (neocollagenesis) and tissue remodelling within the treated area, contributing to gradual improvement in skin texture and acne scar appearance over time.



Because Subcision targets the underlying structural cause of Rolling scars, it addresses more than just the skin's surface. By releasing the fibrous bands beneath the skin while stimulating collagen remodelling, Subcision provides a foundation for more effective long-term improvement and is often combined with other acne scar treatments—such as Fractional CO2 Laser, TCA CROSS, microneedling, or collagen-stimulating injectables—to achieve optimal clinical outcomes.

Subcision is one of the most effective treatment options for Rolling acne scars caused by fibrous bands (fibrotic adhesions) beneath the skin. Unlike treatments that primarily improve the skin's surface, Subcision addresses the underlying structural cause of specific acne scars.

• Directly Releases Fibrous Bands Beneath the Skin
  Subcision is specifically designed to release fibrous bands (fibrotic adhesions) that tether the skin downward. These adhesions are a major contributing factor in the development of Rolling scars, causing the skin to appear depressed and uneven.

• Particularly Effective for Rolling Scars
  Rolling scars generally respond well to Subcision because this scar type is primarily caused by subdermal tethering rather than collagen loss alone. Releasing these fibrous bands helps reduce the tension beneath the skin and creates a better environment for tissue remodelling.

• Helps Improve Skin Texture
  Once the fibrous bands have been released, the depressed area may gradually elevate as the skin undergoes its natural healing process. This can result in smoother skin texture and a softer appearance of acne scars over time.

• Can Be Combined with Other Acne Scar Treatments
  Subcision is frequently incorporated into a combination acne scar treatment plan. Depending on the individual's scar type and severity, it may be performed alongside Fractional CO2 Laser, RF Microneedling, or other collagen-stimulating treatments to optimize overall clinical outcomes.

• Targets the Underlying Cause of Rolling Scars
  Because Subcision focuses on fibrous bands beneath the skin, rather than only improving the skin surface, it addresses one of the primary causes of Rolling acne scars, making it an important treatment option for appropriately selected patients.

Subcision is designed to address fibrotic adhesions beneath the skin, which are one of the primary causes of Rolling acne scars. Following treatment, patients may experience gradual improvement as the skin heals and remodels.

Potential treatment outcomes include:

• Helping release fibrous bands that tether depressed acne scars.
• Improving the appearance of Rolling acne scars by reducing skin tethering.
• Promoting a smoother and more even skin texture.
• Supporting the skin's natural wound-healing process.
• Stimulating new collagen formation (neocollagenesis) in the treated area.
• Improving overall skin irregularities caused by acne scarring.
• Enhancing treatment outcomes when combined with other acne scar procedures.

Treatment outcomes vary among individuals depending on the type of acne scars, their severity, the personalized treatment plan, and adherence to post-treatment care instructions.

Following Subcision, mild swelling, bruising, tenderness, or a feeling of tightness in the treated area is common and generally improves as healing progresses.

To support recovery, patients are advised to:

• Apply cold compresses during the first 24–48 hours, following your physician's instructions.
• Avoid touching, pressing, massaging, or rubbing the treated area.
• Do not pick or scratch bruised areas.
• Take all prescribed medications exactly as directed.
• Avoid strenuous physical activity or excessive sweating during the first 24–48 hours.
• Avoid saunas, steam rooms, and hot baths for approximately 7–10 days, or as advised by your physician.
• Avoid vigorous exercise until your physician confirms it is appropriate.
• Apply a broad-spectrum sunscreen daily and minimise direct sun exposure.
• Avoid exfoliating treatments, chemical peels, or other aesthetic procedures on the treated area until the skin has fully recovered.
• Attend all scheduled follow-up appointments so your physician can monitor your healing and treatment progress.



If you experience excessive swelling, increasing pain, persistent redness, signs of infection, or any unexpected symptoms, contact your physician or clinic promptly for further evaluation.

Subcision is an effective treatment option for selected Rolling acne scars, particularly when fibrous bands beneath the skin are the primary cause of scar tethering. By releasing these fibrotic adhesions, the procedure helps reduce tension beneath the skin while supporting the body's natural healing response and collagen remodelling.

Because every patient's acne scars differ in type, depth, severity, and skin characteristics, a personalized consultation with a qualified physician is essential before treatment. A comprehensive assessment allows the most appropriate treatment plan to be developed, which may include Subcision alone or in combination with other acne scar treatments for optimal results.



If you are concerned about acne scars and would like personalised advice regarding Subcision Treatment, the medical team at Seven Days Clinic is available to assess your skin, discuss your treatment options, and create an individualised treatment plan tailored specifically to your needs.