If you have deep acne scars that never seem to improve no matter what you try, you are not alone. Some of our patients are surprised to learn that some scars are actually “tethered” down from underneath, which is why creams, peels and even lasers can only do so much. Subcision is a specific treatment that directly targets this root cause and it often flies under the radar compared with more “famous” or “trendy” procedures.
What is subcision, in simple terms?
Subcision is a minor in-clinic procedure that releases deep, sunken acne scars from below the skin.
A very fine needle is guided just under the surface to gently break the fibrous bands that are pulling the scar down, a bit like snipping the strings holding a tent peg in place.
Once those “tethers” are released, the scar can lift, and the body starts to fill the area with new collagen over time. As this fresh collagen forms and remodels, the previously deep dent often looks softer, shallower and less obvious in everyday lighting.
How subcision helps acne scars
Many boxcar and rolling scars are not just shallow marks; they are anchored from beneath. The principle behind subcision is to:
- Loosen the anchors (fibrous bands).
- Create a small internal space.
- Allow the skin to heal with new collagen in that space.
Older methods often used subcision on its own as a one-off or stand-alone treatment. While that can still help, modern acne scar management has evolved. Today, subcision is frequently paired with collagen-stimulating injectables to support better quality healing and faster visible improvement.
A modern upgrade: Subcision + PDRN (salmon or trout DNA)
After a scar is released, the skin needs to repair itself in a smooth, organised way. That is where PDRN comes in.
PDRN (polydeoxyribonucleotide) is a regenerative ingredient derived from purified salmon or trout DNA, used to support tissue repair and collagen production. When injected into or around areas that have just been subcised, PDRN can:
- Support healthier cell turnover and microcirculation.
- Encourage more robust collagen formation.
- Help the treated area heal more evenly and comfortably.
In everyday terms, this combo means you are not only freeing the scar from underneath, but also “feeding” the skin with a collagen-stimulating booster so results can build more quickly and more predictably than with subcision alone.
Advantages of subcision for deep acne scars
Subcision offers several key benefits, especially for deep, tethered scars:
- Targets the real cause
Instead of only resurfacing the top of the skin, subcision focuses on the deep bands that are actually pulling scars down. - Preserves most of the skin surface
Because the work is done under the skin, there is less risk of surface burns, strong peeling or widespread pigment change compared with aggressive lasers or strong chemical methods. - Low to moderate downtime
Most people experience mild swelling or bruising for a few days, which is often easy to cover with makeup. There are usually no large scabs or raw patches to hide for weeks. - Works well with other treatments
Subcision can be combined with PDRN, RF microneedling or other collagen-stimulating treatments to improve overall texture and refine the remaining scars over time.
Is acne scar subcision safe?
When performed by a trained doctor who understands facial anatomy and scar types, subcision is considered a safe and reliable procedure. As with any injectable treatment, there can be temporary side effects like bruising, mild soreness or small lumps, but these usually settle on their own over several days.
The key is a controlled, gentle technique: careful depth, deliberate movements and proper aftercare. In skilled hands, the risks are low and the benefits for suitable scars can be significant.
Worried about pain? What the procedure actually feels like
Feeling nervous about a needle under the skin is very normal, especially if it is your first time. Most patients are pleasantly surprised by how manageable subcision feels with proper preparation.
Before the procedure, a strong numbing cream is applied to the treatment area and left on long enough to take full effect. During the subcision treatment, patients often describe the sensation more as pressure, tapping or a dull tug rather than sharp pain.
The session is usually quite swift. Afterward, you can expect some tightness, mild swelling and occasionally some bruising, but most people are able to return to work or daily activities almost immediately, accepting a short period of “touch-up-with-concealer” downtime rather than hiding away for weeks.
Is subcision right for your scars?
Subcision is not for every type of scar, but it can be a game-changer for the right ones—especially deep boxcar and rolling scars that feel “stuck down” when you stretch the skin. The best way to know is to have your scars examined under good lighting and from multiple angles by an experienced doctor.
If your acne scars are affecting your confidence and you are curious whether a targeted, low-downtime approach like subcision (possibly combined with PDRN) could help, consider taking the next step. Book a consultation with our doctors to discuss your concerns, understand your scar pattern and find out if subcision is a suitable treatment option for your skin.
