Deborah Tosline wrote and published “Skin Remodeling DIY: An Introduction to the Underground World of Do-It-Yourself Skincare” in 2015. Her approach to skin care is based on a scientific background, love of research and over 30 years of DIY skincare experience.

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Note: this article contains some graphic information about a dermatologic medical procedure.

I recently acquired a 2-inch scar that runs down the middle of my forehead and as a result, learned new (to me) information on skin care as I researched “laceration healing progression” and “atrophic scar management”. Atrophic scars are those scars that form a depression in the skin surface and may result from acne or trauma.

As I searched, read and planned my DIY scar healing treatment protocol, one dermatologic scar treatment called skin subcision stood out. 

Subcision is a simple medical procedure that uses a sharp needle to release connective tissue beneath a scar. 

Subcision or “subcutaneous incisionless surgery” was developed by Orentreich and Orentreich in 1995 as a minor surgical procedure used to treat depressed scars. A tri-beveled hypodermic needle is inserted beneath and parallel to the skin adjacent to a scar. The needle is maneuvered in a sweeping motion beneath the scar to gently cut or break connective tissue that attaches the scar to deeper subcutaneous tissue. When the connective tissue is released, the skin depression lifts.

During subcision you may hear a snapping sound as the fibrous strands beneath the scar or wrinkle are broken.

The procedure results in one puncture wound. Much of the blood associated with the broken connective tissue is squeezed out to prevent a large blood clot beneath the skin, however some blood is allowed to remain. Clot formation provides a foundation for new collagen production and further lifts or elevates the atrophic scar.

In 2019, a study titled “Subcision and Microneedling as an Inexpensive and Safe Combination to Treat Atrophic Acne Scars in Dark Skin: A Prospective Study of 45 Patients at a Tertiary Care Center” assessed forty-five patients who were given a total of four subcision/microneedling treatments; with one treatment every four weeks. The results showed scar improvements in 95.4 percent of the participants. The patient reported ratings are provided in the following table.

I had recently seen the word “subcision” while reading one of Dr. Desmond Fernandes’s skin needling publications (IMO one of the best skin docs in the world). Dr. Fernandes uses subcision and skin needling to treat lip wrinkles. At the time, I didn’t understand what subcision meant but I did not forget the word.

After reading about the use of subcision for scar treatments, I was intrigued. 

My impression is that subcision is not extensively practiced and instead, laser and other (more expensive) scar treatment options are recommended. Is subcision a secret simple protocol for treating atrophic scars and wrinkles? IMO if Dr. Fernandes uses subcision to treat lip lines then that’s the only endorsement that I need. It’s innovative to use subcision to treat wrinkles; most of the references that I found use subcision to treat acne scars.

Subcision is an inexpensive “safe, less invasive [love that], simple technique that provides significant long-term improvement… [that] can be safely and easily combined with other treatments…”.

I searched dozens of local derms and med spas in the Phoenix, AZ metropolis and found three who advertise subcision on their webpage. I’ve booked an appointment for a virtual consult to determine if a Glendale, AZ doc would be willing to use subcision to treat a couple of lip lines that I’ve acquired through the decades so that I could check this simple procedure out. 

In the meantime, I treat my new forehead scar meticulously and am keeping it covered continuously for at least a month. I deep massage the heck out of it when it is exposed. I apply fresh aloe vera leaves to the scar all night and silicon wrinkle pads all day. With all of my DIY scar pampering, I don’t think that my scar will need subcision.  Regardless, I’ll let you know what I find out.

If you need more information about DIY skin care, go to the library, search the Internet, read my past Blog articles, or get my book “Skin Remodeling DIY: An Introduction to the Underground World of Do-It-Yourself Skincare” 

Take good care of yourselves!

XO Deborah

This article is intended to be used as general information only and is in no way intended to replace medical advice, be used as a medical treatment program, diagnosis, or cure of any disease or medical condition. There are no warranties, expressed or implied, regarding the effectiveness of the practices described in this article. Products or substances discussed herein are for educational purposes only and are not intended as recommendations of the author.