Therapeutic Update on Acne Scarring

June 2014 | Volume 13 | Issue 6 | Features | 651 | Copyright © June 2014


Amy E. Rose MD

New York University, The Ronald O.
Perelman Department of Dermatology,
New York, NY

harvested from posterior auricular skin can also be placed. Subcision has long been utilized in the treatment of acne scars, particularly rolling acne scars with dermal banding and tethering. A large bore needle is inserted into the mid dermis and using a fanning technique, the dermal bands are released allowing the base of the acne scar that was previously bound down to rise closer to the surface of the surrounding skin. Bleeding and subsequent clot formation then occupies the potential space created when the bands are released. Subcision is often combined with dermal fillers, which can be used as a more sustainable material to fill in the potential space rather than the clot alone. The procedure is relatively easy to perform and is low cost with main side effects including mild bleeding and bruising. A randomized, split-face study comparing subcision to 100% TCA in 20 patients with rolling acne scars showed significantly (P= 0.001) better reduction in scar depth with subcision.5 Additionally, more pigmentary alterations were noted in the TCA group.

Conclusion

A combination approach that considers both the patient’s and the physician’s limitations generally has the best chance for success. The face of an acne scarred patient is often a landscape of mixed terrains with rolling scars that require filler with resurfacing and deeper boxcar or ice pick scars that need surgical approaches. While emerging technology will no doubt improve outcomes for acne scar patients, we would be wise to remember that prevention of scarring via an appropriately aggressive acne treatment regimen is always the best strategy.

Disclosure

The author has not disclosed any relevant conflicts.

References

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AUTHOR CORRESPONDENCE

Amy E. Rose MDamyrosemd@cosmetiquemd.com
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