Subcision is a minimally invasive procedure designed to treat depressed acne scars, particularly those known as rolling or boxcar scars. This technique involves inserting a specialized needle beneath the skin to mechanically break the fibrous bands that tether the scar tissue to the underlying deeper layers. By releasing these tethers, the skin is allowed to elevate, which smooths the surface contour and stimulates the body’s natural collagen production in the resulting space. Understanding the number of sessions required is necessary for managing patient expectations and planning treatment.
The Typical Treatment Range
The number of subcision treatments needed is highly individualized but generally falls within a predictable range for moderate to severe scarring. Most patients require between two and four sessions to achieve a satisfactory level of improvement in scar depth and appearance. Few patients see their desired final results after only a single session because the fibrous bands often require repeated release and the complete collagen remodeling process takes time. A “session” involves the physical release of the scar tissue followed by the body’s natural healing response. While initial improvement is often noticed after the first treatment, the maximum benefit is usually realized after the second or third session as collagen continues to build within the dermal pocket created by the subcision.
Variables That Influence the Number of Sessions
The primary consideration is the type and depth of the scar itself, as deeper, more established rolling scars necessitate more extensive tissue disruption and therefore more sessions. Newer scars generally respond more quickly to subcision compared to older, long-standing scars that have developed stronger, more rigid tethering bands. The individual’s biological healing response and capacity for collagen production also play a significant role in the overall number of treatments. Patients who generate new collagen efficiently may see faster and more pronounced results, potentially reducing the need for an additional session. Skin type, often categorized by the Fitzpatrick scale, can also influence the protocol; darker skin tones may require more cautious, less aggressive treatments to avoid post-inflammatory hyperpigmentation, sometimes necessitating more, but less intense, sessions to reach the desired outcome safely.
Spacing and Overall Treatment Timeline
Proper spacing between subcision treatments is necessary to allow the skin to fully heal and for the collagen remodeling process to occur. Dermatologists typically space sessions approximately four to eight weeks apart, ensuring that the body has adequate time to build new tissue in the treated area before being disrupted again. Treating the same area too soon can interfere with the healing cascade and potentially increase the risk of side effects. This required interval means that the overall treatment timeline extends over several months, even if only a few sessions are necessary. The gradual nature of healing means that the final, most noticeable results will continue to evolve for up to six months after the final procedure.
Combining Subcision with Complementary Treatments
Integrating subcision with other therapies can significantly modify the total number of subcision sessions needed. Combining subcision with treatments like dermal fillers, energy-based devices, or microneedling often leads to better and faster results than subcision alone. The goal of this combined approach is efficiency, optimizing the outcome of each session. The simultaneous use of temporary dermal fillers, such as hyaluronic acid, immediately after subcision is a common strategy to prevent the scar from retethering to the underlying tissue during the healing phase. By physically propping up the newly released scar, the filler acts as a scaffold, which can effectively eliminate the need for a subsequent, dedicated subcision session. Combining subcision with energy devices or microneedling also stimulates a greater overall collagen response, sometimes achieving the desired depth correction in fewer treatments.