A depressed acne scar is not only a surface problem. Underneath it, fibrous bands can tether the scar tissue to deeper facial structures, which is why a pitted mark can still look deep long after the breakout itself has healed. Subcision is one of the few in-office procedures built to address that deeper problem directly, and it is not available everywhere.

What Subcision Does That Topical Products Cannot

Subcision is a minimally invasive procedure that improves the appearance of depressed acne scars, sometimes described as valley scars, by breaking the fibrous bands that hold the scar down. Once those bands release, the scar is free to elevate toward the level of the surrounding skin, which can make the surface look smoother.

The technique is often described as a kind of keyhole surgery for deep acne scars, because it works through a very small entry point to release scar tissue that is attached to deeper facial structures. It is performed in an office setting using a small needle or a blunt cannula, and it is regarded as a safe and effective treatment when it is matched to the right kind of scar.

The goal is not erasure. The goal is to change how the scar sits in the skin so it catches light more evenly and reads as less prominent from a normal conversation distance.

Which Acne Scars Are Good Candidates for Subcision

Subcision targets depressed scars, the ones that sit below the level of the surrounding skin. If a scar is pitted, tethered, or shaped like a shallow valley, it belongs to the category this procedure was designed to treat. Scars that are mainly a difference in color, without a depression, are a separate problem and need a separate plan.

Because the procedure depends on how much fibrous tethering sits beneath the surface, the only dependable way to know whether it will help is an in-person evaluation. A dermatologist can feel the scar, judge its depth, and watch how the surrounding skin moves. Photos taken in consistent lighting can help you describe what bothers you most.

What Happens During an In-Office Subcision Session

Subcision is performed in the office and does not require a hospital stay or general anesthesia. The dermatologist places a fine instrument beneath the scar and works it to free the fibrous attachments holding the skin down. As those attachments release, the scar can rise.

Will you feel it?

Comfort is one of the most common questions about subcision, and there is no single answer that applies to every patient. What you feel depends on the numbing approach used, the depth and location of the scar, and your own sensitivity. Ask the practice directly how they manage discomfort, what numbing they use, and what patients typically report afterward.

Which instrument does the dermatologist use?

Published descriptions of subcision mention both a small needle and a blunt cannula. Which one is used is a technical decision that varies with the dermatologist and with the scar being treated. If you want to understand the plan for your face, ask what instrument is planned and why it was chosen.

Recovery After Subcision: What the First Week Looks Like

Most patients can return to work or normal activities within 1 to 2 days. Minor bruising or tenderness may linger for about a week. That timeline makes planning straightforward: schedule the appointment when a couple of low-key days will not cause a problem, and check your calendar for anything important in the week that follows.

Follow the aftercare instructions your dermatologist provides, because those instructions are written for your specific treatment rather than for the procedure in general. Ask about sun protection, skincare products, and anything you should pause while the skin settles. If something seems to be healing unusually slowly, call the office rather than waiting for a scheduled follow-up.

Where Dermal Grafting Fits Into Acne Scar Treatment

Subcision is a release. Dermal grafting is a different type of intervention that comes up in the same conversation, and the two are frequently discussed together when a dermatologist plans treatment for depressed acne scars. In broad terms, a graft places tissue beneath a scar to give it more support, rather than simply freeing the tether that pulls it down.

The specifics vary widely between practices, including the technique itself, the material involved, and the recovery that follows. Because of that variation, the useful move is to ask for an explanation of what a graft would involve in your case, who would perform it, how many visits it would take, and what downtime to expect. If the practice does not offer grafting, ask whether subcision alone would make sense for your scars or whether you should be referred elsewhere.

Why Not Every Denver Practice Offers Subcision

Not every dermatology office offers subcision, and there is no public directory that reliably lists which Denver practices do. Some offices concentrate on medical dermatology, others on injectables and laser devices, and the procedure menu at any given clinic reflects the training and interests of the clinicians who work there.

Practices that focus on acne scar revision tend to be the ones that keep surgical scar techniques in their toolkit. Colorado Dermatology Center in South Denver is led by board-certified dermatologist Dr. James M. Swinehart and offers procedures that many practices do not, including acne scar revision. More than three decades of clinical experience informs how those treatment plans get built.

Questions to Ask Before You Book

A short list of questions will tell you more about a practice than any marketing page. Bring these to your consultation and listen for specific answers rather than general reassurance.

• Do you perform subcision in the office, and how often do you do it?
• Which scars on my face would you treat with subcision, and which would you leave alone?
• Are you planning subcision by itself or alongside another technique?
• How do you manage comfort during the procedure, and what do patients usually report?
• What should my first week look like, and what symptoms would make you want to hear from me sooner?
• What improvement is realistic for my skin, and how long would it take to show?

Clear answers to those questions are a reasonable expectation. A dermatologist who performs these procedures regularly can explain the reasoning behind a plan in plain language and can tell you honestly when a different approach would serve you better.

Setting Expectations for Improvement, Not Erasure

Acne scarring is a structural change in the skin, and no procedure removes it completely. What subcision can do is change how a depressed scar sits, which can make it less noticeable in everyday lighting. Ask your dermatologist to describe the improvement they expect for your specific scars, and ask whether they would plan one session or more than one visit over time.

Keeping a set of photos taken in consistent lighting helps you judge change objectively over months rather than comparing today’s mirror to a memory. Bring those photos to follow-up visits so you and your dermatologist are looking at the same evidence.

Frequently Asked Questions

Is subcision painful?

Comfort varies, and there is no single answer that applies to everyone. What you feel depends on the numbing approach used, the depth and location of the scar, and your own sensitivity. Because protocols differ between practices, the most reliable answer comes from asking the dermatologist who would perform your treatment what they use and what patients typically report afterward.

Can subcision get rid of acne scars completely?

No procedure removes acne scars entirely. Subcision is designed to improve the appearance of depressed valley scars by breaking the fibrous bands that hold them down, allowing the scar to elevate and the skin to look smoother. Think in terms of meaningful improvement rather than erasure, and ask your dermatologist what change they expect for the scars you have.

Can you have subcision while taking Accutane?

This is a clinical judgment rather than a rule you can look up, and guidance varies between dermatologists. Tell your prescribing dermatologist about every medication you take, including isotretinoin, and ask whether they want you to pause treatment or wait before scheduling subcision. Follow the instructions you are given rather than advice from a forum.

Which needle is used for subcision?

Descriptions of the procedure mention a small needle or a blunt cannula, and the choice depends on the dermatologist’s technique and the scar being treated. There is no single instrument that applies to every case. If you are curious about the plan for your skin, ask what will be used and why during your consultation.

How soon can I go back to work after subcision?

Most patients can return to work or their normal activities within 1 to 2 days, though minor bruising or tenderness may linger for about a week. Planning your appointment around a quiet couple of days keeps the recovery comfortable, and your dermatologist can provide aftercare instructions specific to your treatment.