Link to progress pictures:
I just had subcision today and will be posting pictures almost everyday so you can see the progress.
ME: white, 25, female, cystic and flammatory acne since puberty that is finally under control (thank you accutane, BP, and retin-a)
MY TYPE OF ACNE SCARS: rolling (soft depressed) acne scars, mostly on cheeks and temples. I'd say mine are mild to moderate... they feel severe of course. I have hyperpigmentation (red spots after pimples) but subcision does not treat that...I am using Tri-Luma cream to address that (mix of retin-a, hydroquinone, which is a bleaching cream, and some steroid)
MY RESEARCH ON ACNE SCAR TREATMENTS: I spent tons of time researching all sorts of acne scar treatments and went on several consultations with various doctors. I considered lasers (ablative and non-ablative), dermabrasion, chemical peels, injectible fillers, and of course subcision.
- Invasive lasers, chemicals, and dermabrasion are all very pricey (in the thousands of $) and have widely varying results and side effects. I generally concluded that the cost was not worth the risks...i don't want to risk side effects like hyperpigmentation and do not want to risk not getting results since it's so expensive.
- Non-invasive lasers seem good in theory but I felt I need something a little more aggressive and something that specifically addressed acne scars (wheras those non-invasive lasers mostly address wrinkles).
- Fillers are temporary and again, don't try to repair the scars. They are good for no downtime and if you need a really quick solution
- Subcision is underrated and not talked of much... I've decide it's because it's not glamorous like lasers and other treatments that have advanced technology behind them to justify the big price tags. Subcision is just a man with a needle -- barbaric sounding, really... and not lucrative... so it's not something doctors will try to sell any chance they get. This is why research is important --- to see past the marketing selling those fancy boxes that shoot out red, blue and yellow light at your skin.
WHY SUBCISION FOR ME: Few reasons.
- (1) LOW RISK, as long as the doctor knows what he's doing. If he does it right, you don't risk getting more scars or hyperpigmentation, like you possibly could with lasers or chemicals or dermabrasion. Also, you're not messing with good skin! a lot of other treatments burn or sand good and bad skin.. subcision just digs in and breaks up scar tissue to allow it to scar evenly and encourage collagen to grow. I consider this much less invasive than lasers, peels, etc...plus lower downtime (a week or less... few days if you don't care about a few bruises)
- (2) LOW COST - i paid $500 bucks...if it doesn't work that well, who cares? It's spending $5,000 on fraxel that I'd care about if it didn't work.
- (3) GOOD LOGIC: addressing each scar individually, under the skin where it is (for my type of scars) rather than trying to sand down all skin (good or bad)
- (4) RESEARCH: i found scholarly articles on clinical studies. One in particular was a study on 40 people getting one subcision session. The results were an average of 50% improvement in scars, and 90% of patients felt their appearance was improved. This is a very realistic and (in my opinion) great result. Plus, a second treatment can improve the results even more.
FIND A GOOD DOCTOR: make sure it is a dermatologist or plastic surgeon (not a nurse) that has done it before and can show you pictures
BEFORE PROCEDURE: take Arnica (to help bruising) starting two days before treatment. When you go in, they inject your face to numb you up. The numbing is the worst part but tolerable. I have rolling scars covering most of my cheeks so I received about 20-30 pricks of that numbing needle and felt everyone... it stung. It feels a little bit worse than a cortisone shot you'd get for a pimple. I maybe had extra shots because I sometimes don't respond to it (one time a dentist simply could not get me numb -- kept missing the nerve bundles, i guess, since their location vary slightly from person to person). Also, it can help to bring a friend to hold your hand.
PROCEDURE: Takes about an hour, may a little more (for me at least). Doctor used 20-gauge needle on me to insert under each scar and rotate under skin. Doing so breaks up scar tissue that is holding down the top layers of the skin that created those dreadful drepressions in the first place. This movement makes noise! I could hear a few to sometimes several "snaps" or "crunches" for each scar he dug under. The idea is that once the scar tissue is broken, the top layers of skin are released and new collagen will form and your skin will scar evenly and smoothly.
AFTER: You will be bruised and swollen and will probably see pinpricks of blood at some of the poke sites. I'm on day one as I'm writing this but I don't feel disfigured. I can probably go in public and peole will only notice if they are within 10 feet and do a doubletake. Doctor prescribed tylenol codeine for pain and icing for three days. I can put on make up starting the day after treatment. Doctor suggested taking a week off but depending on how comfortable one is, less time can be taken off.
RESULTS: results take at least 4 weeks but probably more like 6-8 weeks to see how effective the treatment was since it takes collagen time to build up.
Again, here is a link to my progress photos:
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