How Do We Treat Acne Scarring with Subcision?
This page is for general education only. Individual assessment is required before any treatment; suitability, risks, downtime, and results vary between patients.
A doctor-performed treatment approach for selected acne scars
Acne scar treatment in Hong Kong often requires a combination approach. This page explains when subcision may be considered and how it is used as part of a doctor-led treatment plan.
Acne can lead to longer-term skin changes, including textural irregularities, redness, and pigmentation. Acne scarring develops when inflammation affects normal collagen repair, resulting in uneven skin surface or visible marks.
Subcision is a minor surgical technique used in selected cases to address certain types of depressed acne scars. It focuses on releasing fibrous attachments beneath the skin that may contribute to a tethered appearance.
At Alluna Medical, treatment planning is individualised. Recommendations are based on clinical assessment, scar type, and suitability, with a focus on balanced, medically appropriate care.
Understanding Acne Scars
Acne-related skin changes can vary in form and severity. Common presentations include:
Atrophic (depressed) scars such as rolling, boxcar, and ice-pick scars
Post-inflammatory erythema (persistent redness)
Post-inflammatory hyperpigmentation (PIH)
Mixed patterns, which are common
Different scar types respond to different treatments. Subcision is generally considered for tethered, depressed scars, particularly rolling scars.
Current Treatment Approaches
Management of acne scarring often involves combining different modalities to address both structure and surface changes.
Depending on individual assessment, options at Alluna may include:
Subcision for selected tethered scars
Collagen-stimulating injectables to support dermal remodelling
Skin boosters for hydration and skin quality
Fractional laser resurfacing for texture (used selectively due to longer downtime)
Light-based treatments for redness and pigmentation
You may refer to our scar management overview within the Alluna Circle for a broader explanation of these approaches.
Subcision at Alluna
How subcision works - A technique used to release selected tethered scars
Subcision involves inserting a fine instrument beneath the skin to release fibrous bands that may be pulling the scar downward. This may:
Reduce tethering of the scar
Contribute to gradual improvement in skin surface contour
Trigger a wound-healing response that may support collagen remodelling over time
Our approach
At Alluna, subcision is performed by a doctor following clinical assessment. Technique, depth, and treatment extent are adjusted based on individual anatomy and scar characteristics.
Subcision may be performed:
As a standalone procedure
In combination with hyaluronic acid-based injectables for structural support
With collagen biostimulators to support longer-term remodelling
Alongside skin boosters as part of overall skin quality optimisation
Combination treatments may be discussed where appropriate, but are not required for all patients.
Addressing Redness and Pigmentation
Some patients experience persistent redness or pigmentation following acne.
Light-based treatments available at Alluna may be used, where appropriate, to:
Reduce visible redness associated with post-inflammatory erythema
Improve uneven pigmentation (PIH)
Please refer to our redness and pigmentation treatment page with IPL (intense pulsed light therapy) for further details.
Who is Suitable for Subcision?
Suitability is determined after medical assessment. In general, subcision may be considered for:
Patients with rolling or tethered depressed acne scars
Individuals seeking improvement in skin texture rather than complete scar removal
Patients without active infection or uncontrolled acne in the treatment area
Those able to accept temporary downtime such as bruising
Subcision may be less suitable for:
Predominantly ice-pick scars or superficial pigmentation without tethering
Individuals with certain bleeding risks or medical contraindications
Patients seeking immediate or complete correction
A consultation is required to determine whether subcision is appropriate.
What patients value at Alluna
Patients who seek care at Alluna are often looking for a measured, doctor-led approach rather than a single treatment solution.
Commonly valued aspects include:
Doctor-led assessment and treatment: All procedures, including subcision, are performed by a doctor with attention to anatomical considerations and safety.
Individualised treatment planning: Recommendations are based on scar type, skin condition, and personal preferences rather than a standardised protocol
Combination-based approach: Where appropriate, treatments such as subcision, dermal support, and skin quality optimisation are thoughtfully combined to support outcomes
Clear and balanced communication: Expected benefits, limitations, and potential risks are discussed to support informed decision-making
Focus on natural-looking improvement: Treatment is guided by gradual, proportionate changes rather than aggressive correction
A discreet and considered experience: Care is delivered in a private, calm setting designed for comfort and continuity
This approach is intended for individuals who prefer a structured, medically grounded plan for acne scar management.
The Subcision Treatment Journey
1. Consultation
A detailed consultation is performed to assess scar type, skin condition, treatment history, and expectations. A personalized plan is then discussed.
2. Procedure
Typically performed under local anaesthesia
Duration varies depending on the area treated
Combination treatments may be performed in the same or separate sessions
3. Recovery and downtime
Swelling and bruising are common and may last several days to over a week
Temporary tenderness or firmness may occur
Many patients are able to resume routine activities shortly after, depending on individual recovery
Visible improvement develops gradually over time
If fractional laser is included, additional downtime will be discussed in advance.
Results and Expectations
Subcision may lead to improvement in the appearance of selected acne scars. However:
Outcomes vary between individuals
A series of sessions is often required, depending on scar type and severity
Combination treatments may be recommended to support overall improvement
Complete scar removal is not typically achievable
Improvement occurs gradually over time as part of the skin’s healing and remodelling process
Treatment is planned with the aim of achieving balanced, natural-looking improvement within appropriate safety limits.
Possible Risks and Side Effects
All procedures carry potential risks. For subcision, these may include:
Bruising and swelling (common and expected)
Temporary discomfort or tenderness
Small risk of bleeding or infection
Temporary lumpiness or unevenness during healing
Rarely, nerve or vessel injury depending on treatment area
Subcision may not be suitable for individuals with certain medical conditions, active skin infection or inflammation in the treatment area, bleeding risks, or where the scar type is unlikely to respond to this technique.
Risk profile and suitability vary between individuals. A full discussion is provided during consultation before proceeding.
Frequently Asked Questions
Is subcision painful?
The procedure is performed under local anaesthesia. Patients generally tolerate the procedure well under local anaesthesia.
How many sessions will I need?
This depends on scar severity and response to treatment. Many patients require a series of sessions spaced over time.
Is there downtime?
Bruising and swelling are common and may last several days to over a week. Downtime varies between individuals.
Can subcision be combined with other treatments?
Yes. Combination approaches with dermal fillers, skin boosters, or collagen-stimulating injectables are commonly used to enhance results.
Is subcision suitable for all acne scars?
No. It is most effective for rolling or tethered scars. Other scar types may require different or additional treatments.
When will I see results?
Some improvement may be visible early, but full results develop gradually over several weeks to months.
Speak With Us
Subcision is a considered procedure that benefits from careful assessment and clear expectations. It is not typically a treatment that can be appropriately selected based on online information alone.
If you are considering treatment for acne scarring, we recommend arranging a consultation with our doctor. This allows us to:
Assess whether subcision is suitable for your scar type
Discuss alternative or complementary options
Provide a realistic understanding of expected outcomes and downtime
You are welcome to contact our team to arrange a consultation at a convenient time.
⚠️ Disclaimer: This page is for educational purposes only and not medical advice. Please consult a qualified medical professional for an individual assessment and tailored recommendations.
More on Scar Management at Alluna:
