Subcision is a specialised minor surgical procedure used primarily to treat rolling acne scars by releasing the fibrous bands that pull the skin downwards. It is regarded as one of the most effective treatments for this type of acne scarring and is often combined with other procedures to achieve the best possible cosmetic outcome.

Acne scars are generally classified into three main subtypes: rolling scars, boxcar scars and ice pick scars. Because each subtype develops differently, they require different treatment approaches. Many patients have a combination of scar types, making a personalised treatment plan essential for achieving optimal long-term improvement.

Rolling scars are characterised by broad depressions that create the appearance of “hills and valleys” across the skin. These scars often become more noticeable under different lighting conditions because they are tethered to the deeper layers of the skin by fibrous scar tissue. This tethering pulls the skin downwards, producing the characteristic shadowing and uneven skin surface that many patients find difficult to conceal.

Subcision works by inserting a specialised surgical instrument beneath the skin to carefully release these fibrous bands. Depending on the severity and extent of the scarring, Professor Firas Al-Niaimi may use a traditional Nokor needle or advanced instruments such as the Taylor Liberator, which has been specifically designed to treat more extensive acne scarring. Once these scar attachments are released, the skin is able to lift naturally, producing a smoother and more even appearance.

Subcision is frequently combined with other acne scar treatments to maximise results. After the tethered scars have been released, procedures such as Fillers for Acne Scars can restore any underlying volume loss, while Fractional Laser, Laser Resurfacing or Microneedling can further improve collagen production and refine the skin surface. Patients with deep ice pick scars may also require Punch Excision for Acne Scars as part of a comprehensive treatment programme.

The procedure is performed under local anaesthetic and is generally well tolerated. Following treatment, temporary swelling and bruising are expected and form a normal part of the healing process. The extent of recovery depends on the severity of the scars and the size of the treatment area, and detailed aftercare instructions are provided to support optimal healing.

Professor Firas Al-Niaimi is one of the UK’s leading experts in acne scar surgery and has performed hundreds of subcision procedures. His extensive experience allows him to accurately identify which patients will benefit from subcision and how best to combine it with other advanced acne scar treatments to achieve the most natural and long-lasting improvement.

If rolling acne scars are affecting your confidence, subcision offers a highly effective, evidence-based solution that addresses the underlying cause of the scarring rather than simply treating the skin’s surface, providing significant and lasting improvements in skin texture and appearance.