Which Skin Treatment Reigns Supreme?

When I first heard about these procedures, I was skeptical.

Rolling tiny needles across my face or undergoing a “subcision” sounded more like medieval torture than modern skincare. But after seeing the remarkable results in my clients, I became a true believer.

Let’s explore these game-changing treatments in depth to determine which you might be right for you.

Understanding the Science of Skin Repair

To grasp why microneedling and subcision are so effective, we need to understand how our skin heals and regenerates. Our skin is in a constant state of renewal, shedding old cells and producing new ones.

However, sometimes this process needs a little nudge, especially when dealing with stubborn scars or texture issues.

Both microneedling and subcision work by triggering the body’s natural healing response, but they do so through different mechanisms.

Microneedling: Thousands of Tiny Healers

Microneedling creates thousands of microscopic punctures in the skin’s surface. These tiny injuries signal the body to increase collagen and elastin production.

Collagen, the protein responsible for skin’s structure and firmness, and elastin, which gives skin it’s elasticity, are crucial for maintaining youthful, healthy-looking skin.

The increased production of these proteins helps to improve overall skin texture, reduce the appearance of fine lines and wrinkles, and even out skin tone. It’s like giving your skin a wake-up call, reminding it to kick it’s regenerative processes into high gear.

Subcision: Breaking the Bonds of Scars

Subcision takes a more targeted approach, focusing specifically on depressed scars, particularly those caused by acne. These scars are often tethered to deeper layers of skin by fibrous bands.

Subcision involves using a special needle to break these bands, allowing the depressed scar tissue to rise to the surface level of the surrounding skin.

This process physically releases the scar and stimulates collagen production in the treated area. The result is a smoother, more even skin surface and a significant reduction in the appearance of deep, pitted scars.

Microneedling: The Versatile Skin Rejuvenator

Microneedling has gained immense popularity because of it’s versatility and relatively minimal downtime. Here’s a closer look at why it’s become a go-to treatment for many skincare enthusiasts:

Addressing Multiple Skin Concerns

One of the biggest advantages of microneedling is it’s ability to tackle a wide range of skin issues. From fine lines and wrinkles to acne scars, enlarged pores, and uneven skin texture, microneedling can address them all.

This makes it an excellent option for those looking to improve their overall skin quality without targeting just one specific concern.

Customizable Treatment Depth

Microneedling devices allow for adjustable needle depths, typically ranging from 0.5mm to 2.5mm. This customization enables practitioners to tailor the treatment to each patient’s specific needs and skin concerns. Superficial treatments can address issues like fine lines and minor texture irregularities, while deeper treatments can target more stubborn scars and wrinkles.

Minimal Downtime

One of the reasons I often recommend microneedling to my busy clients is the relatively short recovery period. Most people experience some redness and mild swelling for 24 to 48 hours post-treatment, but can usually return to their normal activities within a day or two.

This makes it an attractive option for those who can’t afford extended downtime.

Enhanced Product Absorption

The micro-channels created by the needles stimulate collagen production and increase the skin’s ability to absorb topical products. This means that any serums or creams applied after the treatment can penetrate deeper into the skin, potentially enhancing their effectiveness.

Suitable for Various Skin Types

Microneedling can be safely performed on all skin types and colors, with a lower risk of hyperpigmentation compared to some laser treatments. This makes it an excellent option for people who have darker skin tones who may be more prone to pigmentation issues with other treatments.

The Importance of PRP

For those looking to supercharge their microneedling results, combining the treatment with platelet-rich plasma (PRP) can be incredibly effective. PRP, derived from your own blood, is rich in growth factors that can further stimulate collagen production and accelerate healing.

I’ve seen remarkable improvements in skin texture and tone when microneedling is paired with PRP.

Subcision: The Scar Specialist

While microneedling is the jack-of-all-trades in the skincare world, subcision is the specialist, focusing primarily on treating depressed scars. Here’s why subcision has become the go-to treatment for those stubborn, deep acne scars:

Immediate Visible Improvement

One of the most satisfying aspects of subcision for both practitioners and patients is the potential for immediate results. As the fibrous bands tethering the scar are released, many patients notice an instant improvement in the appearance of their scars.

This immediate gratification can be a significant psychological boost for those who have long struggled with the appearance of their scars.

Effective for Deep, Stubborn Scars

Subcision excels at treating deep, rolling, or boxcar acne scars that have been resistant to other treatments. These types of scars often don’t respond well to surface-level treatments like chemical peels or superficial microneedling.

By targeting the root cause of the scar’s depression, subcision can achieve results where other treatments have failed.

Long-lasting Effects

By physically breaking up the scar tissue and stimulating new collagen formation, subcision can provide long-term improvement in scar appearance. While some patients may need multiple treatments for optimal results, many see significant, lasting improvements after just one or two sessions.

Combination Potential

Subcision can be effectively combined with other treatments for even more dramatic results. For example, performing subcision and then following up with dermal fillers can provide immediate volume to depressed areas, creating a smoother skin surface.

Additionally, combining subcision with treatments like microneedling or laser resurfacing can further improve overall skin texture and tone.

Beyond Acne Scars

While subcision is primarily known for it’s effectiveness in treating acne scars, it’s applications are expanding. Some practitioners are now using modified subcision techniques to treat cellulite and even certain types of wrinkles.

This versatility makes it an increasingly valuable tool in the aesthetic medicine toolkit.

Choosing the Right Treatment for You

Deciding between microneedling and subcision isn’t about determining which treatment is superior overall. Instead, this involves selecting the most suitable treatment for your specific skin concerns and goals.

Here’s how to approach the decision:

Consider Your Primary Skin Concerns

If your main goal is overall skin rejuvenation, addressing fine lines, and improving skin texture and tone, microneedling is likely your best bet. It’s an excellent all-around treatment that can provide noticeable improvements in these areas.

On the other hand, if you’re primarily concerned with deep, depressed acne scars, particularly those that have been resistant to other treatments, subcision might be the more effective choice. It’s specifically designed to target these types of scars and can often provide more dramatic results for this particular issue.

Evaluate Your Tolerance for Downtime

Microneedling typically has a shorter recovery period, with most people able to return to their normal activities within a day or two. There may be some redness and mild swelling, but it’s usually easily concealed with makeup after the first 24 hours.

Subcision, being a more invasive procedure, generally requires a longer recovery time. You might experience swelling, bruising, and tenderness for 5-7 days post-treatment.

If you have a big event coming up or can’t afford much downtime, this could influence your decision.

Consider Your Pain Tolerance

While neither treatment is excruciatingly painful, there is a difference in discomfort levels. Microneedling is generally well-tolerated with topical numbing cream, and many patients describe it as feeling like a mild sunburn during and immediately after the treatment.

Subcision, being more invasive, usually requires local anesthesia. While this means you shouldn’t feel pain during the procedure, you may experience more discomfort during the recovery period.

Think About Your Budget and Time Commitment

Microneedling often requires multiple sessions for optimal results, typically spaced 4-6 weeks apart. While each session is generally less expensive than subcision, the total cost over a series of treatments can add up.

Subcision, while usually more expensive per session, might achieve significant improvement in fewer treatments. Some patients see dramatic results after just one or two sessions.

Consider Combining Treatments

Many dermatologists and aesthetic practitioners are now combining microneedling and subcision for comprehensive scar treatment. They might start with subcision to release deep scars, then follow up with a series of microneedling treatments to improve overall skin texture and tone.

This combination approach can provide the best of both worlds, addressing deep scars while also improving overall skin quality. However, it does need a greater time and financial commitment.

Preparing for Your Treatment

Whether you choose microneedling, subcision, or a combination of both, proper preparation can help ensure the best possible results and a smooth recovery. Here’s how to get ready for your treatment:

Consult with a Qualified Professional

The first and most crucial step is to have a thorough consultation with a qualified dermatologist or aesthetic practitioner. They can assess your skin, talk about your goals, and recommend the most suitable treatment plan.

Don’t be afraid to ask questions about their experience with the procedure, expected results, and potential risks.

Adjust Your Skincare Routine

In the weeks leading up to your treatment, you may need to change your skincare routine. This often includes:

• Avoiding retinoids and other potentially irritating active ingredients for at least a week before treatment
• Staying out of the sun and avoiding tanning beds
• Discontinuing use of blood-thinning supplements like fish oil or vitamin E (always ask with your doctor before stopping any supplements)

Plan for Downtime

Even though microneedling has minimal downtime, it’s still a good idea to schedule your treatment when you don’t have any major events or commitments in the following days. For subcision, you’ll want to clear your schedule for at least a few days post-treatment to allow for proper healing.

Arrange Transportation

If you’re having subcision or a combination treatment that involves local anesthesia, you’ll need someone to drive you home after the procedure. Even with microneedling, it’s nice to have someone accompany you if possible, as your skin may feel sensitive immediately after treatment.

Stock Up on Recovery Essentials

Before your treatment, gather supplies you might need during recovery. This could include:

• Gentle, fragrance-free cleanser
• Hyaluronic acid serum for hydration
• Broad-spectrum sunscreen (crucial for protecting your skin post-treatment)
• Ice packs or cold compresses to reduce swelling
• Any specific post-care products recommended by your practitioner

The Treatment Experience

Knowing what to expect during your treatment can help reduce anxiety and ensure you’re prepared for the experience. Here’s a general overview of what you might expect during microneedling and subcision procedures:

Microneedling Procedure

1. Cleansing: Your practitioner will thoroughly cleanse your skin to remove any makeup, oil, or debris.
2. Numbing: A topical numbing cream is usually applied and left on for about 30 minutes to ensure your comfort during the treatment.
3. The Treatment: Using a microneedling device (either a roller or a pen-like tool), your practitioner will move the device across your skin in a systematic pattern.

You may feel a slight prickling or scratching sensation, but it shouldn’t be painful.

4. Serum Application: After the microneedling, a soothing serum (often containing hyaluronic acid or growth factors) is typically applied to the skin.
5. Post-Treatment Care: Your practitioner will provide instructions for caring for your skin in the days following treatment.

The entire process usually takes about an hour, including the time for numbing.

Subcision Procedure

1. Marking: Your practitioner will carefully mark the areas to be treated.
2. Anesthesia: Local anesthesia is administered to ensure your comfort during the procedure.
3. The Treatment: Using a special needle or cannula, your practitioner will carefully break the fibrous bands beneath the scar.

You shouldn’t feel pain, but you may feel some pressure or tugging.

4. Compression: After the subcision, pressure is applied to the treated areas to control bleeding and swelling.
5. Post-Treatment Care: Your practitioner will provide detailed instructions for caring for the treated areas and managing any swelling or bruising.

The subcision procedure itself is relatively quick, often taking only 15-30 minutes, but the entire appointment may last longer because of preparation and post-treatment care.

Post-Treatment Care and Recovery

Proper aftercare is crucial for achieving optimal results and minimizing potential side effects from both microneedling and subcision. Here’s what you can expect during the recovery period and how to care for your skin:

Microneedling Recovery

Immediate Aftermath: Your skin will likely look red and feel sensitive, similar to a sunburn. This is normal and typically subsides within 24-48 hours.

Days 1-3:

• Keep your skin clean using a gentle, fragrance-free cleanser
• Apply any recommended serums or moisturizers
• Avoid makeup for at least 24 hours
• Stay out of the sun and apply a broad-spectrum sunscreen if you must go outside
• Avoid sweating, swimming, and strenuous exercise

Days 4-7:

• Your skin may feel dry or start to peel lightly. This is normal and part of the skin renewal process
• Continue with gentle skincare and sun protection
• You can usually resume your normal skincare routine after about a week, but introduce active ingredients gradually

Weeks 2-4:

• Continue protecting your skin from the sun
• You may start to notice improvements in skin texture and tone
• Follow your practitioner’s guidance on when to schedule your next session if you’re doing a series of treatments

Subcision Recovery

Immediate Aftermath: Expect some swelling, bruising, and tenderness in the treated areas. Your practitioner may apply tape or bandages to provide compression.

Days 1-3:

• Apply ice packs to reduce swelling
• Keep the treated areas clean and dry
• Take any prescribed medications as directed
• Avoid touching or massaging the treated areas
• Sleep with your head elevated to minimize swelling

Days 4-7:

• Swelling and bruising should start to subside
• You may be able to gently cleanse the area and apply recommended skincare products
• Continue to avoid sun exposure and use sunscreen when outdoors
• Avoid strenuous exercise or activities that could impact the treated areas

Weeks 2-4:

• Most swelling and bruising should decide
• You may start to see improvements in the appearance of your scars
• Follow up with your practitioner as scheduled to assess your results and talk about any extra treatments

Remember, everyone’s skin is different, and healing times can vary. Always follow the specific instructions provided by your practitioner and don’t hesitate to contact them if you have any concerns during your recovery.

Potential Risks and Side Effects

While both microneedling and subcision are generally safe when performed by qualified professionals, it’s important to be aware of potential risks and side effects:

Microneedling Risks

• Temporary redness, swelling, and sensitivity
• Dry or flaking skin
• Potential for infection if proper sterilization procedures aren’t followed
• Risk of hyperpigmentation, especially in darker skin tones
• Possible breakouts or milia (small white bumps) in acne-prone individuals

Subcision Risks

• Bruising and swelling
• Infection
• Scarring
• Uneven results or dimpling of the skin
• Potential for nerve damage (very rare)

To minimize these risks, always choose a qualified, experienced practitioner and follow all pre- and post-treatment instructions carefully.

Maximizing Your Results

To get the most out of your microneedling or subcision treatment, consider these tips:

1. Stay Consistent: If you’re doing a series of treatments, stick to the recommended schedule.
2. Protect Your Skin: Sun protection is crucial, especially after these treatments when your skin is more sensitive.
3. Follow a Good Skincare Routine: Use quality products recommended by your practitioner to support your skin’s healing and regeneration.
4. Stay Hydrated: Drinking plenty of water can help support your skin’s healing process.
5. Be Patient: Full results from these treatments can take weeks or even months to become fully obvious as your skin regenerates.
6. Consider Combination Treatments: Discuss with your practitioner whether combining treatments or adding complementary procedures could enhance your results.

Frequently Asked Questions

What is microneedling?

Microneedling is a cosmetic procedure that involves creating tiny punctures in the skin using fine needles. This process stimulates the skin’s natural healing response, promoting collagen and elastin production.

How does subcision work for acne scars?

Subcision treats acne scars by breaking up the fibrous bands that pull the scar downward. A special needle is inserted beneath the skin to release these bands, allowing the depressed scar to rise and create a smoother surface.

Is microneedling painful?

Most people find microneedling tolerable with the use of a topical numbing cream. Some describe the sensation as a mild prickling or scratching feeling.

How long does it take to see results from subcision?

Some improvement may be visible immediately after subcision, but full results typically develop over several weeks to months as the skin heals and collagen production increases.

Can microneedling be done at home?

While at-home microneedling devices are available, professional treatments are generally more effective and safer. At-home devices typically use shorter needles and may not provide the same level of results as professional treatments.

How many subcision treatments are needed for acne scars?

The number of subcision treatments needed varies depending on the severity of scarring. Some people see significant improvement after one session, while others may need 2-3 treatments for optimal results.

Does microneedling help with wrinkles?

Yes, microneedling can help reduce the appearance of fine lines and wrinkles by stimulating collagen production and improving skin texture.

Is subcision suitable for all types of acne scars?

Subcision is most effective for depressed scars, particularly rolling and boxcar scars. It’s less suitable for ice pick scars or raised scars.

How often can I get microneedling treatments?

Most practitioners recommend spacing microneedling treatments 4-6 weeks apart to allow for proper healing and collagen production between sessions.

Can subcision be combined with other treatments?

Yes, subcision is often combined with other treatments like dermal fillers, microneedling, or laser resurfacing for more comprehensive scar treatment.

Key Takeaways

• Microneedling is versatile, addressing multiple skin concerns with minimal downtime.
• Subcision specifically targets deep, depressed scars, often providing dramatic improvements.
• The choice between treatments depends on your specific skin concerns, downtime tolerance, and desired results.
• Both treatments can be combined for comprehensive skin improvement.
• Proper aftercare is crucial for optimal results and minimizing side effects.
• Always choose a qualified professional for these treatments to ensure safety and effectiveness.