If you’ve tried lasers for acne scars—especially the much-hyped picosecond laser—and still feel like your skin hasn’t improved as much as you expected, you’re not alone. Many people invest in resurfacing treatments thinking acne scars are simply surface flaws. But here’s the hard truth: most acne scars go much deeper than your skin’s surface. That’s why relying on laser alone often leads to underwhelming results.
To truly transform acne-scarred skin, one technique stands out as a must-have—subcision. It’s not just another option; for many patients, it’s the missing piece of the puzzle.
Acne Scars Aren’t Just Skin-Deep
Let’s get one thing clear: acne scars are not just pigmentation issues or uneven skin texture. They’re the result of structural damage beneath your skin, usually in the dermis, caused by inflammation and collagen destruction from acne.
Imagine your skin like a building. Pigmentation and surface issues are like chipped paint or cracked tiles—they’re superficial. But true acne scars are like a collapsed floor underneath. You can repaint and re-tile all you want (think of resurfacing with picosecond lasers), but unless you rebuild the foundation, the structure will always look sunken or distorted.
This is where subcision becomes essential.
What Is Subcision?
Subcision is a minor surgical procedure where a doctor uses a needle to release the fibrous bands tethering the scar to deeper tissues. These bands are what cause that “sunken” appearance in rolling and tethered scars.
When you cut these fibrotic strands, two important things happen:
- The skin lifts from underneath, reducing the depth of the scar.
- The body’s natural healing response kicks in, stimulating collagen production where it’s needed most—deep in the dermis.
This dual action addresses the root cause of the scar, not just the surface. No laser can reach or release those tethers effectively. That’s why resurfacing treatments alone often plateau, no matter how advanced the technology.
The Over-Promise of Lasers
Picosecond lasers have become popular for acne scar treatments. They’re marketed as quick, minimal-downtime solutions, and they do have a role—especially for:
- Treating post-acne pigmentation
- Improving overall skin tone
- Mildly stimulating collagen in superficial scars
But here’s what most people aren’t told: picosecond lasers don’t break the fibrotic bands responsible for deeper atrophic scars like:
- Rolling scars (soft depressions with sloping edges)
- Tethered scars (attached to underlying tissues)
- Boxcar scars (sharp-edged depressions)
Think of it this way: using only a laser is like trying to flatten a dimpled mattress by ironing the sheets. It may look smoother for a bit, but the indentations are still there.
Why Subcision First, Then Laser?
At our clinic, we believe in sequencing your treatments for the best long-term results.
- Subcision comes first to break the tethers and elevate the scar base.
- Then, resurfacing treatments like picosecond or fractional lasers can work more effectively on the new, flatter surface.
This combo approach ensures that your investment in laser treatments isn’t wasted. You’ll get more visible, longer-lasting results.
What Happens If You Skip Subcision?
When people skip subcision, even the most expensive or high-tech laser treatments can lead to:
- Disappointment in results
- Wasted time and money
We’ve seen many patients come to us after spending thousands elsewhere, only to hear, “I wish someone told me this earlier.”
The reality is: without subcision, many scars simply don’t budge.
Let’s Get Real About Results
No single treatment is a miracle. Acne scar revision is a journey, not a one-session solution. But when done right—with subcision as a core step—the results can be life-changing.
Expect:
- Scar depths visibly reduced
- Skin looking smoother, not just brighter
Our Clinic’s Approach
At our clinic, we specialize in treating complex acne scars using proven, research-backed techniques—not trends. Our subcision procedures are performed by highly trained professionals, ensuring precision and safety. When appropriate, we utilize advanced tools such as blunt cannulas and specialized needles to minimize bruising and downtime. Subcision is also paired with complementary treatments—like fillers, biostimulators, energy-based devices, or regenerative therapies—to enhance healing and maximize long-term results.
Every skin is different. But the principle remains the same: You can’t fix deep problems with surface solutions
Final Thoughts: Invest in What Works
If you’re considering laser for acne scars—or if you’ve already tried it with minimal improvement—don’t lose hope. The issue may not be the laser, but what was missing from the plan: subcision.
You deserve a real, honest solution that goes beyond skin-deep. Acne scars may be stubborn, but with the right foundation, you can rebuild your skin.
