Does microneedling work for tethered scars, or is subcision the only option for that?

Question

I think the chicken pox scar I want to fix is tethered. Would microneedling break that down, or is subcision the way to go?

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne scars require a combination approach using our HIDEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of acne scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic acne scars and indented acne scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be been improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional laser such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone.

Subcision works well alone and in combination with other laser and RF platforms, including fillers and air subcision. TCA Cross can be combined with subcision. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your acne scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian

Phillip Chang, MD · Answer

Hi lisalynch

Microneedling has shown to help improve a number of skin issues. A 2009 study showed that over 80% of patients who used this procedure to treat acne scarring had assessed their treatment as ‘excellent’ and felt that their acne scars were visibly reduced. To learn more about this procedure, please visit our website.

Jason Emer, MD · Answer

Depressed scars can be improved with vascular lasers like Yellow laser or Excel V when they are red --- and with CO2 spot treatments, fillers, microneedling with PRP, and subcision to help with texture and blending. I recommend getting a formal evaluation with a scarring expert. Best, Dr. Emer​

Nelson Lee Novick, MD · Answer

Subcision is specifically geared to breaking up scar collagen tethering and for naturally promoting the production of new, native collagen, elastic fibers and dermal matrix to replace the scar tethers. Microneedling, on the other hand, while often marketed as a scar treatment,  is best reserved for the most superficial of scars and mostly for improving the superficial color and texture of treated scars so that the treated areas better blend with the surrounding normal skin tissue.  Expecting microneedling to significantly improve a deep chicken pox scar would be like expecting a hammer to screw in a screw. Make sure that you consult with a scar specialist and be certain to ask to see his/her personal befores and afters before agreeing to proceed. Best of luck.

Does microneedling work for tethered scars, or is subcision the only option for that?

Answers (4)

Answer: Subcision For Tethered Scars; Microneedling For Improving Superficial Texture & Color

Answer: Subcision For Tethered Scars; Microneedling For Improving Superficial Texture & Color

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Does microneedling work for tethered scars, or is subcision the only option for that?

Answers (4)

Answer: Subcision For Tethered Scars; Microneedling For Improving Superficial Texture & Color

Answer: Subcision For Tethered Scars; Microneedling For Improving Superficial Texture & Color

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Recommended reading

Everything you need to know about Microneedling

Our mission is to create a world where every investment in modern beauty is Worth It.