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Blunt blade subcision effective in treating acne scars

A blunt blade subcision procedure was effective in treating atrophic acne scars, with mild adverse effects, according to published study results.

Researchers in Tehran, Iran, studied 18 patients (11 female; average age, 25 years) with moderate-to-severe bilateral atrophic facial acne scars considered eligible for subcision between September 2012 and March 2013.

Local anesthesia was a tumescent solution of 50-mL 1% plain lidocaine, 1-mL 0.1% epinephrine, and 10-mL 8.4% sodium bicarbonate solution in 1-L normal saline injected subdermally. A blunt subcision blade, a stainless steel blade in 6-cm or 13-cm length and 1.5-mm width, gradually narrowing edges and a rounded blunt tip, was used for the subcision.

“The blade length allows distant scars in the area to be reached through one penetration site,” the researchers wrote.

At 7 days after subcision and at 6-months follow-up, early postoperative complications, overall aesthetic improvement and persistent discoloration or lumpiness were measured, and photographic documentation was conducted.

Marked improvement was noted in nine patients (50%) and moderate improvement in six patients. (33.3%) within 6 months of the procedure. Discoloration or lumpiness were not observed at 6 months.

Seven patients noted tenderness at 7 days after the subcision, but constant pain was not noted; mild-to-moderate swelling was noted by five patients at that time. There were three patients with periorbital ecchymoses. Within 3 weeks, the swelling and ecchymoses resolved.

After treatment, 12 patients (66.7%) reported high satisfaction with results, while 5 patients (27.8%) reported moderate satisfaction and one patient reported no change.

“This novel technique of subcutaneous undermining using a blunt subcison blade seems to be a safe and effective method for atrophic scar treatment,” the researchers concluded. “The technique is associated with a short recovery time and a low rate of serious complications. In addition, the technique’s simplicity and low cost could make it a suitable first step in the treatment of most cases of atrophic acne scars.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.