Understanding deep acne scar treatment
Deep scarring involves loss of tissue and fibrous tethering under the skin. Surface-only treatments cannot lift a scar that is being pulled down from beneath, which is why single-modality plans often disappoint.
Subcision uses a fine instrument passed under the scar to release those bands, allowing the depression to lift and new collagen to form in the released space. CROSS applies a focused agent precisely into narrow ice-pick scars to stimulate collagen at the base without affecting surrounding skin.
Fractional CO₂ laser or MNRF is then used to remodel the surrounding texture. The sequence and spacing matter as much as the individual procedures, and both are planned at the consultation.
This may suit you if
- Rolling scars that look tethered when you stretch the skin
- Deep boxcar or ice-pick scars on the cheeks and temples
- Scarring that has not improved with peels or facials
- Patients able to commit to a multi-session plan with some downtime
What happens at the clinic
- 1
Assessment and consent
Scar types are mapped, suitability is confirmed, and the expected degree of improvement is discussed honestly before you agree to proceed.
- 2
Numbing
Topical anaesthetic, and local anaesthetic where needed, is used so the procedure is tolerable.
- 3
The procedure
Subcision, CROSS or fractional resurfacing is performed as planned for your scar pattern, often in combination within the same visit.
- 4
Recovery and next session
Aftercare is explained in detail, and the next session is scheduled once the skin has fully recovered.
Aftercare
- Cold compresses as advised for the first 24 hours after subcision
- Barrier-repair moisturiser and strict sun protection during healing
- Avoid gym, steam and swimming until the skin has settled
- Do not apply actives until you are cleared to restart them
Possible side effects
- Bruising, swelling and tenderness for several days
- Temporary pigmentation, particularly in deeper skin tones
- Rarely, nodule formation at a subcision site, which is treatable
- Variable response between scar types on the same face
