A 2026 split-face trial found subcision with suction improved atrophic acne scars more than subcision alone. People with rolling scars can use that finding to ask direct questions before booking a procedure. Subcision releases tethered scars with a needle or cannula placed under the skin.
According to the PubMed trial listing from the U.S. National Library of Medicine, the trial treated one facial side with subcision alone and the other side with subcision plus suction. Both sides improved, but physician-rated and patient-rated improvement scores were higher on the suction side.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- What did the 2026 trial test?
- Does earlier suction research agree?
- Are rolling scars a good fit for subcision?
- What should you ask before a procedure?
What did the 2026 trial test?
The trial focused on atrophic acne scars treated within the same patients. That split-face design controls for skin type, age, and healing. One side received subcision alone and the other received subcision plus suction. Both treatments improved scars.
Scores on the Acne Scar Improvement Grading Scale were higher with suction for physicians and patients, according to the PubMed trial listing from the U.S. National Library of Medicine. The reported differences were p=.002 for physician ratings and p=.026 for patient ratings. The authors concluded that subjective assessments favored suction-assisted subcision. They suggested the added benefit was clinically visible even when scar counts changed less.
Does earlier suction research agree?
An earlier Northwestern pilot used one subcision treatment on both sides, then 10 suction sessions on one side. It measured Acne Scar Severity Scale, Improvement Grading Scale, Quantitative Global Scarring Grades, and patient preference. In that pilot with 28 treatment areas and 154 treatments analyzed, patient-assessed improvement was 37% with suction versus 24% without at one month, but not different at four months, according to the full pilot text on ResearchGate.
Dermatologist raters found no difference. That pattern suggests early patient-perceived change may fade without longer follow-up. Taken together, the two studies support added suction as a possible booster, not a guaranteed larger scar removal. Ask whether your clinic expects early texture or lift change, longer contour change, or both.
Are rolling scars a good fit for subcision?
Rolling scars and tethered boxcar scars respond best to subcision. The tool cuts fibrous bands that pull the skin down. An efficacy summary reported about 50% improvement, with 90% of 40 patients noting better appearance. Westlake Dermatology states ideal candidates have moderate-to-severe scarring, good skin health, and realistic expectations, according to its subcision guide.
Ice-pick scars, active acne, infection, bleeding problems, and poor healing need a different plan. Bring your scar history, isotretinoin use, keloid history, and pigment-change history to the consult. Ask the doctor to name your scar types during an exam. If most scars are rolling or tethered, subcision fits better than if most are ice-pick or untethered boxcar.
What should you ask before a procedure?
Common harms include pain, swelling, prolonged redness, and pigment change. One review cited by the research packet found residual redness in five patients, hyperpigmentation in three, and mild hypopigmentation in two, according to the cosmetic dermatology review in the Journal of Cosmetic Dermatology.
Darker skin needs a clear pigment-risk plan and sun-protection plan. Westlake Dermatology also frames the consult around sessions, suction details, downtime, combinations, and measurement. Use these questions: Ask how your clinic will photograph and grade scars before and after.
- How many subcision sessions do you advise for my scars, and what suction device, pressure, timing, and aftercare do you use?
- What downtime, bruising, swelling, redness, pain, and pigment risk should I expect?
- Will you combine treatment with laser, microneedling, filler, or chemical peel, and in what order?
- How will you measure change with photos, scar counts, or grading scales?
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