Adding suction to subcision gave better scar improvement than subcision alone in the 2026 split-face trial. Subcision is a minimally invasive treatment that releases tethered acne scars from below the skin. The trial compared the two approaches on opposite sides of the face in people with atrophic acne scars. Both sides improved, but physician and patient ratings favored the suction side, according to the U.S.
National Library of Medicine PubMed listing PubMed record for the 2026 trial. The paper appeared in Dermatologic Surgery vol. 52(10):989-993, Oct. 1, 2026, Epub Apr. 23, 2026, by Diab et al.
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?
- Who is this result for?
- Why did doctors and patients notice more benefit?
- What are the limits and next questions?
What did the 2026 trial test?
The trial tested subcision versus subcision with suction for atrophic acne scars. Subcision was already an established minimally invasive technique, while suction was proposed to prevent early redepression but had limited evidence, as described in the Dermatologic Surgery journal index journal index entry. Both treatments significantly improved scars in the comparison, according to Wolters Kluwer Ovid / Dermatologic Surgery Ovid Dermatologic Surgery page.
The added question was whether suction made improvement visibly better. Physician-rated and patient-rated Acne Scar Improvement Grading Scale scores were significantly higher on the suction-treated side, at p=.002 and p=.026 respectively. That split-face design helps because each person serves as their own comparison.
Who is this result for?
This result matters for people with depressed atrophic scars. It is most relevant for rolling scars, where fibrous bands pull skin down. Subcision fits those scars because it undercuts tissue without surface cutting or sutures.
That mechanism releases the tether and allows the depression to lift. People with icepick or mainly raised scars are outside this result. A dermatologist can map scar types at a visit and say whether subcision applies.
Why did doctors and patients notice more benefit?
The authors concluded subjective assessments favored suction-assisted subcision, suggesting clinically perceptible benefits not fully captured by objective scar-counting methods. In other words, the face can look smoother even when a lesion count changes little. That distinction matters for treatment choice.
A mirror improvement may matter more than a number on a chart. Still, scores are judgments, not permanent cure. Lighting, swelling, and healing stage can affect how scars look during follow-up.
What are the limits and next questions?
An important limit comes from an earlier U.S. split-faced, rater-blinded randomized trial. That trial found no significant lasting difference between arms, only a temporary patient-reported edge for suction, according to the Research Square preprint by Shi et al. preprint record.
So the long-term advantage of suction remains inconsistent. Ask a board-certified dermatologist whether suction adds enough benefit for your scar pattern. Also ask who performs suction, how often, and how results are tracked. Plan for bruising and swelling for 1-2 weeks plus possible temporary firmness or nodules, and discuss post-procedure suction burden before consent, according to Revelus Dermatology subcision care page.
- Do I have mainly rolling, tethered scars?
- What suction schedule follows subcision, and what does it require at home?
- How will improvement be judged: photos, grading scale, or scar count?
- What follow-up treats remaining texture or color?
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