Can Subcision with the Cannula be an Acceptable Alternative Method in Treatment of Acne Scars?

BACKGROUND AND OBJECTIVES: Most people who experience the acne suffer from damage under the surface of their skin which causes saucer-like depressions or pits on their skin. Sometimes the skin loses its underlying support and develops fibrous bands of tissue between the skin and subcutaneous layer, which pull on the epidermis and cause a wavy texture called as rolling scar. Treatment of acne scars is a therapeutic challenge that may require multiple modalities. Subcision is a procedure that has been reported as a beneficial method in the treatment of rolling acne scars. Although Subcision is a valuable method, its efficacy is mild to moderate because of the high recurrence rate and patients dissatisfaction due to some side effects include post procedure inflammation.

MATERIALS AND METHODS: This pilot study is a clinical trial. The 8 patients suffered from mild to severe rolling acne scars on their face with symmetrical distribution of lesions, underwent Subcision with the Cannula No 18 and 21 and followed-up for 3 months. Outcomes of Subcision procedures were assessed by 3 board certified dermatologists (blind) after 2 session of treatment. The patients' satisfaction was considered to compare with dermatologist's opinions. The degree of improvement and satisfaction of the treatment estimated with these points: poor: 0, fine: 1-3, good: 4-6, and very good: 7-9. The data were finally analyzed with SPSS-18 software.

RESULTS: Subcision with the Cannula showed good and very good improvement in about 88% of patient with a satisfaction good and very good improvement in all of patients (100%). Assessment of photographic data showed 100% improvement in scar depth, topography and overall appearance of acne scars. The average numbers of lesions before the treatment were 24.8 ± 12.1 and after treatment it was reduced to 12.8 ± 2.1 (p<0.05).

CONCLUSION: Subcision with the Cannula appears to be a safe method with high efficacy in the treatment and high satisfaction in patients as we observed an interesting cure rate (more than 50% after 2 sessions). It demonstrates to be a safe procedure because it performed by single perforation in each side instead of multiple perforations that helps to reduce the patients' pain and risk of scars. In other hand Cannula-based Subcision needs considerable fewer sessions of surgery and also less recovery time.