EGWs6uuBZ3pp-zGuVVdmeLgkJG4 Across the Avenue: Needling aka Subcision: A Solution for Acne Scars

Needling aka Subcision: A Solution for Acne Scars

After years and years of struggling with terrible acne, I had finally gotten it under control. Unfortunately, it left behind some pretty terrible scarring. I had read lots of articles on procedures that could help with acne scarring, but because it's on my face, I had always been nervous about going through with any of them. I finally decided that if I was going to do it, I wanted to find the best dermatologist in the D.C. Metro area. I figured it would give me my best shot and ease my nerves a little more, knowing her reputation. The downside...she doesn't take insurance. Yep, it was going to be an expensive trip. (The consultation fee alone costs $200.)

The Consultation
I went in thinking I was going to arrange for a microdermabration session. About five minutes into the appointment, I learned that I had it all wrong. The doctor explained a few things about my skin and my scarring that I had never heard from any other dermatologist and she explained that the most effective procedure would actually be needling, as known as subcision. To paraphrase her explanation in an extreme way, I pictured my scar as a valley. She was going to go in with a needle and loosen up/detach the skin at the bottom of the valley, so that the scarred area could fill up again. After asking a laundry list of questions and feeling a bit unprepared since I thought I was coming in for a microdermabrasion consultation, I felt comfortable with this procedure as the right move. I made my appointment on an early Friday morning before a holiday weekend, to give myself a bit of extra recovery time.

The Big Day
On the day of the procedure, I came in with a make-up free face. I had put on moisturizer without thinking about it, but it didn't matter because the first thing the assistant did, after pulling my hair back and placing a surgical hair net on me, was to wipe my face with an alcohol wipe. When the doctor came back in, she explained that she was going to use a local anesthetic to numb me, in order to prevent as much pain and discomfort as possible.

Time to Get Numb
Let me tell you, when she first started injecting the Lidocaine shots into my face, it was a pain I was not ready for. Because she had to give me so many shots to numb the entire area she planned to work on (both cheeks and a small spot on my temple), it left me initially thinking I'd rather go without the Lidocaine. If I was going to have needles shoved into my face either way, why not just go to town on the scars, right? She must have read my mind because she told me that while the shots of Lidocaine may feel bad now, the needling would feel much worse. I had to trust her on this one. 

I might as well share this embarrassing tidbit: during the local anesthetic injections, I got nauseous and asked if it was normal to feel like I was going to throw up. Both the doctor and the assistant were really great about it. They leaned me back even further and placed a cool compress on my forehead and neck. Apparently, it's not all that uncommon, especially if you're nervous to begin with.

Let the Needling Begin
While there are a few different tools that can be used for needling, my doctor prefers to do each and every scar manually with a pen. While she does call it her arm workout for the day, results tend to be better this way. She began on the right side of my face. While I could feel some of the pressure of the needle, I certainly couldn't feel anything close to the pain I felt when she gave me the local anesthetic. A few times during the procedure, I could feel what seemed almost like a jiggling. I am 100% sure I didn't not want to feel the real pain that was involved in those moves and was oh-so-thankful that I had the Lidocaine. The same procedure was done on my left cheek, along with a small area on my left temple. All and all, the procedure was done in around an hour and a half. The assistant placed a healthy layer of cream on to prevent infection and then came back a few minutes later to apply a thick layer of sunscreen. She raised the bed to sit me up and told me to relax for a bit, so that I can get used to be upright again.

The Aftermath
Oh good lord, I was NOT prepared for what I was about to see in the mirror as soon as the procedure was over. Now, I had been told by my doctor and had also read quite a few articles that said many people are able to return to work right after the procedure. I was clearly not one of those people! I don't know how to best describe my initial horror as I looked in the mirror, but my jaw dropped to the floor. It was a purple and red mess that I would have equated to a terrible burn, had I not known any better. Let's just say I was never so happy to have "prepared for the worst" by scheduling this procedure for a Friday before a long holiday. It gave me 4 days to re-coupe (aka hide inside my house). Although I had brought a hat to protect myself from the sun on the way out of the appointment, it came in even handier as part of my attempt to be incognito walking to the metro and riding to my husband's office to pick up the car. 

Helpful Tip: Prepare to have someone pick you up afterward!

Day 1
Swollen and Scabbed
Day Four
Much Lighter
Aftercare was pretty simple. Keep it clean, keep it moist. To clean the area, I was told only to lightly let the shower water wash over it-no rubbing or scrubbing. I was given cellular turnover pads that I was supposed to use each day. They are really strong, but the idea was to keep the area irritated, to promote collagen stimulation. I also kept a thick layer of sunscreen on it and reapplied it every 2 hours with a clean Q-tip. The fourth day really was a turning point. The purple/red color turned to a lighter pink and I was able to put foundation on to cover it up. Did it look great? No. The foundation didn't make it look normal, but it certainly did help and it was a good enough fix that no one stared or asked any questions about it. I didn't like the feel of it though and couldn't wait to get home to rinse it off. 

The first week, I really couldn't tell if anything was different. The coloring and swelling was just too extreme. Around day 8, I began to see a major difference on the left side of my face. It was pretty dramatic right off the bat, which was awesome, since this procedure sometimes takes 8 months or more to see the full result. In fact, my husband commented on how great it looked before I even mentioned it to him. By three weeks, I was extremely pleased. I'd say about 80% of my scarred areas had already successfully responded to the procedure. As awful as I found the procedure initially, I am so happy that I did it. After years of struggling with bad skin and being so self-conscious of my scars, it feels amazing to have found something that provided real results!

At my one month visit, I had 2 small areas that were still pretty depressed and while my doctor did say that we need to give it time to fully take effect, I was offered an amazing opportunity...

Turns out, the representative for the NEO laser wants to demo it for my doctor to see if she likes it and I am a great candidate for it. She asked if I'd like to volunteer as one of the demo patients, free of charge, of course. A $6,000 laser treatment for free? Guess how long it took me to answer. Stay tuned as I review the laser treatment!