What should you know about boxcar scars subcision?

Boxcar scars are depressed acne scars with relatively defined edges. Some are shallow and broad, while others have sharper borders or a deeper base. A clinician examines the scar's shape, depth, skin thickness, and any active acne before deciding whether subcision fits.

In subcision, a small needle or cannula is guided under the scar after the skin is cleansed and numbed. Its movement separates fibrous strands that pull the scar downward. This creates space for the skin to lift and for healing tissue to form beneath the treated area. Not every boxcar scar is tethered, so releasing the underside may help one scar more than another.

Share your history of raised scars, cold sores, bleeding problems, allergies, and medicines or supplements with the clinician. Active inflammatory acne may need attention first, because treating scars while new lesions continue can make the overall texture harder to judge.

Expect swelling, bruising, tenderness, or temporary unevenness after treatment. Keep the area clean, follow the dressing instructions, avoid picking at crusts, and use the recommended sun protection while the skin settles. A clinician may combine subcision with acne scar laser treatment or another technique when scar edges, surface texture, or pigment changes need a different approach. The plan may involve more than one appointment, with time allowed to assess healing between treatments.

Contact the treating clinic if pain is escalating rather than easing, swelling is rapidly increasing, the skin becomes hot and increasingly red, or drainage is thick or foul-smelling. Seek urgent medical help for heavy bleeding, breathing difficulty, facial swelling involving the mouth or eyes, or symptoms of a severe allergic reaction.

Ask: Are my boxcar scars tethered enough for subcision? Which scars will you treat? What instrument and anaesthetic will you use? How long should bruising or swelling last? Would laser treatment add value, and how will you judge progress before repeating treatment?