Efficacy and Safety of Subcision and Microneedling in Treatment of Atrophic Acne Scar

Abstract

Background: Acne vulgaris is a common skin disorder, with atrophic scars being a frequent sequela. Various treatments exist, but combination therapies like subcision and microneedling have shown promise in addressing different scar types effectively. Objective: To evaluate the efficacy and safety of combining subcision and microneedling in treating atrophic acne scars. Methods: A prospective study was conducted on 160 patients (aged 18–40 years) with atrophic acne scars. Participants underwent four sessions of combined subcision and microneedling at monthly intervals. Scar improvement was assessed using the Goodman and Baron qualitative grading scale, and patient-reported outcomes were recorded. Results: Grade 4 scars (60% of patients at baseline): 32% improved by 2 grades, 68% by 1 grade; none remained at Grade 4 post-treatment. Grade 3 scars (26%): 31% improved by 2 grades, 64% by 1 grade; 5% showed no improvement. Grade 2 scars (14%): 86% improved by 1 grade; 14% had no improvement. Patient satisfaction: 31% reported 75–100% improvement, 31% reported 50–74% improvement, and 35% reported 25–49% improvement. Transient erythema, edema, and pain (resolved within 2–3 days); occasional bruising and hyperpigmentation. Conclusion: The combination of subcision and microneedling is a safe, cost-effective, and efficacious treatment for atrophic acne scars, particularly for rolling and boxcar types. It demonstrated significant improvement in severe scars (Grades 3 and 4) with minimal downtime and high patient satisfaction. Further comparative studies are needed to optimize treatment protocols.