TITLE:
Subcision in the Treatment of Acne Scar in Iraqi Patients
AUTHORS:
Hayder R. Al-Hammamy, Abd-Allah S. Mohammad, Ihsan A. Al-Turfy
KEYWORDS:
Subcision, Acne, Scar
JOURNAL NAME:
Journal of Cosmetics, Dermatological Sciences and Applications,
Vol.5 No.2,
June
16,
2015
ABSTRACT: Background: Acne vulgaris is a very common skin disease
among young people which might be associated with scarring that has a great
impact on the emotional, psychological and social life of the patients as it
will go with them for life. Subcision is a new technique for the
treatment of acne scars. Objective: To assess objectively and subjectively the
efficacy and safety of subcision in the treatment of depressed acne scars. Patients
and Methods: This is an open-label therapeutic trial. A total of 16 patients
were enrolled in this study. Twelve were males and 4 were females.
Their ages ranged from 19 - 39 with a mean of 26.64 ± 5.64. The duration of
scar varied between 6 months and 10 years with a mean of 4.14 ± 2.54 years. subcision
was done by introducing a sterile, hypodermic, 18-gauge needle. The needle was
held by a three ml syringe for better orientation of the sharp tip of the
needle. It was kept horizontal to the skin surface with the bevel up, and was introduced
in a high sub dermal plane. The needle was slowly advanced parallel to the skin
surface. Initially, rapid, repetitive linear back-and-forth motion of the
needle makes the skin free of the underlying scar. This procedure was repeated
in all directions in a fan-like manner. Results: According to Modified Sharquie’s scoring system for grading acne scars, 4 (25%)
patients had severe grade, 11 (68.8%) patients had moderate grade and only 1
(6.2%) patient had mild grade. Evaluation at 6 months after treatment revealed
that 8 (50%) patients had mild acne scar, 7 (43.8%) had moderate acne scar and
only 1 (6.2%) patient still had severe grade. This change in the grades was
statistically significant (p-value = 0.01713441). The average score before
treatment was 13.13 ± 2.363; it became 9.50 ± 2.944 after 6 months. By paired
t-test comparison, the difference in the score was statistically highly
significant (p = 0.000044). Regarding the photographic assessment, the
difference in the visual analogue scale before and after treatment was
statistically significant (p-value = 0.043823). All patients were satisfied
regarding subcision as treatment for their acne scars with variable degrees. In
general the reported side effects were transient and vanished within 3 - 7 days
apart from firm bumps which resolved within 12 weeks in all patients. Conclusion:
Subcision
appears to be simple, safe, minimally invasive, well-tolerated, and effective
surgical procedure that provides significant long-term betterment for depressed
acne scars especially for the rolling type.