What causes scarring?

Hi guys… I’m new to this forum. I’m 24 and I have mild acne, but when I get any acne it’s usually very noticeable. 🙁 I have had acne since my teens.

Anyways, my question is : What causes scarring? I have always heard from day one that you shouldn’t pop your acne at all because it will cause it to leave scars aftewards. My problem is that I don’t touch my pimples and yet they still scar!!! The scarring is what really bothers me, because I have quite a few of them on my face that have been there for months. I don’t think these scars will go away… and its really depressing.

Most of the acne I get is around the temples of my forehead, but I also get breakouts all throughout my face every now and then. Some people have told me if the pimple is active for more than a week, usually it can scar even if you don’t touch it. I have also had some people tell me that you should pop them because they scar if you don’t as well.

What is right and wrong? What should be done for acne that just won’t go away, no matter how much you keep your face oil free and how much benzoyl peroxide you apply? Thanks for your help…

-Steve

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43 thoughts on “What causes scarring?

  1. Hi Steve,
    It dosnt really matter how much BP you use or how much you keep your face oil free with washing. Acne is all about how much oil you produce and how closed off your pores are (caused by water retention in the skin).

    Washing more or applying more harsh chemicals can just make your skin produce MORE oil making the problem worse, even if you clean all the oil up right away.

    Now in terms of scarring. The scars are produced by pimples that are located in the lower layers of the skin. It dosnt matter what you do, as long as there is enough oil production and you pores are sufficently closed off these pimples wil grow, and will scar. The oil/puss that is produced expands out and makes a big hole in the skin. When the puss and oil is finnaly gone, the hole gets filled back in with connective tissues. These tissues are woven in weird patterns, these patterns are called scars :cry

    To prevent future scaring you have to decrease your oil production or get water out of your skin. You can do these things through supllments and diet. There are many people here and many posts already made that can help you through these things.

    Once your acne is gone, there are cheap ways to help get rid of these scars.

    PS: once a pimple is clearly on the surface, take a fine, sterile needle and poke it gently till you break the surface. Then take a piece of tissue on each hand and gently squeese it moving your finger up and down to kinda wiggle it out. once you get it all out (ussually a bit of bloody water will come out) you dab up the extra fluid then put some antibacterial ointment on it. (ie. tea tree oil, grapefruit seed extract, netosporin ext.)

    Hope this all helped… GOOD LUCK! 8)

  2. Hi Steve 😀
    I have asked several dermatologists the same question you asked, “Why did I scar from acne when I did not do anything to it?” I say several because I have tried different ones over the years trying to find one that wasn’t just guessing at how to get rid of my problem. Right now I don’t have much of a problem with acne at all but I do have some scars from past acne.

    First, red marks will go away in time they really are not true scars.

    True scars from acne are depressions in the skin.

    The depressions are caused by the infection that is inside the inflamed pimple/cyst eating up the collagen in the dermis level of your skin. Once the inflammation (pus) goes away there is an empty pocket in the lower level of your skin, the dermis, which is the level below the epidermis, and the epidermis sinks in, and is seen as a depressed scar on the surface of your skin. This empty eaten out area fills in with short collagen fibers between the lower dermis, and the upper epidermis level of your skin that actually hold the scar in place, and no matter how many peels or laser treatments you get the scar remains depressed.

    Sometimes wiping off the pus head, if there is one involved with the pimple, with a sterile gauze pad that has a dab of 70% alcohol on it, and applying a good antibiotic cream or gel afterwards to the area like zinc bactrin will kill off the inflammation that is still in the upper epidermis level of your skin, and your skin will heal on the surface without a scar, because the lower dermis level will not be eaten away. People tell you to not squeeze because squeezing can force the infection into the lower dermis level of your skin and then it can get worse, and end up scarring.

    If you have a deeper infection like a cyst that does not have a pus head on the surface of your skin, and hurts when you touch it then you could get an injection from your dermatologist that is done directly into the cyst. This injection could be an antibiotic that is injected. When antibiotic is used this way it will be a local and not a systemic antibiotic. This is much better than taking antibiotics by mouth, which is systemic treatment and can cause other problems. I had some of these injections directly into the cysts in the past, and when this is done the cyst does not make a scar. I have read that sometimes cortisone is used for this injection instead, and this also makes the inflammation go down, and the end result is the same because the skin does not scar.

    Does this make sense to you? I am trying to explain what a doctor told me when I asked why I got the scars I got.

    Don’t despair if you have any acne scars now.

    If they are truly depressed scars there are things that can be done. I recently had a procedure called Subcision done on a rather nasty scar that was on my cheek. You have to find a doctor who really knows how to do this procedure, and has done it on many patients before you because it takes great skill to do it right. The doctor numbs the area of your skin where he/she is going to do the procedure. He/she will mark the area with a surgical marker. The Subcision is done with a needle that has some sort of cutter on it. I did not see the needle so couldn’t say what it actually looks like. I could not see anything but I could hear the sound in my ears of the strands of my collagen breaking. It sounded like threads being cut. After the procedure the nurse cleaned off the surgical marker and applied a bandaid but she applied it tightly to cut down on the swelling. You don’t want to swell up too much. The bandaid stayed on for about 8 hours before it fell off and I could get a better look at the bruise I had. I did not receive any instructions to put anything on the area but I was told it was ok to put the MSM/aloe cream I use and the Jojoba oil also, which I did. I have a second appointment to see this doctor for the same procedure next month because the doctor said that the scar might need a second Subcision. Today it is 7 days since the procedure and the bruising is almost gone. I can’t see the scar at all. The idea behind this new procedure is that when a scar forms the healing of the collagen becomes ‘short’ in places between the outer epidermis level of the skin and the inner dermis level of the skin. The doctor just cuts the ‘short’ collagen fibers and they hopefully will be replaced by fresh collagen that has ‘longer’ fibers attaching the lower dermis to the upper epidermis. When the length of the collagen fibers between the upper epidermis and the lower dermis level of the skin are elongated the scar disappears from the surface of the skin. Flawless skin is the result. Can you believe that? I keep looking in the mirror at my former terrible scar, and it is not there now!

    I know all of this sounds just too simple but that is what is so amazing about this procedure! It is so simple, and so safe. It will not work on all scars because some scars are only in the upper epidermis level of the skin, and can only be removed by removing the upper layer of the skin several times over and over in order to reach a lower level where the skin evens out.

    Be careful and make sure any doctor you see is an expert in scar revision because going to someone who is only interested in making a lot of money off of you could leave you with the same scars you had when you first saw the doctor and with a smaller bank account afterward or worse the doctor could do something wrong, and leave you with worse scars from whatever they do to you.. Some doctors are doing laser on people who should have Subcision, and the patient wonders afterwards WHY the laser did not remove the scars. It is because the collagen fibers are holding the scar in place!

    Good Luck I hope I have helped in some small way. :angel
    Solomio

    PS I am going to include this reply to you in my thread on getting rid of shallow acne scars since I have had this positive experience with Subcision. The funny part is that I went to this doctor to get a chemical peel, which is much more expensive than the Subcision, and she said that Subcision would get rid of the really bad scar that was on my cheek. She does this procedure all the time with positive results. I may still get the chemical peel some time in the future for my more superficial scars. I hope you have as much luck as I have had.
    God Bless!

  3. Hi Nomad,
    I am so excited about what has happened to me! :muti

    Everytime I would walk into a room I knew everyone would focus on this particular scar because it was on my cheekbone area, and very noticable. Now this scar is gone, and if a part of it should return in the next 3 weeks I know I have a good doctor who will take care of it without causing any permanent harm.

    I added something to my post after your read it. It is funny that I originally went to this doctor to find out if I was a good candidate for a TCA peel and ended up getting rid of the most horrible scar I had!

    She did give me a prescription for an antibiotic just to be on the safe side, and as much as I do not like antibiotics I have been taking it because it is for only 10 days, and afterwards I will take my probiotics to help re-establish my system back to normal. 😀

  4. Wow thanks for the great responses Nomad and Solomio. 😀

    Unfortunately, I don’t have the money to pay my dermatologist a visit… nor to have the surgery you are describing. Maybe once I am a bit older and out of grad school. 😐

    I guess I need to spend some time looking through these threads since you said there is a way to “prevent future scaring” by decreaseing oil production. I have been cursed with oily skin and scalp since I was young, most notable on my forehead/temples/nose. That mixed with extremely porous skin makes my face an oil and dirt collecting plate.

    Anyways… when you suggested using a pin to prick the pimple, you said “when its clearly on the surface”. I have a few cases where there is a bump on the surface ( the pimple is noticeable ), but you can’t see any white center or puss. Nothing can be done to get the puss to surface (tried hot showers, hot face wash, etc). It’s these ones that usually sit for a week or more and never go away… thus the scarring occurs. Is that procedure only for pimples where there is puss is at the surface? Should this be done on ones where no puss is seen for quite some time? Thanks again.

    -Steve

  5. When I said “it” can clearly be seen on the surface, i meant the oil/puss itself.. you are telling me all you can see is a lump.. thats called a cysts and should NEVER be poked or squeezed under any circumstances. But the lump that you see is only skin, and is deffinatly NOT “it” :roll

  6. Maya Hi, 😀
    I have been saying WOW all week and the bruise is almost gone today. I don’t think that collagen can reform in only a week? But maybe it can? I have been doubling up on my alpha lipotic acid to 400 mg a day since I had the Subcision, and I am using the jojoba oil and the msm/aloe cream morning and night. I originally was going to wait a full month before publishing my experience with Subcision but when I saw Steve’s plea on the board I decided to tell what I was experiencing.

    Since I occasionally get a break out the doctor gave me a prescription for Retin A. I have been testing it on my chin where a zit was trying to get going and it went! I got the generic Retin A, and the price was about 1/2 of the regular product.

    Something else about this Subcision procedure that I went through that is quite interesting…I paid only $85 American dollars for this procedure. If I had wanted to have the scars I have on the left side of my cheek done she would have charged me only $150 American dollars for the procedure, and I live in a place where the cost of living is extremely high! I opted for the one scar at $85 because I did not know how I would react to the procedure, and I am a big chicken.

    Do you remember that I tried self needling on this scar a while back and had some improvement? But I was too big a chicken to carry on with the needling procedure by myself. Subcision must do the same thing as needling because of the sounds I could hear of the collagen threads being broken. I also have to say that this doctor took several pictures of my scar. I think she is going to use these pictures in a presentation of some kind?

    Something else…she gave me the prescription for Retin A as I have already stated. Her price for a medium deepth TCA peel (Blue Obagi Peel) is $500, and she does not think it is necessary to go on the expensive Obagi treatment before the peel. The Retin A does the same as the expensive pre-peel Obagi treatment that the other doctor wanted me to buy and the other treatment costs an additional $450 for the fancy Obagi treatment that is used before the Obagi peel.

    Once again there is something else…she told me that a laser called the V-beam does more to fill in shallow surface acne scars than any peel can by stimulating collagen below the surface of the skin. The V-beam does NOT remove or burn any skin on the surface epidermis, it works below the surface of the skin in the lower dermis layer, and stimulates the collagen there. She has done this to other patients with excelent results, and she charges $450 for a full face treatment with $150 being the ‘set up fee’ of the laser, and the set up fee is included in the price. Lasers take a lot of energy to run! She does the cheeks only for $300, which also includes the set up fee. Right now I cannot affort to do this but will keep it in mind for the near future.

    Are you going to get needled by a permanent make-up person or a tatoo person in the near future? I thought I read somewhere you said you were going to do this? :angel

    Solomio

  7. I guess my next question would be : Is there certain care for cysts that should be taken to make them go away? These are the type of acne that usually sit around for a week or more and cause my scars. If I touch them, I get scars, if I don’t touch them I get scars as well! Seems like a no win situation.

    I have tried various things on them ranging from BP, neutregena multi vitamin acne treatment, witchhazel, etc. with no good results.

    -Steve

  8. Hi SZ200
    😀 The following is from my first post on this thread…hope it helps you some as this method did help me.

    If you have a deeper infection like a cyst that does not have a pus head on the surface of your skin, and hurts when you touch it then you could get an injection from your dermatologist that is done directly into the cyst. This injection could be an antibiotic that is injected. When antibiotic is used this way it will be a local and not a systemic antibiotic. This is much better than taking antibiotics by mouth, which is systemic treatment and can cause other problems. I had some of these injections directly into the cysts in the past, and when this is done the cyst does not make a scar. I have read that sometimes cortisone is used for this injection instead, and this also makes the inflammation go down, and the end result is the same because the skin does not scar.

    If you are in a graduate program do you have insurance with your school? This procedure is covered by most all insurance companies. If not then call around to derms and tell them you are a college student who needs help but are short on cash. Some doctors do have a heart. You might find someone who will charge you a price that is more fair than most doctors charge.
    Good Luck,
    Solomio

  9. Steve,
    A lot of people put ice on cysts to bring down the inflammation.

    Don’t put the ice directly on your skin but instead put a cover between your face and the ice. If you put it on your skin without something in between your flesh might freeze and you could get broken caps from this. This is what happens to people who live in freezing climates, and do not protect their faces from the icy cold and the wind. I used to live in such a climate, and remember seeing older people with broken caps on their faces from the freezing cold.
    Solomio

  10. Thanks. I have insurance through my college, but its mainly for emergency situations and wouldn’t cover derm visits.

    I’ll try the ice suggestion. I’m going to do some more research on the different types of acne (cysts, regular pimples, etc.). I never really knew there were different types, other than just regular pimples and blackheads. I guess my problem is classifying what I have and using the right treatment described here by you guys. 😛

    Thanks again to all.

    -Steve

  11. Solomio how deep was the scar you had subcised. Was it completely healed or did it still have a purple color to it. Does this procedure work on non-acne scars and just say if the scar goes as deep as the subcutaneous fat layer.

    Also about cysts which just remain lumps. I used to get these and they would stay for months and then leave a red brown mark when the lump goes. But they never permanently left a scar. In fact i used to wait until they dried up and then i would shave over them with a razor blade. Quite effective gets rid of the dried lump quite well, but sometimes it could leave a fresh purple mark though but nothing serious. But don’t keep shaving over the scars. A lot of men get acne on the lower jaw and chin line and they shave over it every day. It will keep making the scar sore and coarse and it will probably leave an indententation.

  12. 😀 Scarred4life e-mail me on this forum and I will tell you who the doctor is who did the Subcision.

    😀 Will205 The scar that I had Subcised had collagen fibers that extended from the upper epidermis layer to the lower dermis layer of my skin. I had a cyst there a long time ago and again the second time next to the same area I had a second cyst. Both cysts left indented scars that were joined together to make a very ugly elongated looking scar. There was no color in this scar it was just indented quite a bit.

    Subcision was originally used in Europe (France) to get rid of dimples in skin on the butt. You know what I mean? Some people have dimples in their butts and they don’t like them when they wear thong bathing suits. So the French found a way to get rid of these dimples.

    Then some doctors started doing Subcision to peoples faces to get rid of deep wrinkles; the type of deep wrinkles that extend down to the collagen in the dermis level of the skin.

    Then some doctor(s) got the idea that Subcision would get rid of acne scars. It does!

    Maya is doing the needling procedure, which is a little like Subcision BUT the needle is a bit different for Needling from the needle that is used for Subcision. The Needling needle is straight, and the Subcision needle has a tiny little crossbar on it to cut the collagen fibers. Also, I had painkiller injected so I did not feel any pain but I bled a lot from the procedure, and had a pressure bandage on the site that stayed for 8 hours to keep the swelling down. There was a big bloodclot afterwards under the skin.

    I am going to write about my experience again in February after 4 weeks have pasted since the procedure. I have learned it takes 4 to 6 weeks for the collagen to replenish itself in the skin. Right now my former scar is only a touch of color. I am scheduled for a second Subcision because the doctor told me that some people need a second Subcision to completely getting rid of the scar. Once collagen has filled in an indented scar the scar does not come back.
    :angel

  13. hi solomio,please rate by how many percent does your skin pops-up after subcision. thanks

  14. 😀 leandro,
    Right now it is 2 weeks since I had the Subcision (Jan 13), and I have at least 4 more weeks for natural collagen to fill in. All the bruising is gone, and all I have is just a tiny narrow red mark exactily where the scar used to be. I am female so I use make-up. With the make-up on I say that the scar is between 80 to 90 percent improved. Make-up covers the red mark very well. I will know in 2 weeks, when it is time to return to the doctor, the total outcome of this procedure.

    The real test is to stand in front of a mirror with an overhead light glarring down. I have 2 places in my house like this (lucky me), and the scar is pretty much gone in both of these locations when I look at myself in the mirrors there. Perhaps during the first week in February, when I go back to see the doctor I might not need a second Subcision on this particular scar. I am hopeing for this outcome.

    I still have trouble believing that this has worked for me! After looking at this ugly scar for so long it is a shock of a sort to have it gone so fast!
    Do you know what I am saying?
    solomio

  15. hi, can you give me your e-mail address, I would like to e-mail you my pictures of saucer scars and would like to inquire if these treatment will help through subcision. Thanks

  16. 😀 Hi leandro,

    If you register you will be able to send me a ‘private message.’

    All you do then is click on my name for my profile.

    When my profile comes up on the screen you will see a button with a pm in it. This pm stands for ‘private message’. I have been saying e-mail that was the wrong term for this service. I guess I said that because the pm works the same as an e-mail box.

    The scar has to be deep enough for the collagen fibers to reach from the top epidermis level of your skin down to the lower dermis level in your skin. Subcision works if the collagen strands are holding the center of the scar down so it makes a depression in your skin. Most scars that have any depth to them are being held down by short collagen fibers between the two layers of skin. Cutting the short collagen fibers, and allowing new longer collagen fibers to grow in their place makes the scar rise up in height to the level of the rest of the epidermis.

  17. hi, friend tell us something about your subcision results, Well keep us updated. Maybe your scars have sunk-back????

  18. 😀 Hi leandro,
    The one scar I had Subcised is still at 80% to 90% filled in, and it will be a month on the 13th. You can tell that there is no swelling because there is no tenderness when you touch the spot. The bruising went away weeks ago. There is only a short pinkish line where the scar used to be. I cover this up with make-up.

    It is nice to have people look at me instead of looking at the ugly scar I used to have on my cheek.

    Leandro you should consider registering your identity on this board. It is free, and no one will bother you with spam or anything. You will be able to use the private message service after you register.

    Solomio

  19. TO ALL UK PEOPLE

    If you are interested in getting skin needling done professionally – Contact Julie Arnold – she is the Acne and Scar specialist at Bio2Clinic – based in Leamington Spa (in Warwickshire). 01926 424666 She is truly an amazing person – very empathic as she has suffered acne and scarring herself, so she really understands (unlike some derms who have never experienced acne or scarring).

    An hour of needling will cost £250 (pretty cheap considering I have heard quotes from £500 up to £2000 for the same!) It is hard to determine whether 1 session will be sufficient – I hear that it normally takes 2-3 sessions for amazing results – depends what your scars are like and also how well collagen increases in you.

    All the needles are disposable, and the machine is state of the art – created specifically for scar revision – rather than just a tatoo machine.

    There is normally a £35 consultation fee for a discussion on your skin needs and to do an analysis on skin type etc. – to make sure that your skin is suitable for certain types of treatments.

    I have negotiated with Julie that anyone quoting my name will NOT be charged the £35 consultation fee. – so make sure you mention me LOL!! Maya Reddy

    My first needling session with Julie will be on the 7th of March!!!!!!!!!!! YIPEEEEEEEE

    Good luck and wish me luck!!

    Maya

  20. Sista good luck!!! wow and that gal is definetly generous. 🙂

    Will look forward to hear how that goes!

    Mari 😀

  21. hi there. I think you could be the lucky one with subcision. As far as I know that I read many post messages in the forums. They rate that subcision improves by only 10 to 15 %. I haven’t done subcision yet but this March first is my first schedule in subcision. Since I stop Roacccutane last August2002 and wait for 6 months to have my first subcision. I will post messages this March if I have my subision done!!

  22. 😀 Hey leandro,

    I read way in the past on the voy board where a person went to a doctor for Subcision, and they only got a 30% to 40% improvement the first time so I know that lower % results happen. The doctor who did this person’s Subcisions is located in New Jersey. I have to wonder if the scars were shallow or deep? I think that if the scars were shallow then the results would not be the same as those gotten from deeper scars being Subcised.

    I posted on my most recent Subcision experience in the other scar thread earlier this weekend.

    My doctor refused to do my shallow scars. She said they were not deep enough to Subcise. I am wondering if she has done shallow scars in the past, and they did not respond as well as deep scars do to the procedure?

    Leandro are you going to take vit C and ALA as I did. I think these supplements really help with the final outcome.

    My doctor wanted me to use Cetaphil to wash my face but I did not because Cetaphil wash always breaks me out. Doctors seem to really like Cetaphil wash. Then there is my theory about not sleeping on my face until the skin settled down. That was 2 weeks for me the first time, and I am doing it this time.

    I’m waiting another 4 to 6 weeks before I pass final judgement on my outcome.

    I still have to find a way to finish off my shallow scars.

    I am beginning to think about needling again for the shallow scars. Problem is that no one where I live does needling.

    My doctor wants me to give Retin A a chance to work on the shallow scars.

    Leandro, I wish you all the Luck in the World with your Subcision(s). I am guessing you will be having multiple scars Subcised? Don’t worry about having it done as long as the doctor gives you injection(s) before the procedure all you will feel is the collagen strands breaking. Afterwards your face will be a bit sore for several days, and a bit bruised. It’s not bad at all!

    I got a PM from a person who lives in Texas who is looking for a doctor who does Subcision. Leandro, are you located in Texas?
    Solomio

  23. I am an Asian living in the Philippines. There is a doctor in Manila who does subcision!! I will post soon on the 1st or second week of March if I had my subcision done already.

  24. hi, i have done my first subcision today on 3 rolling scars. I will update my report after 7 days.

  25. hi solomio, did your doctor prescripe antibiotics in you after subcision procedure. my doctor prescribe me cefalexin. I dont like taking antibiotics, could i use vitamin c instead of taking antibiotics??

  26. 😀 😀 Hi leandro,
    I am so happy you have had Subcision done! I pray that you have as much luck as I have had!

    Since the doctor goes inside your skin with an instrument it is always possible that some bacteria could have entered the wound during the procedure. Bacteria that could have been present in the air in the room during the procedure could cause an infection.

    An infection in a Subcised wound would cause terrible scarring.

    So please take the antibiotics your doctor wants you to take for this procedure. My doctor had me take Cephalexin 250mg every 6 hours for 5 days. I healed up perfectly with no problem.
    Solomio

  27. hi, its been 3 days since my subcision. Today my derm takes -off my bondage. I used to have subcision on 3 scars. So my skin is bruising yet. I use a florescent lamp and mirror to see my scar. I can’t say any more improvements coz its only 3 days, well my skin pops-up above skin level. I will update my story after 3 more days. One of the scars i have notice has sunk-back. 3 scars are considered rolling

  28. Hi leandro,
    I have to ask you some questions so I can understand what is going on with your scars.

    Were all 3 of your scars deep or shallow or a mix of deep and shallow?

    Did you feel the strands of collagen being broken while the doctor was doing the Subcisions?

    When I had the first Subcision on my scar there were so many strands of collagen being broken that I lost count.
    When I had the second Subcision on the same scar there were only 4 strands of collagen that broke…so this told me that those last 4 strands were what was left holding my scar on one end.

    I still have a reddish mark that is under the skin instead of on top of it where I used to have the scar. I have gone from 100% filled in after the second Subcision to 90% filled in, and as time is going by the area is looking like it is going back to the 100% filled in. It feels this way too when I touch the area. I have been told that it can take up to a year for collagen to regrow once it has been cut.

    I wonder if this is what is going on with you? Maybe you need to give it some time so the collagen can fill in?

    Leandro, are you taking at least a gram of vit c a day? Humans don’t make vit c in our bodies. Many other animals make vit c in their bodies. Vit c is necessary for the body to make new collagen. How about MSM or ALA? Both of these are forms of sulfur and sulfur has a role in making collagen in the skin and it also makes your hair and nails grow. You also need enough calcium, silica and magnesium in your diet to make strong collagen. Has your doctor prescribed anything to encourage collagen re-growth in the scars you had Subcised?

    My doctor has me using Retin A because it encourages collagen to re-grow in Subcised scars. She also told me that Retin A can do more to cause collagen to fill in shallow scars, that have not been touched, than having expensive TCA peels. I do believe she is right because my shallow scars (I did not have anything done to my shallow scars) are looking smoother, and my scar that I had Subcised (the one that was quite deep) is actually feeling smooth when I touch it.

    Please ask your doctor about Retin A. The only draw back to using Retin A is you have to be very careful about ultra violet light (sun light) and use a sunblock during the day. I am using a generic Retin A so it is much less expensive that the original, and it is working just fine.
    Solomio

  29. hi solomio. My 3 scars are shallow nor deep(in between). But they are all rolling scar types. The doctor did prescribe me Cephalexin 500mg and Tranexamic Acid 500mg(brand name is Hemostan) both for 5 days. Hemostan is for the treatment of blood clot and hemorrhage. I was subcised last friday on march 21. I take all this medication until monday(3 days only). then shifted on vitamic c.
    My bondages was taken-off by my derm last monday. I take a warm bath at tuesday. At wednesday(yesterday), i have a strange feeling that 2 of my scars have sunk back, definitely i frankly want to say no improvement takes place, swelling went down on 2 scars only redding of the face remains. My other scar is still elevated but there is only a very small swelling remains( i havent seen it sunk down yet). I frankly want to say subcision really sucks. If one of my other scar sunks after 3 weeks , I would say that it aint worth my money spending it.

    I hear collagen being cut on the 1 scar(still raised). The 2 other scars I didn’t hear collagen tearing. The first scar took long enough my derm to subcise and has many blood in it.(about3 minutes). The other 2 scars(which sunk back down) took only 2 minutes altogether. Maybe it was the Hemostan and the antibiotics that cause the 2 scars to sunk back down. I have heard people in the http://www.voy.com/10956 said that some of them took 3 to 4 weeks the swelling to fade. I think the longer the swelling the better the result. Can you please enlighten me why is it , mine took only 5 days to subcise(the sweelings) to sunk back-down(the scars). WHY????is it because I am taking these oral hemostan and cefalexin? Do you think i should go for another subcision after 2 months with these 2 scars that sunk back.
    You said before that your scars have level-up why did you performed another subcision on the same scar?

  30. Hi leandro,
    I read your reply this evening.
    It looks like you had only one scar Subcised, which was the one where you heard (felt) the collagen strands being cut.

    The other two sound more like needling. But even with needling I believe you feel or hear strands of collagen being cut? I don’t know what the doctor did here but like I said I think he only Subcised one scar.

    The bruise ( the blood clot under the skin) holds the top layer of skin up and away from the bottom layer that it has been cut away from. I don’t know why your doctor would not want that to happen?

    Remember that once a scar has been Subcised you can see improvement up to a year away.

    I had the second Subcision done because when I had the first one done my doctor wanted me to make a second appointment so I went ahead and made the second appointment after the 1st Subcision.

    My scar was close to level on the day I went in for the second appointment but it was down a little. This is when she did the second Subcision where she cut only 4 strands of collagen. The first time around there were many strands of collagen cut.

    Now I still have the reddish mark that is under the skin where the scar used to be. I think I will have this line for a few months? I am still at about 90% filled in. The scar I had was really deep before the Subcision.

    Leandro, my doctor refused to Subcise shallow scars. She said the scar had to be a certain depth in order to get good results. That could be what happened with the two scars you did not feel or hear any collagen being cut.

    The scars have to go from the top layer to a lower layer of skin and in between there are these long strands of collagen between the layers that hold the layers to each other. When deep scars are formed the collagen strands don’t heal right and some collagen strands heal shorter than they should be. These shorter strands hold the top layer of skin down closer to the bottom layer of skin and the result is a deep indented scar.

    When these strands of collagen are Subcised they release the top layer of skin and it raises up. Some doctors will put a filler in the new pocket that has been created. Some doctors will not put anything in the pocket because new collagen will form in time and the hope is that the new collager will have longer strands that will make the scar disappear completely.

    With needling often the shallow scars will disappear, and I do not think the doctors who are doing needling really know WHY needled scars disappear. The theory is that the damage caused by the needle causes the body to respond by creating NEW collagen to deposit in the shallow scar area. I hope you see this happen for you.

    Do not dispair because the other 2 scars have dropped down. Give them time to recover. Take your vit c. Be kind to yourself.

    Have you asked your doctor about Retin A? Retin A encourages new collagen to form under the top layer of skin. It really helps to fill in shallow scars. I am using Retin A at 0.05% and my shallow scars are looking much better. Yes, I am impatient too like you are and I would love to see them disappear all at once but my doctor explained that it takes time. I am not sure how long I will be on this strength but in time I will be using a stronger strength. I plan to go 6 months on this strength, and make an appointment to see her again for an evaluation. Then she may up the strength of Retin A for me. I believe that she told me she uses 2%. I am not sure if this high a dose is available for the general public. My doctor has been using Retin A for years and has gone up in strength over time. This is what she told me. She had beautiful skin with no wrinkles, no scars of any sort.

    Leandro, come back here, and give us periodic reports on how you are doing.
    Solomio

  31. Hi solomio. Its been 12 days since the subcision. I went to my derm yesterday for check-up. He said that the 2 scars he subcise were not quite deep, the 2 scars seem to have no improvement. The other 1 scar he subcise was very deep and there is more anesthesia and it has totally raised(erase depress scar) but as the swelling went down, it sank a little(not much). However I still got a very small bruising left but all the swelling has gone.
    Hi I have a question for you. The 1 scar he has subcise has totally raised but the area(where he went to insert a needle during subcision) sank a little, Size is 1cm X 1/2cm of the area he subcise(1 scar)
    Do you think in time it will raise above skin(the 1 scar that its area subcise sank a little)?? Please answer my questions coz I am slightly very very worried about the procedure.

  32. 😀 WoooHooo Leandro,
    Yes, the one scar that was deep will continue to improve for you for up to a year! I know that the one I had has finally lost the reddish mark that was under the skin. AND I can tell by putting my finger on where it used to be that it is filling in more with new collagen under the skin.

    Leandro it takes time for everything to come together. Don’t get nervous about it because once the scar is finally gone it will be gone forever!

    Sounds like your doctor is still learning which scars will respond to Subcision?

    Does he want to do another Subcision on the scar that is responding to the treatment?

    Have you asked your doctor for a prescription for Retin A to get rid of the shallow scars? I use the generic made by SPEAR…there are several generics on the market and they are much cheaper than the original. The original costs around $50 for 20 grams 0.05 strength, and the generic costs around $30 for 20 grams same strength. It might be cheaper where you live…where I live drugs are way over-priced.

    Since I have been using the Retin A every night I have seen a big improvement in my shallow scars. They are much less now, and something else has happened. I have used the salicylic peel kit 2 times now since going on the Retin A full time and my skin is responding much better to the salicylic peel now than it did before I started the Retin A. I will use the peel in the morning and that evening I will skip the Retin A because I want to give the skin a rest. The next night I start up again using the Retin A. You can go out after doing this type of peel because the skin does not peel until a couple of days later on. Then the peel, at least for me, is a gentle flaking that goes on for a couple of days. When the peel is done the shallow scars look even less than they were.

    When I am peeling I use the Racial Perry Gentle Scrub. Actually I use the Racial Perry Gentle Scrub several times a week all of the time because it makes my skin feel smooth, and it really cleans out the pores. It never irritates me…it really is gentle.

    Leandro, please keep in touch, and let me know if you get another Subcision on the same scar. Please let me know if your doctor gives you the prescription for Retin A, I know it will help you as it has helped me. I am using the Tretinoin Cream, USP, strength 0.05%, generic made by SPEAR. But as I already said there are other generic brands on the market, and if you can afford the price there is the original.
    Solomio

  33. Hi? I have done my subcision already last march 21(last 19 days). On 3 scars were they were considered rolling the 2 scars remained the same. While the other scar sunk back down. I thought it will raised-up. The 2 scars the doctor subcised were not very deep. The 1 scar he subcised was very deep and put many anesthesia.

    Yesterday I have consulted another doctor who performed subcision. I had asked her what happen to the one scar coz it sunk back down(more depression). She told me that the 1 scar was very deep during subcision and it damaged the connective tissue therefore it sunk back down(more depression than the original scar). She told me also that there is no possibility that it will raised above skin in time. Well I guess subcision was a failure to me. I guess I would like to excise the 2 other scar this june.

    She didn’t mension (second doctor) that retin-a would get scars.

  34. I had asked her what happen to the one scar coz it sunk back down(more depression). She told me that the 1 scar was very deep during subcision and it damaged the connective tissue therefore it sunk back down(more depression than the original scar).

    Leandro,
    Subcision is surposed to damage the connective tissue…that is WHAT Subcision IS. I don’t think your doctor understands about this procedure. I realize that in different parts of the world there are different ideas but as I said damaging the connective tissue…actually CUTTING the connective tissue is what is surposed to happen. That is what you heard and felt break when the first doctor cut it with the funny needle.

    Please Leandro be patient, it has been only 3 weeks. Do not give up hope. As I have explained to you already the healing process takes time. It is close to 2 months for me now since the second Subcision I had on the same scar area and the small depression that formed after everything healed is filling in completely for me now. The new connective tissue (collagen) is coming in from the left side of the Subcised area. I guess that is how my body is dealing with replacing the new connective tissue (collagen). I thought it might come from the bottom up but instead it is reconstructing from the left to the right.

    HANG IN THERE LEANDRO…you have a ways to go yet before you are done with this procedure. Please don’t do anything not needed like getting a lot of more work done before you have healed.

    It is up to you to tell the doctor you WANT to try Retin A BECAUSE a doctor in California US is prescribing Retin A BECAUSE it makes the connective tissue (which is collagen) grow in faster. It can take up to a year for a Subcised scar to fill in completely for some people.

    It has been only 3 weeks for you!

    Please keep in touch because I am waiting for the day you tell me that your scar…at least the deep one is filling in completely for you.
    Solomio

  35. hi solomio, i have bought Retin-A cream .05%. So you told me to apply this on 1 scar that has been depressed after subcision. I will update my progress here after 3 weeks for the results that you have been told me…

  36. 😀 Hi Leandro,
    Just follow the directions and be sure to apply it only once a day. Bedtime seems to be the best time because our bodies do all ‘repair’ work at night when we sleep.

    I use Retin A on my cheeks as well as the area where I had the Subcision done because I have small shallow scars there that the Retin A is getting rid of by making new connective tissue (collagen) grow under the skin to fill in the slight depressions. I am also applying it where I had the Subcision because it makes the collagen grow in faster.

    Don’t become impatient with your progress!

    I have been using the Retin A since after the 1st Subcision that was 3 months ago and I am really seeing and feeling the results on my skin now. It takes time to work.

    Hand in there Leandro! :tu
    Solomio

  37. Solomio, I am scheduled for subcision in another month. My doctor started me on Retin A about 3-4 weeks ago. She said that use of Retin A prior to subcision would give me a better result. My doctor also wants me to use Retin A after the subcision as that would also give me a better result. Did you begin Retin A use immediately after your subcision or did your doctor recommend something else to put on your skin while it was healing from the subcision?

    I have read that it is not good to discontinue Retin A use for more than a day or two. Thus, I am wondering what my doctor is going to recommend that I apply to my face for the 3-5 days immediately after the subcision. If I stop using the Retin A while I am healing won’t that set me back? Do you think I will continue to use Retin A and there will be no gap in usage? I am using Retin A 0.05%. I’d appreciate your thoughts. You know a lot about subcision and Retin A. I appreciate the info you ave given all of us through your posts.

  38. Hi, The 1 scar sunk back down(got bigger than the original scar) did not improve until now. I went to my original doctor. He said theres nothing he can do about the scars. The 2 other scars i would rate has no improvement either(all 3 scars for subcision). Subcision really sucks.
    I am bothered for the 4 scars on my face. 3 scars for subcision(last march) and the other 1 scar for excision(today). I went to the 2nd doctor today, she excise one of my scars(not those 3 subcisions which i have done). Well the doctor perform excision(not punch excision). She cut the scar-out and stitch the scar and told me to return on monday(it only contains 3 stiches for 1 scar). I only did perform 1 excision. I want to observe it, if the scar is gone well, then i will excise the remaining 3 scars which cause by subcision. I will update my results this coming monday if my stiches will be taken-out by the doctor.

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