Subcision-suction method for acne scars

[SarahVaughter]

The Subcision-suction method: A new successful combination therapy in treatment of atrophic acne scars and other depressed scars.

S Aalami Harandi, K Balighi, V Lajevardi,, E Akbari

Conclusion:

"Frequent suctioning at the recurrence period of subcision increases subcision efficacy remarkably and causes significant and persistent improvement in short time, without considerable complication, in depressed scars of the face."

Full article here: https://http://www.owndoc.com/pdf/therapy-in-treatment-of-atrophic-acne-scars.pdf

Prior to suctionng, instead of subcision, needle the scar aggressively with the single needle from all angles or use a dermastamp.

From the study:

"start of suction on third day after subcision for flat and depressing subcised scars and its continuation at least every other day for 2weeks."

"high grade of improvement was mostly in patients in group A1 who had almost daily suctioning in the first week of suctioning period"

"On the first days, we used less negative pressure; but in the subsequent sessions, depending on the condition of scars, we could increase negative pressure (even to maximum: −70 mmHg), length of time (not more than 4 s in each pass) and the number of suctioning passes (even 8–12 passes) per session."


Subcision is a much more aggressive method than needling/stamping so you should actually start suctioning sooner than 3 days after needling/stamping. Start a day after.
The suctioning method is so new and this (cheap!) method is so rarely used by doctors that the absolutely optimal approach is not known yet and you have to basically improvise and try different approaches.
The study used 0.1 bar (10%) underpressure and our pump sucks stronger but on the other hand, more suction is necessary because you're not doing a subcision first.


UPDATE: We are now selling these pumps here:
https://http://shop.owndoc.com/product-info.php?suction-pump-scars-pid212.html

Please read these two forum postings. They contain some good tips from our forum members regarding the suctioning method:

https://http://forums.owndoc.com/dermarolling-microneedling/indented-forehead-shingles-aftermath-(/

https://http://forums.owndoc.com/dermarolling-microneedling/14-month-update-skin-keeps-getting-better



Other interesting methods to improve scars:

https://http://forums.owndoc.com/dermarolling-microneedling/Saline-injections-for-acne-scars

https://http://forums.owndoc.com/dermarolling-microneedling/Autologous-(own)-blood-injection-for-acne-scars-or-atrophic-scars

[healingtoday]

If anyone is interested in trying the suction method, I've been using a kit like these:

https://http://www.google.com/images?um=1&hl=en&biw=853&bih=529&tbm=isch&sa=1&q=cupping+suction+kit&aq=f&aqi=&aql=&oq=

It creates very good suction and you would want to get one especially for the face.

I've been trying it for a little bit...its too early to say about the results.  I just needled my scars several days ago and I'll start suctioning and will report on if I see any results.

[qchris50]

This is a great article, I wonder if anyone has tried it with needling yet.

[soon]

Hi all,

I have one ice pick scar that I'm guna try to improve with the "suction method".

I'm hoping someone can guide me on how its done.

First I will try it with a syringe.

I'm clueless as to how often I do it and how long I'm meant to keep suction going.

Haven't had much luck doing an online search so any advise will be appreciated.

Cheers soon

[Fredrik]

I am also genuinely interested in performing this on myself, I have a few questions that I would love to get some expertise answers to before I start experimenting on myself.

- Would it be possible to go around with, let's say some tape to keep your skin constantly stretched after needling/dermarolling to force constant haemorrhage? If not, would it be good to perform suction several times a day or would that just do more bad than good?

- Can dermarolling also cause the fibers to release scarred tissue, or is needling from different angles the only option?

- While needling, would it be beneficial to pinch the skin for easier penetration with the needle? Like they do with the subcision.

Thanks a lot for sharing this new technique, the article gave me some new hope :-)

[FINLEY]

There is hope, thanks to Sarah.  I have been doing the subcision procedure on myself with good success- the improvements are incremental and steady.  (Living in the states, it was difficult to find a supplier of sterile, injectable saline and 28 gauge syringes, but I eventually found I can get them on-line from Allegra Medical, no questions asked.)

I never use the same syringe twice during one session of subcision, so I go through several syringes every 3 wks but they, and the saline, are inexpensive.  I have been needling using dermal stamp, and rolling my face with a 2mm roller every 6 wks, and performing subcision every 3 wks, so that every 6 wks I am combining the rolling and stamping session with needling and subcision.  I have had no problems, which may be because I use very good aseptic technique, washing everything down with alcohol before starting the procedure, filling the syringes using sterile technique, and cleaning my face and hands repeatedly with alcohol before each injection.  I must admit, it takes some bravery to do this to one's self, and I say this as a RN, but it can be done.  I have decided to pull out my 1.5 mm roller, which can be used every 3-4 wks, and start doing the entire combined procedure every 3 wks just to push it along a little faster.

Also, I love Alcare Plus, which can be bought on-line- I rub it into my skin many times per day on the days after I roll.  It is an alcohol foam product used in hospitals to cut down on staph infections- it has an emollient which keeps the skin from drying out.  

I am so empathic with anyone who struggles with acne scarring, having lived with it for 44 yrs before I started working with Sarah and her products, so I hope this advice will be helpful.  Sarah is a gift from above!

Good luck!  

P.S.  I feel I actually "hear" the scar tissue releasing most when I am using the dermal stamp, which I do 6-8 times per scar each session, rotating the stamp slightly clock-wise after each punch.  (My advice is to repeatedly clean the skin with alcohol soaked cotton balls throughout the procedures.  I do not know if everyone agrees with that, but it works for me.)

[soon]

Hi FINLEY,

Thanks so much for all your detail and experience.

Personally, for now I'm not going to use injections.

I will single needle as usual but then want to try "suction"

I have a syringe with no needle that I hope I can use for this.

I've ordered this.....

https://http://www.dealyea.com/Product/Facial-Pore-Cleanser-Cleaner-Blackhead-Acne-Remover.htm

But not sure if it would be as good as manual suction (fighting immature urge...actress, bishop hehee)

I hope its just done post needelling.

Advise from anyone who's tried this would be great. If not guess I'll try 2minutes daily for a few months (suction only, needle as per instructions)

FINLEY I agree.....Sarah is truly a genuine & giving soul. It's like that saying "do what you love & the rest will follow"

She cares and she's not "fluff" I like her edge....I bet she doesn't suffer fools......hmmm maybe this

Is my last post jk

All the best,

Cheers soon

[soon]

Sorry if this is a bit far from topic but.....

I was looking at healingtodays link and was wondering if suction cups,

have any benefits to normal skin.

Cheers soon

[SarahVaughter]

I think that Finley combines it with another method I was writing about: Saline injections.

https://http://forums.owndoc.com/dermarolling-microneedling/Saline-injections-for-acne-scars

   
Finley, I am surprised you had problems with getting the sterile saline solution (also called a physiological solution) because I believe they sell it OTC in any pharmacy to clean wounds. I have it in the first aid kit in my car. It is better to buy many very small bottles and always open a new one with each new session.

Medline Sterile Saline Solution, .9%, 5ML, Box: 100

https://http://www.amazon.com/Medline-Sterile-Saline-Solution-9/dp/B000K6WHEG/ref=pd_sim_hpc_2


> I'm clueless as to how often I do it and how long I'm meant to keep suction going.

"The protocol for suctioning was: start of suction on third day after subcision for flat and depressing subcised scars and its continuation at least every other day for 2weeks."

"On the first days, we used less negative pressure; but in the subsequent sessions, depending on the condition of scars, we could increase negative pressure (even to maximum: −70 mmHg), length of time (not more than 4 s in each pass) and the number of suctioning passes (even 8–12 passes) per session."



-70mm Hg is 0.1 bar underpressure, not very much. Our pumps create a much stronger underpressure and this is required because our customers will not sever the fibrotic strands by doing a subsicion and hence need a much stronger underpressure.

Preventing the fibrotic fibers from re-attaching doesn’t need such a high underpressure. As they explained, they also wanted to cause a hematoma to enhance the effect.

On the other hand, bruising is associated with diminished scars (one of our customers testified to that here: Improvement in acne scars with suction method).

The suctioning method is so new and this (cheap!) method is so rarely used by doctors that the absolutely optimal approach is not known yet and you have to basically improvise and try different methods.

 


> Can dermarolling also cause the fibers to release scarred tissue, or is needling from different angles the only option?

You have to really aggressively needle or stamp the scar to release the fibrotic tissue.


> While needling, would it be beneficial to pinch the skin for easier penetration with the needle? Like they do with the subcision.

Probably yes but you may end up with a hematoma.

[soon]

Would this method be beneficial for surgical scars?

I'll need a tummy tuck & breast lift from weight loss so

I'm trying to learn all I can to do post op to reduce scars.

[Dollys]

Sarah,

Can you start selling the Nokor Needles with scalpel top as we who live outside US can not buy them anywhere on the Internet, please sell them in smaller packs the boxes of 100 and we will be many customers ordering from you

https://http://www.allegromedical.com//syringes-c570/needle-admix-18g-1-1-2-in-thin-n-p548849.html?engine=shopping&utm_source=shopping&utm_medium=feed&CS_003=9164468&CS_010=ff80808111238d9d011124b67e644b9d&gdftrk=gdfV21244_a_7c477_a_7c2723_a_7c548849

[SarahVaughter]

I will think about it but you do not need Nokor needles to perform subcision. "Ordinary" needles such as diabetic needles will do for ordinary scars. It is not easy to perform or self-perform horizontal needle subcision - you can end up with skin nodules or possibly even small scars.

  You should certainly first try many dense and deep vertical needlings with our very thin single needles, combined with some kind of suction method and saline injections (I wrote a forum posting about saline injections). Only if this method fails should you consider horizontal subcision.

[FINLEY]

As someone who has just completed her 10th subcision session, I agree totally with Sarah.  You will see results with vertical needling and saline injections, with suction, or not.   Additionally you could, as I have done, add derma stamping to the sessions.   After I derma roll my entire face, I single needle each scar, and then press into the scars with the derma stamp approximately 6-8 times.  Following that, I do the saline injections.  I believe, anecdotally, that my results are very good.  (Sometimes when I look in the mirror I am surprised to see my face looking so much smoother!!!!!!!)  The last thing you want to do is to do more harm......

[soon]

Yay FINELY,

I'm excited to read this method has worked so well for you.

Because of your results & detailed explaination, I'm going to try it.

Hope you don't mind some questions.....

1. Do you use any suction device? If so what?

I've ordered small suction cups as pore cleaning device isn't strong enough.

2. Do you use a new "fresh" needle every single time you penetrate skin? Or one needle

per scar?

3. As a nurse what do you think is the best treatment for surgical scars? Short & long term.

Thanks

Soon

[FINLEY]

Last question, first: I have no experience with surgical scars, sorry.  I do think I would use a derma roller on them initially to see if the resurfacing effect of derma rolling alone would provide improvement.  I think going slowly would be my advice.  Sarah might have some further advice......

I do, however, have lots of experience with acne scars: I do use a fresh single needle for each session, but not for each scar.  As one works with the needles one notices when the needles seem to dull.  I do sometimes use 2 needles per session, but the second needle might not be used extensively, thus having some "life" left in it.  I do reuse those needles, running the needle under water and gently placing needle on a plate, submerged in alcohol for at least 20 minutes- I then place the needle gently back into original packaging, seal package, and use it for part of another session, if it seems not to have dulled.  (A dull needle will not be helpful to release scar tissue fibers.)

I also have not used a suction device so can give no advice regarding use.

I have been using a 20% solution of Salicylic acid (available on Amazon) on enlarged pores I have on my nose- it does appear to be slowly shrinking the pores, and it has greatly slowed down oil production; I especially appreciate having no more shiny nose at mid-morning.   (I do keep a bowl of ice water on the counter to use to dilute the acid when each 5 minute session is ended; then I rinse with cool water.)

I no longer derma roll my nose- the skin on my nose seemed to tolerate derma rolling poorly, unlike the rest of my face, neck and upper chest, all which respond very well to derma rolling.

As a nurse, my best advice is to follow Sarah's directions very closely- prepare all of your equipment on an area that you have cleaned thoroughly with alcohol.  Fill your syringes very carefully being careful not to touch the roller, needles, etc. to any other surface before you use on your face.  (As with any endeavor, good preparation is the key, and this is an endeavor.  I feel that it takes a lot of courage every time I perform the procedure.)

Good luck- the results are worth the effort!