Journal de recherche clinique et expérimentale en dermatologie
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Taylor liberator full field subcision of acne scarring under tumescent anaesthesia

Asif Hussein, Cormac Convery

Acne scar morphology is dependent on the severity, depth and extent of the inflammatory and healing process that follows the development of an inflammatory acne lesion. Small superficial lesions will trans- epidermally discharge, and complete healing will often follow. If dermal inflammation is severe, follicular necrosis and sloughing will produce a focal intradermal atrophic scar. The dermal inflammatory process leads to the destruction of the follicle and also damage to the perifollicular dermal collagen architecture. Re epithelialisation of these necrotic, sloughed follicles will lead to dilated epithelialised tract formation. These vertical, tunnel-like, post-follicular necrosis remnants form the ice-pick atrophic scar subtype that we are all familiar with occurs. The enzymatic activity and inflammatory mediators will destroy deeper structures, leading to atrophic boxcar and rolling scar formation. As these scars mature, there is wound contraction that leads to further indentation.