Introduction
There are various treatment modalities, with common ones being group therapy, individual therapy, family therapy, and couple therapy. Modalities that utilize evidence-based therapy result in positive outcomes. During these treatments, clients meet therapists in an innocuous, private, and supportive environment. The goal of therapy is for clients to explore their feelings, beliefs, and behaviors to enable them to address their challenging experiences and memories and gain better self-awareness. This paper evaluates the success of treatment modalities in treating subcision and acne.
Selected Modalities
The selected treatment modalities are subcision and fat cavitation. Subcision is a minor surgical procedure utilized to treat depressed acne scars (Bhargava et al., 2019). These scars occur when fibrotic strands pull the skin downwards, resulting in superficial indentations. Fibrotic strands are broken using a sharp end of a needle detaching it from the scar of the causal tissue. As a result, fibrotic strands and collagen deposition are released during the wound healing process leading to cosmetic improvement of the scar.
Fat cavitation shapes one’s figure and improves the sculpt by tumbling pockets of fat without the need for invasive surgery. Cavitation is a proven medical principle that uses ultrasound energy to the targeted area of fat cells, transforming the fat to a liquid state (Taha et al., 2021). Cavitation focuses on a specific fatty area without affecting the surrounding tissues. The common areas where cavitation works best are the buttocks, abdomen, and thighs.
Skin Conditions
Subcision is effective in treating acne scarring, precisely depressed acne scars. Depressed acne scar occurs when the body produces an unsatisfactory amount of collagen. A dermatologist inserts a hypodermic needle beneath the scar to break and loosen the fibers used to connect the scar with the underlying tissue. As a result, the depressed scar is lifted and released the collagen at the site of the needle aids in diminishing the appearance of the scar (Healthline Media, 2022). The procedure is repeated 3-6 times within four weeks after every treatment. On the other hand, cavitation is a non-surgical and non-invasive treatment that does not need anesthesia. It is comfortable and painless as it is used in getting rid of excess body fat. The conversion of fatty cells to a liquid state aids the lymphatic system in processing and dispersing fatty acids through the body’s filtration system.
Analysis of the Evidence
Bhargava’s et al. (2019) article has a key contribution to assessing treatment modalities of subcision in treating acne scars. The resource presents interesting evidence by presenting extensive background information regarding acne scars. According to the authors, acne vulgaris is prevalent in adolescents. Besides, acne scars are a common form of the sequel of the inflammatory process that affects approximately 95 percent of patients suffering from acne vulgaris. The evidence presented in this article is that subcision and microneedling effectively treat acne scars, among other types of scarring. The authors demonstrate that microneedling is efficient in enhancing acne scars as it aids in achieving at least grade 1 improvement.
The article also presents important information that is key to the current study. According to Bhargava et al. (2019), subcision is a treatment approach used in releasing fibrous tissue causing scar elevation. The study found that subcision effectively improves deeper and wider rolling scars compared to the shallow and small ones. Consequently, the journal is very informative and supportive of my current area of study since it addresses and discusses in detail the treatment modalities of subcision and acne scars. The study also enriches the current research by adding other subcision is effective if integrated with skin-suctioning therapy in treating atrophic acne scars. Bhargava et al. (2019) further found that using subcision synergistically with other modalities such as fractioned microneedling radiofrequency, fractional Carbon Dioxide laser, and platelet-rich plasma increases the efficiency of the treatment. Finally, the article’s strength is that it has a robust method that aids the researchers collect the study data. The use of real pictures in demonstrating the efficiency of subcision and microneedling in treating acne scars. However, the article’s weakness is that it does not have a review of the past literature on the study topic.
Credibility of this Evidence
Bhargava et al.’s (2019) research present credible information. The article was recently published in 2019 by certified dermatologists in R.D. Gardi Medical College in Ujjain. Other researchers agree with the findings and claims presented in this article. For instance, Rai and Tandon (2021) agree with Bhargava et al. (2019) that acne scars are common in approximately 90 percent of adolescents. Dadkhahfar et al. (2020) further claim that subcision is a surgical intervention utilized in treating skin conditions such as cellulite, depressed scars, acne scars, and wrinkles. Besides, Rai and Tandon (2021) stress that using a needle in the subcision aids in breaking the collagen bundles within the superficial layer of the dermis, which causes scars. Rai and Tandon (2021) and Dadkhahfar et al. (2020) agree that microneedling targets superficial boxcar scars while subcision utilizes a needle inserted beneath the scar to manipulate and release fibrous tissue that pulls the scar downwards.
Both Dadkhahfar et al. (2020) and Rai and Tandon (2021) agree with Bhargava et al. (2019) that subcision has several adverse effects. According to these authors, the post-treatment effect of subcision is swelling, erythema, post-inflammatory hyperpigmentation, bruising, keloid formation, and paresthesia. Dadkhahfar et al. (2020) emphasize that depression recurrence is a key negative effect of subcision procedure that subjects patients to subsequent sessions. However, Bhargava et al. (2019) recommend that one should apply sunscreen over the entire face three times a day to counter some of these adverse effects. Rai and Tandon (2021) also used real patients’ pictures to demonstrate the skin improvements of the patients who underwent subcision. However, Dadkhahfar et al. (2020) demonstrated the subcision procedure using animated pictures of skin. Dadkhahfar et al. (2020) used a systematic review in their study and found similar results to those of Rai and Tandon (2021) and Bhargava et al. (2019).
In multiple instances, the reviewed resources have agreed with and supported the findings of Bhargava et al. (2019) article. Although they deviate from their studies’ method, the three studies have similar conclusions that subcision and microneedling are effective in treating acne scars. The article is paramount as it suggests other treatment modalities that can be integrated with subcision to increase its efficacy.
Conclusion
Treatment modalities are various ways that one uses to seek therapy. Fat cavitation is used to remove excess body fat, while subcision treats scars, wrinkles, and cellulite. Subcision uses a hypodermic needle to break fibrotic strands and prompt collagen deposition, aiding the skin to rise. Bhargava et al.’s (2019) article has confirmed that microneedling and subcision effectively treat acne scars. Other studies have supported most of Bhargava et al.’s (2019) findings that subcision effectively treats deeper and wider rolling scars.
References
Bhargava, S., Kumar, U., & Varma, K. (2019). Subcision and microneedling as an inexpensive and safe combination to treat atrophic acne scars in dark skin: a prospective study of 45 patients at a tertiary care center. The Journal of Clinical and Aesthetic Dermatology, 12(8), 18-22.
Dadkhahfar, S., Robati, R. M., Gheisari, M., & Moravvej, H. (2020). Subcision: indications, adverse reactions, and pearls. Journal of Cosmetic Dermatology, 19(5), 1029-1038.
Healthline Media. (2022). Is subcision an effective treatment for acne scars?Healthline.
Rai, T., & Tandon, M. (2021). Effect of Subcision and Microneedling in the Treatment of Atrophic Acne Scars in Ten Patients: A Case Series. Nepal Journal of Dermatology, Venereology & Leprology, 19(1), 74-80.
Taha, M. M., Aneis, Y. M., Mohamady, H. M., SA, A., & Elsayed, S. H. (2021). Effect of focused ultrasound cavitation augmented with aerobic exercise on abdominal and intrahepatic fat in patients with non-alcoholic fatty liver disease: A randomized controlled trial. PloS One, 16(4), e0250337.