I'm thinking of a TCA peel or Fraxel Restore for my acne scars and redness. I am a frequent international traveler. If I do TCA, I will have to fly out a few days later and won't be able to see the doctor except for a brief check-up two days later. If I do laser, I will have a couple of months between treatments, instead of a couple of weeks. Is it safe to do TCA and then leave the country? If I do laser, is it effective to wait a few months in between?
Laser or TCA Peel for a Frequent International Traveler?
Doctor Answers (5)
Treatment of acne scars
You have been presented with two good options. However, given your particular situation and the type of acne scars you have demonstrated, I would suggest the Fraxel Laser treatment. The Fraxel laser has a relatively short recovery period and can be performed multiple times at intervals that would fit your schedule. The Fraxel laser has shown some very good results in the more shallow acne scarring that your picture demonstrates.
Fraxel and acne scars and quick healing time
I would absolutely recommend the Fraxel laser with the 1550 wavelength for your acne scars. It is uniquely designed to meet your needs and the quick recovery time would be perfect for you. I have many patients who fly in for the procedure and then come back the following month or two for the next session. You will need several treatments but you should have great results! Let me know how it works out.
Acne scars best treated with laser resurfacing
The best and most effective treatment for acne scars is Laser resurfacing. It requires about two weeks for recovery. TCA does not affect acne scars.
Fraxel laser is WORTHLESS, You can have as many treatments as you want but it will not improve the acne scars. Carbon Dioxide laser resurfacing is gold standard.
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Fraxel is probably the way to go for you since it takes a few days of healing
Fraxel is usually a 2 day healing process and can be done on a Friday and is usually normal looking by Monday. This process can be done multiple times at longer interval than 2 weeks. I think this would work the best for you.
The treatment for depressed acne scars
With acne or chicken pox scarring the problem is a difference in topography whereby
the scar surface is at a deeper level than the surrounding skin. This is due to the active disease process destroying the deeper layers of the skin. Without this structural support the skin caves in in the area creating a depression or pit. The scars are noticeable because of the shadows that fall over them in a fashion analogous to the shadow on a street with tall buildings on either side. To rectify this you need to raise the street &/or lower the buildings. Chemical peels cannot be controlled enough to just lower the buildings while lasers can be focused on the edges of normal tissue surrounding an acne pitted scar.
The best current techniques to do this are to make small incisions around the edges of the small scars without excising any skin. This does not add new scars to the skin surface because the incisions are made within the confines of the acne or chicken pox scar pit. Not every scar is a candidate for this. The scar has to be small enough & the depth of the pit must have enough remaining layers of skin
to contract with healing. As these incisions heal the scar is squeezed by the surrounding healing procees. This causes this skin to pucker-raising the street. About 6 weeks later CO2 or Erbium laser may be used to even out the skin
surface under magnification but is not always necessary. This technique does not work for the really small ice pick scars.
Some physicians place a dermal filler to raise the scars but there currently are no very good fillers available for this although I have had some good results with this technique. Using laser alone only results in a 30 to 60% improvement. Despite this it may take more than one laser resurfacing to achieve the desired improvement.
Additionally, the acne would need to be quiescent to carry out this therapy. The treatment can also reactivate acne so close post treatment follow up is called for. I refer patients with active acne to dermatologists as they are better equipped
than I to handle active acne. In some cases the depressed areas can be quite large in which case the only advisable treatment is scar excision.
The ultimate goal seldom achieved is to hide a scar so that it is not visible to the unaided eye & the area in question looks as though nothing untoward has occurred.
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