I never had medical insurance so always had to find my own remedies. but the past several years been seeking more professional treatments like a series of microdermatbration with tactic peels to TCA home peels/microneedle roller with copper peptides among other stuff including collegen creams + all kinds of supplements healthy eating...but nothing seems to fill in the holes like all these treatments claim :( i been more then very patient i used all these things for months/years at a time each.
How Can I Get Rid of Pockmarks Icepick Holes on my Face? I've Tried Everything That I Could Afford!
Doctor Answers 7
Juvéderm® micro injections, TCA CROSS, and fractional ablative laser are all useful
Sounds like you have wasted a lot of money on ineffective treatments.
Basically, the scarring you describe extends quite deeply into the skin, so there is no cream, simple low strength peel, or superficial treatment like microdermabrasion which will be the least bit useful.
Starting with the simplest treatment, Juvéderm Ultra XC® microinjections [~0.05 ml per injection] using a BD-II 0.3 ml syringe with 31 ga needle can often be helpful. This syringe and very fine needle allow very precise extrusion of the Juvéderm® into the upper and mid dermis, filling the scar and to some extent stimulating the production of new collagen. I find it most satisfactory to partially correct each scar, then wait a month or longer and go over my patient's face again, injecting a bit more Juvéderm® wherever it is needed. Several cycles of treatment may be needed to reach optimal correction. This approach also works well for some other scars, for example chickenpox scars and some scars resulting from injury or mole removal. It is best to do this under oblique lighting so the scars are properly visualized, and pre-treatment photos are vital to assess respoonse to therapy.
I prefer Juvéderm® to Resylane® because Juvéderm® is a homogenous gel which flows very smoothly through the 31 ga needle, and stays where it is put after injection; in contrast with Retsylane® which is a slurry of particles and is somewhat less smooth to inject. I prefer Juvéderm® to other homogenous gels because I have the greatest confidence in Allergan's technical competence, manufacturing standards, and integrity compared with other filler companies.
Next, we have TCA CROSS technique, where tiny amounts of trichloracetic acid 90% [TCA] are careully applied to the scar to stimulate collagen remodelling and collagen production. Half a dozen cycles of treatment must be done, and this must be performed by a physician who can identify appropriate scars, handle TCA 90% safely, and manage complications if they arise.
Finally, fractional ablative laser [I like and use the Cutera Pearl Fractional laser], when properly used at appropriate [DEEP] parameters can produce dramatic and long-lasting improvement, often after a single treatment. You have to plan ahead for Pearl Fractional [or other] fractional ablative laser treatment, because your face will be VERY red [like a sunburn] for about 5 days after the treatment, then usually quite pink for 2-3 weeks after that.
Non-ablative lasers and Intense Pulsed Light [IPL] are completely useless for deep scars of the kind that you describe, so don't waste your time and money on that.
Ice pick scars can be improved but they are difficult and require multiple treatments
I would start with TCA deep chemical peels. I would then do a multilayered approach with co2 resurfacing and working form the deeper layers.
Acne Scarring:TCA, Fillers,LASER, Excision
Acne scars are some of the most difficult scars that we treat in facial plastics. Home remedies just aren't enough. Sorry, you need a real doctor...
I typically use a combination approach of laser treatments, strong chemical peels in the scar itself and/or direct excision if necessary for deep scars. Flatter, broader scars are sometimes amenable to fillers. Skin type, downtime, type of scars and finances all play a role in determining what treatments are right for you. Good luck, Hannah Vargas, Kansas City
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Punch excision is the answer!
TCA CROSS can help ice pick scars
TCA CROSS involves the use of 90% TCA placed carefully into the icepick scars that will bore a hole through the icepick scar and then allow for healing, remodeling the architecture of the ocepick scar. This will not remove the scar, but may help remodel it that I believe is then amenable to other procedures like fractionated laser resurfacing, that it would otherwise not respond to.
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