What kind of scar treatment do I need? (Photo)

According to my research, I do have ice pick scars. It seems like the most effecting treatment will be the TCA Cross method, but I can't find a doctor that provides such service. Please help.

Doctor Answers 5

TCA CROSS Technique Can Work Well For Ice Pick (Pit) Scars

I have been performing the TCA CROSS Technique for many years, since shortly after its presentation in the medical literature.  It typically requires between two four treatment sessions on the same sites to achieve optimal improvement, with a minimal 4 week (I prefer 6 week) interval between treatments to allow for the maximum amount of new, native collagen synthesis (neocollagenesis) to occur.

One word of caution, occasionally, certain pits may actually widen after treatment (which can be distressing to patients). However, most often with time--usually a few weeks, these depressions fill in and flatten and result in a gratifying result. 

I have been extremely underwhelmed by the results of fraxel lasers (as well as radiofrequency and ultrasound devices) for the treatment of these scars, finding them supported far more by device manufacturer backed marketing hype than hard science.

And while I have been using medical microneedling for over fifteen years for improving a variety of skin tone and texture problems and for more superficial depressed scars, I have not found it particularly useful for pit scars.

You are talking about your face, and since you have to live with the results of any treatment, if you cannot find someone to treat you in your neck of the woods, it would seem reasonable to invest in traveling to whichever city is closest to you that has an experienced, board certified aesthetic physician capable of performing TCA CROSS. Good luck.


New York Dermatologic Surgeon
4.8 out of 5 stars 23 reviews

Acne Scar Treatment

I would consider a combination of micro needling, PRP, eMatrix, or Fraxel for these type of scars.  Please consult an expert since these scars can be difficult to treat.  Best, Dr. Green

Ice pick acne scars

Thanks for your question. Ice pick scars may be easily treated with TCA CROSS. I perform this treatment in a short office visit. It is actually quite simple.

As as other doctors have said, micro needling with radio frequency (Intensif by EndyMed) can also be used either together or instead. 

We make sure that you get a great response by scheduling regular follow up visits with you. Be well. 

Estee Williams, MD
New York Dermatologist
5.0 out of 5 stars 10 reviews

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Ice pick scar treatments using Hidef Acne Scar Treatments

We utilize a Hidef Acne Scar Protocol that can help improve scars of variable depth to width ratios. For your scars, I would use a combination of e matrix RF and TCA Cross. 

Best, 
DR. Karamanoukian
Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Circled scars

In my opinion, the scars that you have within the circles are deep acne pits.  We do perform TCA cross for these scars. Furthermore,one can use RF microneedling (infini) or microneedling with PRP. Ablative co2 laser is also effective. You should visit an acne scar expert. Hope this helps. Good luck.

Jeffrey Rapaport, MD
Englewood Dermatologic Surgeon
4.6 out of 5 stars 38 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.