How long after TCA cross should I wait for a fractional laser treatment, and vice versa ?

Question

I have done two TCA Crosses. I would like to do more cross treatments. However, I want to get my fractional laser treatments going. Is it a good idea to do one and then the other or should i finish my TCA cross before starting fractional treatments?

Jason Emer, MD · Answer

In our practice, we often perform these treatments on the same day. Acne scars need a combination approach for improvement.  For the best results, one should target the acne scar type.  As everyone has a unique pattern of acne scarring, the best solution is a tailored one.  Typically you need fillers like bellafill and sculptra for atrophic indented type scars with or without subcision.  Subcision for depressed tethered scars.  Vascular lasers like yellow laser, aerolase, excel V or IPL for redness or thick scars. And lasers such as fraxel, erbium, co2 or fractional radiofrequency like venus viva, skinfinity, intensif microneedling RF for textural issues and superficial scarring.  Deep ice pick scars and narrow box car scars are best treated with TCA CROSS and punch excision.  All lasers are combined with microneedling and PRP to get even better results and improve healing times.   The majority of patients will have a collection of different scar types, and hence a tailored treatment plan is needed by an expert physician.  It is never about the laser or product that gives the results, its about the expert behind the equipment that gets you the outcome.  Scars cannot be cured and will need life-long treatments to maintain and build on the results.  Best, Dr. Emer.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Shaun Patel, MD · Answer

Acne scars are best treated using different modalities such as lasers, peels, etc. I would finish the TCA cross treatment sessions as planned and then proceed with skin resurfacing as needed.

Steven F. Weiner, MD · Answer

I do these procedures on the same day. I wouldn't wait a set period of time to do the laser. Remember, acne scars are best treated with multiple modalities.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Most often specialist perform all the procedures in the one day. Reason is because we tailor a treatment method for each scar type. In most patents acne scarring will have a unique fingerprint - hence why scar treatments are NEVER the same for each patient. TCA CROSS is frequently used with fractional lasers. If you watch closely you can see the frosting after TCA application. This means its all over red rover. ie. Protein coagulation is the end point. Fractional laser is then used to treat the walls of box car scars. In 95% of cases, subcision is also used to break scars that lie UNDER your skin. Video shows the TCA application, other videos depict combination treatments. All the best, Dr Davin S. Lim. Brisbane. Australia .

How long after TCA cross should I wait for a fractional laser treatment, and vice versa ?

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