Could I do TCA Cross for the icepick scars? (Photos)

Question

I have permanently opened pores and bunches up lines on cheeks since childhood. Possibly Atrophoderma Vermiculatum? I've always had huge pores, I have (Ehlers Danlos) so maybe thats why. My right cheek has huge open pores and weird bunched up horizontal lines that look like tiny wrinkles. My left cheek has the same but I did get acne there in my 20's that turned into ice pick scars. I was wondering if this looks like Atrophoderma vermiculatum? Anything that may help make the pores look not so prominent, maybe Accutane? I tried topical tretinoin and it didn't help. Could I do TCA Cross for the icepick scars?

Nelson Lee Novick, MD · Answer

From the photos provided, which shows quite a number of dilated (enlarged, patulous) pores, it would seem that TCA CROSS would be an excellent option. I have personally been using this simple and relatively inexpensive no "bells and whistles" approach for twenty years, since it was introduced in the States from South Korea where it had been successfully been employed for treating ice pick scars. Since the concentration of TCA used for this procedure ranges from no less than 80%, but more commonly 100% (which was the original concentration used by the South Koreans), this is not a procedure to be performed at home with product bought over the internet. Improperly performed TCA CROSS can result in severe chemical burns and permanent scarring. Make sure that you consult with a board certified aesthetic physician with expertise and experience with this technique. A thorough cleaning out of all stopped up pores would be advisable before treatment (this alone shrinks many pores) and perhaps a series of superficial peels for blending may be needed following TCA CROSS. Best of luck.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Bushra Ali, MD - Account Suspended · Answer

Hello, 
I don't think the TCA cross would help, I know IPL laser treatment can help reduce the sizes of the pores.
I hope this was helpful.

Could I do TCA Cross for the icepick scars? (Photos)

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Could I do TCA Cross for the icepick scars? (Photos)

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