I am a black male with ice pick scars on both cheeks. Am I a good candidate for subcision? (photo)

Doctor Answers 4

TCA CROSS Most Appropriate For Ice Pick (Pit) Scars

Subcision lifting is best reserved for treating broader-based indented (atrophic) scars, such as rolling scars and some boxcar scars. Ice pick scars are just too deep and narrow to respond well. On the other hand the TCA CROSS  Technique utilizing TCA concentrations of 90%-100% placed down the narrow shafts of the pit scars is a simple, quick and relatively inexpensive method for treating these kinds of scars. It is also useful for shrinking dilated facial pores. Medical microneedling (aka fractional microneedle resurfacting or simply dermal needling) may subsequently be used to  to better blend the surface tone and texture of the treated pits with the surrounding normal skin. Make sure you consult with a board certified aesthetic physician. 


New York Dermatologic Surgeon
4.8 out of 5 stars 23 reviews

No- micronedling and or TCA ideal.

Acne scar revision is a specialised field. For the best results, one should target the acne scar type with ideal treatments. For example deep ice pick scars, and narrow box car scars can be treated with TCA CROSS peels, mixed scars, rolling, and atrophic scars treated with fractional devices such as Fraxel, fractional lasers, PRP and INFINI radiofrequency. Atrophic scars (depressions) can be treated with either fat grafts, or with HA dermal fillers. Tethered and anchored scars are best treated with surgery. In your case TCA CROSS will be good, however you WILL have skin colour changes for 3 -4 months following this, another good method to treat your scar is microneedling RF, with PRP, this will give you a modest result after 3-4 sessions, especially if combined with PRP. More in the video below. 

The majority of patients will have a collection of different scar types, and hence a tailored treatment METHOD will be best. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars.

All the best,

Dr Davin Lim.

Laser, surgical & aesthetic dermatologist.

Brisbane, Australia.

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 60 reviews

Ice Pick Scars/Acne Scars-TCA Cross, excision, microneedling/prp, lasers

A combination approach would be best for these types of scars. I recommend lasers, microneedling/prp, TCA cross, punch excision and fillers. I recommend getting a formal evaluation with an acne scarring expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

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Acne scarring & Microneedling

Thank you for your question. Have you considered microneedling? This treatment can help to resurface scars in 3-5 sessions, has a quick recovery period and the results are great. Microneedling has minimal risk of causing any discoloration, and is a very safe treatment when performed by experienced practitioners, and will work better than subcision. Best of luck, Dr P.

Kaleroy Papantoniou, MD, FAAD
Great Neck Dermatologic Surgeon
5.0 out of 5 stars 24 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.