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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.
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
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.
Ice pick scars are usually treated with TCA cross peels, but usually people mostly have mixed types of scars on their skin and therefore combination of treatments is used. I would suggest you to make an appointment with an expert who will guide you through your acne scar removal process. Good luck!
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.
