Will my acne scars respond to subcision or TCA Cross before I continue with microneedling? (photos)

Acne scars are usually characterized within the subtypes of atrophic, hypertrophic, pigmented, or inflammatory. These subtypes of acne scars can be visually discerning in ambient light and can cause significant cosmetic concerns. Indented and atrophic scars require a combination approach to stimulate collagen and elastin, thereby smoothing contour and uneven skin. These are usually combined with lasers and depigmentation protocols to reduce inflammatory hyperpigmentation (Melarase AM and Melarase PM). Our Hidef protocols for acne scars include fillers such as Sculptra, Juvederm, Radiesse, and Restylane to improve deep acne scars; Vascular lasers to reduce inflammation and post-inflammatory redness and erythema; Fractional lasers to smooth contour and collagen; and Fractional RF to stimulate production of collagen within atrophic scars. Textural improvement and superficial scarring can be improved with Cosmelan peels, TCA Cross for ice-pick scars, deep chemical peels, and fractional CO2. We offer a personalized approach to your combination of scars and a formal evaluation with consultation is recommended to help you achieve your final results. Our plastic surgery office offers subcision and combination TCA Cross to help reduce deeply pitted scars. In terms of pigmentation and skin resonance, we recommend daily use of Melarase AM and Melarase PM coupled with Retinoid creams to achieve brilliant skin.

Best,
Dr. Raffy Karamanoukian
Realself100 Surgeon

The best treatment for acne scars depends upon an
individual’s skin type, age, ethnicity, sun exposure, overall health and most
importantly, the type of acne scars present (ice pick scars, boxcar scars,
rolling scars, hypertrophic scars and variable degrees of hyperpigmentation).
In order to give you an accurate treatment plan, a consultation is required to
properly assess your skin.

An important step for all skin types is sun protection
including the use of daily sunscreen, sun hats and sunglasses, all of which
help prevent aging and sunburns. 

When it comes to acne scar treatments, a combination of
treatments are available including cosmeceuticals (medical grade skin care
products specific for acne including ZO® Skin Health or ZO® Medical,
Skinceuticals® or Glo-Minerals®), advanced laser resurfacing procedures (CO2
laser, Er:YAG laser, Fraxel DUAL®, PicoSure® FOCUS Lens Array), chemical peels
(light, medium, deep including the blue peel), dermabrasion,
augmentation/fillers, excision and/or subcision, punch techniques,
microneedling/rolling, injections (corticosteroids, 5-FU), cryosurgery,
electrodesiccation and microdermabrasion. 

These are advanced techniques so be sure to get an
experienced dermatologist or plastic surgeon consultation for recommendations
and treatment options.

I can't say for sure without an in person evaluation but I would likely consider TCA CROSS and Microneedling.  Both of these treatments do better when they are repeated more than once.  I have been performing TCA CROSS for over a decade with good results.  Make sure to see an acne scar expert.Regards,Dr. Ort