Microneedling vs. TCA cross for ice pick scars, which is more effective?

Microneedling and TCA cross are complimentary and both may be necessary.
TCA cross is used for certain deeper icepick scars, and microneedling is more for general improvement.Dr. Keith Denkler
#RealSelf100 Member

Sometimes one and sometimes the other. This may seem unsatisfying but the shape and architecture of the scars over convex or concave services may determine whether the clinician uses one or the other or both. In general, microneedling as a greater propensity to form collagen then TCA has. TCA tends to be more superficial but that can also be modified. So the technique is not the answer but the clinician. One way to help sort it out would be to see a clinician who has both experience and feels comfortable using both techniques. 

Microneedling is more effective for shallow to medium depth acne scars after a series of treatments. TCA peels are more effective for ice pick scars using the toothpick method. You can take an actual toothpick dipped in TCA and you put the toothpick in the deep acne scar and you wait for the TCA to turn into a white froth. If the TCA toothpick method does not improve it enough after some time, then you might have to excise that deep acne scar. Chase Lay, MD

Good morning and thank you for your question! A combination of TCA cross and microneedling is very effective in treating ice pick scars. I would start with TCA cross first and go from there. TCA cross, microneedling with PRP/Growth Factors, and lasers have all been proven effective for the treatment of ice pick scarring. Best of luck! For more information please feel free to visit our website!

Most patients will have a collection of different scars, however if you only have pure ice pick scars, than TCA CROSS or surgical punch excision is the preferred option. In some patients I combine micro needling with TCA CROSS, but the micro needling is directed at tethered, anchored, atrophic and rolling scars, and not ice pick scars. More on scar revision procedures in the web reference below. All the best, Dr Davin S. Lim.