Would a TCA peel help smooth texture from shallower pitted acne scars that are improving from microneedling?

Question

My acne scars have improved from microneedling (still continuing this tx). With inside lighting, I can only see my deeper scars but in direct sunlight, I see very uneven texture on my cheeks from smaller/shallower scars. I have been interested in subcision (for tethered) but wondering if an overall TCA peel would help improve the entire face texture/possible to do on entire face. I don't want laser tx as I've had multiple types (ex:CO2) & it caused scars. I have olive skintone/half korean.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

This is difficult to answer without pictures. Yes, TCA cross can help improve pitted scars, but a combination approach would give the most improvement with lasers, microneedling/prp, TCA cross, punch excision, Cosmelan and fillers. It will take a series of treatments and may need life-long treatments to maintain. I recommend getting a formal evaluation with an acne scarring expert. Best, Dr. Emer

Davin Lim, MBBS, FACD - Account Suspended · Answer

Yes, depending on the depth of the scars, we can either do focal TCA CROSS treatments or if the depth are shallow box car- v vvv shallow ice pick, then an old fashioned Jessners-TCA at 35% can help. Having said that if you have olive skin, the chances of PIH will be higher, so see someone who work on skin of colour. Pre-prep of your skin maybe needed. Dr Davin S. Lim. Brisbane. Australia.

Would a TCA peel help smooth texture from shallower pitted acne scars that are improving from microneedling?

Answers (3)

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