I have acne scars to my chin and lots of wrinkles above my lip. Would co2 laser or a TCA peel be better for tackling my problems

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Fraxel and/or CO2 are best for resurfacing, but Erbium is a good alternative. I always combine lasers with microneedling/PRP for more robust outcomes. For skin tightening, I recommend a combination of Ultherapy with RF treatments and Sculptra for skin tightening. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

While CO2 laser and TCA are both forms of facial resurfacing which could be helpful for above the top lip wrinkles, in my opinion neither of these treatments are as good as a croton oil or Hetter Peel performed by a doctor experienced in this technique.  Croton oil peeling is the single best means of performing facial resurfacing bar none.  To get these lines it is important to peel deeply. This technique is also wonderful for treatment of acne scars.   I believe that the Hetter Peel  is the safest way to achieve your goals.  Do some research and see if you agree.  Good luck!

A combination of chemical peels and injections of hyaluronic fillers will improve these lip lines as well.  The peels and topical retinoids will improve your skin texture and tone and lines.  The fillers will help fill in the deeper lines aloe the lips.  Chemical Peels or Fraxel will help repair the skin and brighten your whole face. Please consult an expert in cosmetic injections and procedures for the best results. Best, Dr. Green

In the context of peels, sure a TCA with Jessners can help. Spot TCA can be used for deep scars like pick - Ice Pick scars. Given the static photo, CO2 either fully ablative or sessions of CO2 Fractional can help.  
Acne scar revision is a sub-specialised field. For the best results, one should target the acne scar type with ideal treatments and NOT just devices. 

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, and radiofrequency. Atrophic scars (depressions) can be treated with either fat grafts, or dermal fillers. Tethered and anchored scars are best treated with surgical techniques such as subcision. Other surgical techniques that we use include punch elevation, surgical elevation, punch excision and traditional excision of focal scars. Devices should be viewed as tools to get the job done, and NOT as standalone modalities. 

 

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. In the majority of patients its finding the correct combination that give you best results, and everyone is unique! All the best, 

 

Dr Davin Lim. Procedural and aesthetic dermatologist. Brisbane, Australia.