What is the best method to treat remaining boxcar and pitted scars? (Photos)

In addition to past professional treatments past (Fractora Firm/ PRP), I have been dermastamping for the past 18 months with gradual improvement. However the scars on my worst side (left) look harsh as though no collagen was produced at all! I did some research to see if 1) TCA cross 2) subscision or 3) permanent fillers will be a viable option for me at the moment. I dermastamp and suction every 6 weeks with a 2mm stamp and pump. Acne is under control with mild oiliness. Thank you in advance!

Doctor Answers 7

Remaining box car and ice pick scars and how to treat them

You have ice pick and box car scars but you also have some atrophic volume loss as well. You need to treat your scars with different approaches. You can treat all of your scars with one treatment using a 5-7 step process. Find someone near you that has this same approach using multiple different approaches that treats multiple different levels. You don't have to go through multiple different approaches at different times and prolong your improvement. This can all be done in one treatment.


Bellevue Facial Plastic Surgeon
3.9 out of 5 stars 64 reviews

Acne Scarring -- Lasers (Fraxel, Co2/Erbium, VIVA, Intensif); Microneedling/PRP, Fillers (Bellafill); Subcision; Punch Excision

You need a combination approach which will entail a number of laser, microneedling/PRP, filler and TCA cross treatments.  Surgery or subcision maybe necessary as well.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Treatment for pitted acne scars

I would likely start with TCA CROSS.  This is a non-invasive procedure which uses high-strength TCA to promote collagen formation and smooth the skin.  It is important to see an expert and apply the TCA in precise fashion. Too much TCA can cause too much injury and make scars worse.  I have been doing TCA CROSS treatment for over a decade with good results. It is usually beneficial to do multiple treatment sessions over time.

Regards

Dr. Ort

Richard Ort, MD
Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

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 I concur with Dr Weiner. TCA cross, infini  and subscision as a start. I expect that multiple sessions will be needed.  Find an acne scar expert.

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Thank you for your question.  The type of scars you have are harder to treat than some others.  I find that a combination of subcision, possible punch excision, and fillers may be good options.  Aggressive microneedling has also been helpful in some of our patients who have scarring similar to yours.  Best of luck.

Brian Biesman, MD
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Improving acne scarring after treatments

I think I could get you better with the Infini and subcision. TCA cross can help too. Filler will work for rolling scars mostly and not sure of the benefits in your case. 

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Scars and Best Treatment

A combination of fillers, eMatrix, and TCA cross hatch technique will help you reduce these scars and improve the appearance dramatically.  Please consult an expert in acne scars.  Best, Dr. Green

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