TCA cross made atrophic scars worse (Photo)

Question

Mistake #1- I did this at home with 30% TCA. The photo to the left is the before and on the right is where you can see two very dilated atrophic scars. It's only been 8 days, but I'm concerned the affects are irreversible. I've been getting amazing results with TCA peels, but I decided to try the cross method which I'm thinking was a mistake. If I continue with regular peels, would this perhaps go back to the way it was eventually?

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

Yes, mistake #1 was home, self-treatment with a potent acid like TCA. Worse adverse reactions have happened to others who have done so  So, you have thus far been lucky. Second issue, TCA CROSS, which is best used for treating narrow, ice pick scars, if used for broader based boxcar and rolling scars, can potentially widen them, as may have been the case here. 
The good news is that if an imminent scar is treated between the end of week four to no later than the end of week twelve after its creation, there is an excellent chance for significantly or completely improving it with the appropriate treatment, which in this case would seem to be subcision (to elevate and smooth them), since these sites now appear to have been made into broader based rolling-type scars. 
You would be wise to consult with an experienced, board certified cosmetic dermatologist scar specialist. Hope this helps and best of luck.

TCA cross made atrophic scars worse (Photo)

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TCA cross made atrophic scars worse (Photo)

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Everything you need to know about TCA Peel

Our mission is to create a world where every investment in modern beauty is Worth It.