Post TCA 70% I am left with deeper hole, will it shrink in time? (Photos)

Keep in mind, acne scars need a combination approach and a series of treatments to get the most improvement. As everyone has a unique pattern of acne scarring, the best solution is a tailored one. Typically you need fillers like bellafill and sculptra for atrophic indented type scars with or without subcision. Subcision for depressed tethered scars. Vascular lasers like yellow laser, aerolase, excel V or IPL for redness or thick scars. And lasers such as fraxel, erbium, co2 or fractional radiofrequency like venus viva, skinfinity, intensif microneedling RF for textural issues and superficial scarring. Deep ice pick scars and narrow box car scars are best treated with TCA CROSS and punch excision. All lasers are combined with microneedling and PRP to get even better results and improve healing times. The majority of patients will have a collection of different scar types, and hence a tailored treatment plan is needed by an expert physician. It is never about the laser or product that gives the results, its about the expert behind the equipment that gets you the outcome. Scars cannot be cured and will need life-long treatments to maintain and build on the results. Best, Dr. Emer.

Before and afters side by side at 8 weeks will tell the story. At this stage its still early. Your dermatologist maybe more experienced in higher strength peels than I am, however I am conservative when it comes to broad box cars scars, and use a lower strength in a paint mode. For deep scars, I use up to 100%. I warn all patients that the best results are after 8 weeks with OBJECTIVE side by side photos. 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 one device. 
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, PRP and INFINI radiofrequency. Atrophic scars (depressions) can be treated with either fat grafts, or with HA 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. 

 

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. Acne scar dermatologist specialist. Brisbane, Australia.