Will TCA Cross or TCA peel work best for shallow ice pick or boxcar acne scars? (Photo)

Question

After 4 rounds of micro needling I still didn’t see improvement to my icepick and boxcar scars on the cheek. Will TCA Cross work for my scars or is TCA peel better ? I have also tried Laser Genesis but it didn’t work either. These scares on over 15 years old and I’m Asian fair skin.

Raffy Karamanoukian, MD, FACS · Answer

Acne scars are usually characterized within the subtypes of atrophic, hypertrophic, pigmented, or inflammatory. These subtypes of acne scars can be visually discerning in ambient light and can cause significant cosmetic concerns. Indented and atrophic scars require a combination approach to stimulate collagen and elastin, thereby smoothing contour and uneven skin. These are usually combined with lasers and depigmentation protocols to reduce inflammatory hyperpigmentation (Melarase AM and Melarase PM). Our Hidef protocols for acne scars include fillers such as Sculptra, Juvederm, Radiesse, and Restylane to improve deep acne scars; Vascular lasers to reduce inflammation and post-inflammatory redness and erythema; Fractional lasers to smooth contour and collagen; and Fractional RF to stimulate production of collagen within atrophic scars. Textural improvement and superficial scarring can be improved with Cosmelan peels, TCA Cross for ice-pick scars, deep chemical peels, and fractional CO2. We offer a personalized approach to your combination of scars and a formal evaluation with consultation is recommended to help you achieve your final results. Our plastic surgery office offers subcision and combination TCA Cross to help reduce deeply pitted scars. In terms of pigmentation and skin resonance, we recommend daily use of Melarase AM and Melarase PM coupled with Retinoid creams to achieve brilliant skin.

Best,
Dr. Raffy Karamanoukian
Realself100 Surgeon

Best, 
Dr. Raffy Karamanoukian
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

One would not expect a hammer, which is a perfectly excellent tool for nailing in a nail or pulling one out to act as a screwdriver.  So expecting microneedling, which is best for improving very surface or color or texture irregularities, to treat ice pick scars would be like expecting the hammer to successfully screw in a screw. So, no surprises that microneedling for the ice pick scars was unsuccessful and simply a waste of time and money. Likewise, I have been cautioning my regular followers to exercise a great deal of "buyer beware" when considering fraxel lasers, RF and other so-called energy-based devices, as the hard science to support these expensive faddish gizmos lags well behind the heavy marketing to promote their use. Sorry, again. TCA CROSS, on the other hand, which has over a two decade track record for safely and effectively treating ice pick scars and dilated pores in all skin types , and which I have personally been using for this purpose for twenty years, is my go-to for this purpose. You would be wise to consult an experienced, board certified cosmetic dermatologist. Best of luck.

Will TCA Cross or TCA peel work best for shallow ice pick or boxcar acne scars? (Photo)

Answers (2)

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