Would TCA cross help with these acne scars? (photos)

Question

I’ve had 5 rounds of microneedling but my skin still looks the same. I think my scars are too deep. Would TCA cross help with these scars?

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

I am not surprised that microneedling has not been helpful here. I have been performing professional microneedling for well over two decades. While it is often promoted for treating ice pick scars and dilated pores, it is far better for dealing with residual, superficial color and texture abnormalities of the skin that remain after appropriate scar treatments have been performed. In other words, microneedling is best reserved for better blending, like a polishing step, the treated areas with the surrounding normal skin. TCA CROSS, which I have been routinely using for over twenty-two years, is an excellent treatment for ice pick scars and dilated pores that can be used safely and effectively in all skin types. You would be wise to seek out an experienced, board certified cosmetic dermatologist and best of luck.

Would TCA cross help with these acne scars? (photos)

Answers (2)

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