Would TCA peels, subcision, and fillers work on my acne scars, rolling scars, and bad skin texture? (photos)

For you, a combination of treatments will be required.  It is likely multiple subcisions with co2 laser + microneelding and PRP would give a signficant improvement.  To enhance the results and individualized the treatment, TCA cross (chemical into deep scars) and/or punch excisions (surgically removing larger scars) will give even more improvement.  Your type of scarring requires mutliple treatments over time but if you find someone
experienced in lasers and treating all skin types there is little risk for
long term complications and you can get fantastic results. You will need appropriate skin care to prevent
long term hyperpigmentation as well. If you are not willing to have downtime for laser resurfacing (co2 laser) you can
get improvements with fraxel or sublative treatments, but they will take
many more treatments, and will not get as significant a result.   A formal
consultation with a well trained cosmetic dermatologist is essential.
Best, Dr. Emer.

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

In my opinion, when you have multiple scar types you need to treat each scar individually.Seak an experienced doctor who can adresss each scar. Treatment methods will vary per scar. Multiple treatments are usually needed.Avoid doctors that direct you only to one or two modalties. It will work for some not all.The world of acne scars is evolving.Good luck!

OK - first of all thanks for the excellent pictures, especially the first pic. as it gives Specialists a first hand view (or as close as it can get) to viewing your scars. I note you have ethnic skin type (possibly Asian), am I correct?ALWAYS find the best treatment for your scars, and not the other way around. Will needling work? Yes! Will it be better than a tailored program of TCA CROSS, subscison for anchored scars, fractional laser, then filler, probably not. If budget is the main constraint, I would go for a 2-2.5 mm Dermapen program- 5-6 treatments, this will help, as you have rolling scars. Make sure its skin needling that requires numbing cream, or it will not be as effective. Expect a 25-30% improvement at most. Realistically, your scars can be improved by 70-80% with directed scar treatments. All the bestRegardsDr Davin LimLaser specialist, Acne scar specialistDermatologistacnespecialists.com.au