TCA Peel for shallow boxcar acne scars on my cheeks? (Photos)

Question

Hello, I'm considering trying chemical peels to try and address shallow boxcar acne scars on my cheeks. I've read peels aren't very effective for deeper acne scars but am wondering if anyone has seen noticeable improvement for shallow scars.

Raffy Karamanoukian, MD, FACS · Answer

The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

TCA peels in the ranges of 35-50%, so often used for superficial peels to be applied over the entire surface of the skin (not just for the individual scars), carries a risk of postinflammatory hyper and hypopigmentation (sometimes prolonged or even permanent), for any one, but particularly for those with skin of color. So, be very cautious when considering this kind of peel. I treat numerous patients of Asian background in my practice and prefer to individually treat their ice pick scars and dilated pores with the TCA CROSS technique that was developed in South Korea over two decades ago with proven safety and efficacy in which extremely high concentrations of the TCA are placed down the shafts of the ice picks or pores thereby applying it where it is needed and sparing widespread application to the surface of the skin, which significantly reduces the risk of the aforementioned pigmentary problems. Make sure to consult a board certified cosmetic dermatologist with particular expertise in acne scar treatments. Best of luck

Robert T. Buchanan, MD (retired) · Answer

The scars you have will respond to just continual use of Retin-A (tretinoin) over about a year. For faster response you could use a leveling peel, laser resurfacing or microneedling. Make sure you see someone who is an expert in these modalities.

TCA Peel for shallow boxcar acne scars on my cheeks? (Photos)

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TCA Peel for shallow boxcar acne scars on my cheeks? (Photos)

Answers (3)

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Everything you need to know about TCA Peel

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