Will a TCA peel alone get rid of these acne scars? Do I need other treatments? If so, what kinds and how many sessions? (Photo)

Question

I don't have a lot of money to spare (<$1,100 total, preferably <$500 total) for permanent results. I got these scars from a psychiatric med from hell, which I've been off of for 6 months with good results, so the acne's never coming back. It's possible I have a form of Ehlers-Danlos Syndrome which somehow affects how collagen functions in my body. I'm not sure how, though, so would this impact which methods I'd need? What strength of peel would I need? What kinds of acne scars are these?

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

Jason Emer, MD · Answer

A combination approach will give the most improvement. These types of scars need a combination of lasers, microneedling/prp, TCA cross, Cosmelan, punch excision and fillers. It will take a series of treatments and may need life-long treatments to maintain. recommend getting a formal evaluation with an acne scarring expert. Best, Dr. Emer

Lisa Jenks, MD · Answer

I am sorry about your scars.  There is nothing available that will completely get rid of your scars.  However, a combination of various treatments should soften and improve the majority of them.  I recommend starting with a series of microneedling treatments combined with PRP (protein rich plasma).  After that, you may need to consider either having filler injected into the deeper ones/surgical excision/CO2 lasers and/or strong peels such as the TCA.I recommend scheduling a consultation with a physician who specializes in aesthetic medicine.Best of luck to you.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Subcsion with microneedling RF , vertical needling with Botox will give you better results. The expert in FL is Dr Steve Weiner. I would not use a TCA peel for these type of acne scars (tethered and rolling with areas of atrophy)
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. The web reference below will take you to a resource to help you understand acne scar revision at a specialist level. I embedded all the videos in one page to help. 
  
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.

Will a TCA peel alone get rid of these acne scars? Do I need other treatments? If so, what kinds and how many sessions? (Photo)

Answers (4)

Answer: Difficult scars to treat, TCA not indicated for these scars as first line management.

Answer: Difficult scars to treat, TCA not indicated for these scars as first line management.

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Everything you need to know about TCA Peel

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Will a TCA peel alone get rid of these acne scars? Do I need other treatments? If so, what kinds and how many sessions? (Photo)

Answers (4)

Answer: Difficult scars to treat, TCA not indicated for these scars as first line management.

Answer: Difficult scars to treat, TCA not indicated for these scars as first line management.

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Recommended reading

Everything you need to know about TCA Peel

Our mission is to create a world where every investment in modern beauty is Worth It.