Acne Scar Treatment - what type of scars are these? Is TCA Cross necessary?(photos)

Question

Hi, these are my acne scars - grateful if you could tell me what type of scars are these? I'm scared of TCA cross (due to the down time and horror stories). Are lasers suitable for my type of scars? Thanks in advance!

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

Nelson Lee Novick, MD · Answer

TCA CROSS for the treatment of ice pick scars and dilated pores (which is shown in the photos) was in fact originally developed in South Korea for South Koreans. I have been using it regularly to treat these conditions since it was first introduced in the U.S. Since the acid is placed down the shafts of the ice pick scars and dilated pores (and not applied to the surface of the skin), it has proven itself to be safe and effective for all skin types. The horror stories you refer to are likely people improperly applying the acid themselves or from poorly trained or inexperienced practitioners who do so. On the other hand, lasers (as well as some other "bells and whistles" devices) pose the risk of causing proloned or permanent pigmentation problems, particularly in individuals with skin of color. So, you would be wise to consult an experienced cosmetic dermatologist scar specialist. Hope this helps.

Acne Scar Treatment - what type of scars are these? Is TCA Cross necessary?(photos)

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Acne Scar Treatment - what type of scars are these? Is TCA Cross necessary?(photos)

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