How long should I wait after Pico to do TCA cross (for acne scar)? (photo)

Question

I’m underperforming Pico resurfacing. It has been very effective on my shallow scars yet for the ice pick scars, I would like to perform TCA treatment. My dermatologist does not perform TCA so I will be going to another clinic to get this done. Please advise.

Jeff Angobaldo, MD · Answer

Thank your question. Highly effective treatments to help get rid of acne scars is the micro-needling procedure called Skinpen. Microneedling comfortably creates thousands of micro-injuries in the skin to trigger the body's natural wound healing process. This results in skin remodeling, including the formation of collagen and elastin, the two proteins predominantly responsible for the structure of the skin. I would also suggest after you see results from the skinpen to do a CO2 skin resurfacing laser treatment. C02 reaches the deeper layers of damaged skin and stimulating the regeneration of healthy skin underneath. This treatment is also beneficial for uneven pigmentation, photodamage, fine lines and wrinkles, precancerous spots, and a host of other skin imperfections and benign lesions. If you believe you may be a candidate for CO2 laser skin resurfacing treatment, a qualified cosmetic surgeon or dermatologist can carefully analyze your skin and determine if the procedure is right for you.

Jason Emer, MD · Answer

We often perform treatments on the same day. I recommend consulting with an acne scarring expert for a formal evaluation and timeline. Acne scars need a combination approach for improvement.  For the best results, one should target the acne scar type.  As everyone has a unique pattern of acne scarring, the best solution is a tailored one.  Typically you need fillers like bellafill and sculptra for atrophic indented type scars with or without subcision.  Subcision for depressed tethered scars.  Vascular lasers like yellow laser, aerolase, excel V or IPL for redness or thick scars. And lasers such as fraxel, erbium, co2 or fractional radiofrequency like venus viva, skinfinity, intensif microneedling RF for textural issues and superficial scarring.  Deep ice pick scars and narrow box car scars are best treated with TCA CROSS and punch excision.  All lasers are combined with microneedling and PRP to get even better results and improve healing times.   The majority of patients will have a collection of different scar types, and hence a tailored treatment plan is needed by an expert physician.  It is never about the laser or product that gives the results, its about the expert behind the equipment that gets you the outcome.  Scars cannot be cured and will need life-long treatments to maintain and build on the results.  Best, Dr. Emer.

How long should I wait after Pico to do TCA cross (for acne scar)? (photo)

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