Can TCA 15% Reduce my Ice Pick Scar? (photo)

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

Ice pick scars need more aggressive treatments such as excisions, punch grafting , dermabrasions or CO2 laser resurfacing. They are more expensive but worth it since the improvement is permanent. Sincerely,

David Hansen,MD

Chemical peels are not very effective for the treatment of deep acne scarring.  TCA is effective as a pre-treatment for ice pick acne scarring.  I usually treat these deep scars first using a toothpick and 90% TCA.  This is then followed a few weeks later with resurfacing with SmartXide with a tight dot spacing and stacking to get deeper penetration.  I would not suggest using TCA as an at home treatment.  If applied incorrectly it can cause permanent scarring.