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Recommendations For Icepicks / Box Cars? (Pictures Included)

icepick ice pick subcision needling tca make-up

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#1 austra

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Posted 14 August 2012 - 08:39 AM

Hey everyone!
I've been reading this forum for a good few years, and I value your experiences and expertise very much. I'd really appreciate your advice on what I should do about my skin.

I have around 10-15 deeper ice picks or box cars on each cheek, and then around 30-40 very small, shallow ice picks that look almost like enlarged pores. The bigger deeper scars are the biggest issue for me, though I wouldn't mind improving my skin's overall texture either. On good days, I'm not too bothered about my scars and imagine that people hardly notice them, whereas on bad days I feel very self-conscious and unattractive because of them. I don't expect to get perfect skin, I only want my current scars to look softer and less noticeable so that I wouldn't have to obsess over them and wonder if people looking at my face in harsh lighting are only seeing my scars. Posted Image

I've done TCA cross three times with modest results - I'm not sure if this means that I should give up and try something else, or just keep doing more and more tea cross until slowly, my scars would become shallower and better-looking. First couple of times I had a TCA peel on my whole face with cross on pitted scars, but this last time about a year ago I asked my doctor to only do Cross and leave the rest of my skin alone, and I feel it was much more effective that way. Still, the results haven't been impressive at all to my dismay. I hardly see any difference, although there might have been some - it's really hard to tell! Some of my scars do look a bit shallower, but they were so deep to begin with that it doesn't make a big difference over all. Perhaps they just need to be treated countless times before starting to even out and look better. I haven't taken proper pictures until now, so it's very hard to say if Cross has been effective or not.

Either way, I'm not happy with my results so far, and I feel like I should go for more treatments and get some improvement, before I can move on and accept my face as it is.

I've been considering these alternatives:
- more TCA cross (1-3 times)
- Deep FX (1-2 times, for a start)
- punch floats, punch excisions or subcisions
- needling and/or derma rolling on my own to improve general texture

If anyone here has tried these methods for treating my type of scarring, I'd love to hear your experiences and what you would recommend for me. One problem I have is that I live in Finland and I may find it hard get some of these treatments. I have a good doctor for TCA cross and feel very lucky to have found him, but with Deep FX and other methods, I'm not sure if I can find anyone experienced without traveling abroad (which I can't afford for a while). I know of one Finnish clinic that mentions Deep FX on their website, but that's about it. But if something else would seem more effective than Cross, I'd do my very best to find someone who's able to do it.

Here are pictures of my scarring. I tried to get as realistic pictures as possible, but I didn't really succeed with my right cheek and it looks better than it really is in my opinion. I have some make-up on, which may or may not affect how my scars look. I also have some active acne at the moment as you can see, but I expect it to heal soon and if not, I would take care of that before any treatments.

IMG_1983.JPG
IMG_1998.JPG


Please tell me what you think, and thank you in advance. Posted Image

#2 trador

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Posted 14 August 2012 - 09:56 AM

Hello. I dont see any deep ice pick scars. You have scars yeah i can see them but they are not deep at all.

If i were you (if i had a good skin like you) i wouldnt go for needling. I have tried needling on my deep scars. It has worked on my scars a little. But my scars were worse than your and there are many of them. Whole my cheek. So needling is good for me. But you dont have that much scars and they are not deep. Needling can cause some problems on large pores.

Peeling seems best way for you. I am applying a Tretionin acid cream on my face like 4 months. Its a stong one and peels really good. Made my face look better. A little improvement on scars.

I dont think you need that much treatment methods hun. You have a good skin dont risk it. Just be patient and peel it.

#3 austra

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Posted 14 August 2012 - 10:10 AM

Thank you, that made me feel a bit better about myself. :)

To me the scars seem deep, although it could be that TCA cross has lifted them somewhat and they're not as deep as before. Maybe I should try it at least once more, since I have a good doctor I trust for that. Another pro is that he's the best (and almost only one) in the country and his office is right around the corner of my home, so I really need to walk just 3-4 minutes from my doorstep to get there.

I'd love to get some improvement on the most visible deeper and sharp-edged scars, and after that I think I could just let go and live my life. But well, so far cross hasn't seemed to do that for me.

#4 no_hope

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Posted 14 August 2012 - 05:31 PM

god dam you have beautiful skin!. honestly i wouldnt worry about the scars you have at all.be thankful for the skin you have because you could end up making things worse. i would do anything to have the scars you have instead of mine

#5 LZOMG

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Posted 14 August 2012 - 06:39 PM

Their more like Box Cars to me.
I think your skin is amazing, but if your scars really do bother you that much then you could always try Fractional Co2 laser resurfacing with the Fraxel Repair, Deep/Total FX, Mixto lasers are the 3 most common lasers in America that I would recommend

#6 kinimi

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Posted 14 August 2012 - 07:10 PM

Needling can cause some problems on large pores.

So people with large pores shouldn't needle? What kind of problems? What do you mean?

Anyway OP check this thread out:
http://www.acne.org/messageboard/index.php/topic/217908-ok-guys
The supplements, topicals and light therapy will help you get better results with your treatments.

#7 trador

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Posted 15 August 2012 - 12:43 AM

Needling can cause some problems on large pores.

So people with large pores shouldn't needle? What kind of problems? What do you mean?

Anyway OP check this thread out:
http://www.acne.org/.../217908-ok-guys
The supplements, topicals and light therapy will help you get better results with your treatments.


I have tried needling and large pores became larger, now they seem more a scar than a pore. I dont know maybe it only happened to me but i gave up needling on large pores.

#8 no_hope

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Posted 15 August 2012 - 06:26 PM

i wouldnt recomend her to get laser. her problem is isolated, not wide spread. laser should never be done on un scarred skin! it will make your normal healthy skin turn bad and more fragile and alot more prone to scarring. there are other methods rather thenlaser that the OP should give a go.

#9 DRaGZ

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Posted 15 August 2012 - 06:46 PM

laser should never be done on un scarred skin! it will make your normal healthy skin turn bad and more fragile and alot more prone to scarring.


that is not true.

#10 no_hope

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Posted 15 August 2012 - 06:54 PM


laser should never be done on un scarred skin! it will make your normal healthy skin turn bad and more fragile and alot more prone to scarring.


that is not true.

it is true in many cases. dont get me wrong there are cases where unscarred skin that gets lasered remains the same but that doesnt change the fact laser can ruin un scarred skin.

i know your gonna throw your experience in defence dragz but rememeber eveyrone has different skin and everyone heals differently point blank period

#11 DRaGZ

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Posted 15 August 2012 - 07:01 PM



laser should never be done on un scarred skin! it will make your normal healthy skin turn bad and more fragile and alot more prone to scarring.


that is not true.

it is true in many cases. dont get me wrong there are cases where unscarred skin that gets lasered remains the same but that doesnt change the fact laser can ruin un scarred skin.

i know your gonna throw your experience in defence dragz but rememeber eveyrone has different skin and everyone heals differently point blank period


1. I was pointing out that you were saying "lasers will ruin healthy skin" as though it was an all-encompassing fact. That is hyperbolic and completely misleading.
2. The vast majority of fractional laser cases result in nothing medically bad happening to the skin at all. If they did, they would no longer exist due to class action lawsuits, and the medical community would not have suggested it as a modality for widespread use in the first place.
3. There is no real distinction, biologically, between normal skin and "scarred" skin other than scarred skin simply is missing collagen. Your body literally doesn't know the difference. If it did, it would try to fix it. But it doesn't. Because technically it's fine, it just looks bad.
4. I would agree that there is no need for the OP to get laser treatments, especially an ablative laser treatment. Scars are so shallow and so few in number, I don't see how the thinnest layer of foundation wouldn't completely cover it up. In fact, it's pretty much in the realm of "regular wear and tear" of skin over time.

Edited by DRaGZ, 15 August 2012 - 07:07 PM.


#12 Binga

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Posted 15 August 2012 - 07:12 PM

Go for Recell or even better Laviv. Consult some good doctors as I don't think you need any harsh teatment.

Edited by Binga, 15 August 2012 - 07:14 PM.


#13 DRaGZ

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Posted 15 August 2012 - 07:16 PM

Go for Recell or even better Laviv. Consult some good doctors as I don't think you need any harsh teatment.


Both of these are fairly extreme treatments. There is no need for either.

#14 *Inspired*

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Posted 15 August 2012 - 08:24 PM

i wouldnt recomend her to get laser. her problem is isolated, not wide spread. laser should never be done on un scarred skin! it will make your normal healthy skin turn bad and more fragile and alot more prone to scarring. there are other methods rather thenlaser that the OP should give a go.


I really dislike comments like this. Like any scar treatment, there are risks involved. A very small percentage of people have been harmed by fractional ablative laser treatment, and there are many factors that have played a part in that. When you say statements, like "it will make your normal healthy skin turn bad and more fragile and alot more prone to scarring", it scares people who are less informed. It's simply wrong of you to spread false claims, as if it is fact. I know you're against laser treatment, and that's fine. I believe people should be aware of the risks, and properly informed on how to pick a skilled physician when undergoing any treatment. However, that doesn't justify outright false, unproven claims to keep people away from seeking treatment that may help improve their quality of life. If you're going to make statements like a treatment "WILL" cause damage, please back it with scientific proof.

To the OP, your scars are so minimal, I would be delighted to have your skin and wouldn't let it bother me. If you want to continue treatment and you've seen some success with TCA Cross, then perhaps you should stick with it. I don't see any reason to seek out laser treatment, like Deep FX, for your scars. You really only have a few scars and they're very shallow. To me, your skin looks normal. As we age, people are more likely to have enlarged, scarred pores. It's not unusual.

Edited by TokyoGirl, 15 August 2012 - 08:28 PM.


#15 Jeopardy

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Posted 15 August 2012 - 09:40 PM

What length dermaroller do you suggest for ice pick scars? Also, do you recommend green cream?

#16 no_hope

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Posted 15 August 2012 - 11:22 PM




laser should never be done on un scarred skin! it will make your normal healthy skin turn bad and more fragile and alot more prone to scarring.


that is not true.

it is true in many cases. dont get me wrong there are cases where unscarred skin that gets lasered remains the same but that doesnt change the fact laser can ruin un scarred skin.

i know your gonna throw your experience in defence dragz but rememeber eveyrone has different skin and everyone heals differently point blank period


1. I was pointing out that you were saying "lasers will ruin healthy skin" as though it was an all-encompassing fact. That is hyperbolic and completely misleading.
2. The vast majority of fractional laser cases result in nothing medically bad happening to the skin at all. If they did, they would no longer exist due to class action lawsuits, and the medical community would not have suggested it as a modality for widespread use in the first place.
3. There is no real distinction, biologically, between normal skin and "scarred" skin other than scarred skin simply is missing collagen. Your body literally doesn't know the difference. If it did, it would try to fix it. But it doesn't. Because technically it's fine, it just looks bad.
4. I would agree that there is no need for the OP to get laser treatments, especially an ablative laser treatment. Scars are so shallow and so few in number, I don't see how the thinnest layer of foundation wouldn't completely cover it up. In fact, it's pretty much in the realm of "regular wear and tear" of skin over time.

1.i dont care
2.they make you sign papers to prevent lawsuits from happening in the first place..duhh
3. the medical community will and are gonna push anything in the medical comunity that brings in alot of profit. just the way it is
4. there is something called ''reality''. just because biologically there isnt a distinction doesnt mean there isnt a distinction in reality.


i wouldnt recomend her to get laser. her problem is isolated, not wide spread. laser should never be done on un scarred skin! it will make your normal healthy skin turn bad and more fragile and alot more prone to scarring. there are other methods rather thenlaser that the OP should give a go.


I really dislike comments like this. Like any scar treatment, there are risks involved. A very small percentage of people have been harmed by fractional ablative laser treatment, and there are many factors that have played a part in that. When you say statements, like "it will make your normal healthy skin turn bad and more fragile and alot more prone to scarring", it scares people who are less informed. It's simply wrong of you to spread false claims, as if it is fact. I know you're against laser treatment, and that's fine. I believe people should be aware of the risks, and properly informed on how to pick a skilled physician when undergoing any treatment. However, that doesn't justify outright false, unproven claims to keep people away from seeking treatment that may help improve their quality of life. If you're going to make statements like a treatment "WILL" cause damage, please back it with scientific proof.

To the OP, your scars are so minimal, I would be delighted to have your skin and wouldn't let it bother me. If you want to continue treatment and you've seen some success with TCA Cross, then perhaps you should stick with it. I don't see any reason to seek out laser treatment, like Deep FX, for your scars. You really only have a few scars and they're very shallow. To me, your skin looks normal. As we age, people are more likely to have enlarged, scarred pores. It's not unusual.

lol it is what it is. what ever you say wont change the fact that in alot of cases the cons out weigh the pros when it comes to laser. not to mention the negative long term effects it could have on someone

#17 DRaGZ

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Posted 15 August 2012 - 11:27 PM





laser should never be done on un scarred skin! it will make your normal healthy skin turn bad and more fragile and alot more prone to scarring.


that is not true.

it is true in many cases. dont get me wrong there are cases where unscarred skin that gets lasered remains the same but that doesnt change the fact laser can ruin un scarred skin.

i know your gonna throw your experience in defence dragz but rememeber eveyrone has different skin and everyone heals differently point blank period


1. I was pointing out that you were saying "lasers will ruin healthy skin" as though it was an all-encompassing fact. That is hyperbolic and completely misleading.
2. The vast majority of fractional laser cases result in nothing medically bad happening to the skin at all. If they did, they would no longer exist due to class action lawsuits, and the medical community would not have suggested it as a modality for widespread use in the first place.
3. There is no real distinction, biologically, between normal skin and "scarred" skin other than scarred skin simply is missing collagen. Your body literally doesn't know the difference. If it did, it would try to fix it. But it doesn't. Because technically it's fine, it just looks bad.
4. I would agree that there is no need for the OP to get laser treatments, especially an ablative laser treatment. Scars are so shallow and so few in number, I don't see how the thinnest layer of foundation wouldn't completely cover it up. In fact, it's pretty much in the realm of "regular wear and tear" of skin over time.

1.i dont care
2.they make you sign papers to prevent lawsuits from happening in the first place..duhh
3. the medical community will and are gonna push anything in the medical comunity that brings in alot of profit. just the way it is
4. there is something called ''reality''. just because biologically there isnt a distinction doesnt mean there isnt a distinction in reality.


i wouldnt recomend her to get laser. her problem is isolated, not wide spread. laser should never be done on un scarred skin! it will make your normal healthy skin turn bad and more fragile and alot more prone to scarring. there are other methods rather thenlaser that the OP should give a go.


I really dislike comments like this. Like any scar treatment, there are risks involved. A very small percentage of people have been harmed by fractional ablative laser treatment, and there are many factors that have played a part in that. When you say statements, like "it will make your normal healthy skin turn bad and more fragile and alot more prone to scarring", it scares people who are less informed. It's simply wrong of you to spread false claims, as if it is fact. I know you're against laser treatment, and that's fine. I believe people should be aware of the risks, and properly informed on how to pick a skilled physician when undergoing any treatment. However, that doesn't justify outright false, unproven claims to keep people away from seeking treatment that may help improve their quality of life. If you're going to make statements like a treatment "WILL" cause damage, please back it with scientific proof.

To the OP, your scars are so minimal, I would be delighted to have your skin and wouldn't let it bother me. If you want to continue treatment and you've seen some success with TCA Cross, then perhaps you should stick with it. I don't see any reason to seek out laser treatment, like Deep FX, for your scars. You really only have a few scars and they're very shallow. To me, your skin looks normal. As we age, people are more likely to have enlarged, scarred pores. It's not unusual.

lol it is what it is. what ever you say wont change the fact that in alot of cases the cons out weigh the pros when it comes to laser. not to mention the negative long term effects it could have on someone


lol, what facts? You're just saying things based on...what exactly? And those contracts are to prevent people from suing if they have no results, it doesn't prevent suing for unadvertised adverse effects (which many quack doctors HAVE been successfully sued for).

There is nothing I hate more in this world than misinformation and incompetence, and you're misinforming people in the most incompetent way possible.

Edited by DRaGZ, 15 August 2012 - 11:28 PM.


#18 Nope.avi

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Posted 15 August 2012 - 11:33 PM

3. There is no real distinction, biologically, between normal skin and "scarred" skin other than scarred skin simply is missing collagen. Your body literally doesn't know the difference. If it did, it would try to fix it. But it doesn't. Because technically it's fine, it just looks bad.


it's actually abundant in collagen (Type I), it's just laid out differently. http://www.ma.hw.ac....eformation.html

#19 *Inspired*

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Posted 16 August 2012 - 12:34 AM


3. There is no real distinction, biologically, between normal skin and "scarred" skin other than scarred skin simply is missing collagen. Your body literally doesn't know the difference. If it did, it would try to fix it. But it doesn't. Because technically it's fine, it just looks bad.


it's actually abundant in collagen (Type I), it's just laid out differently. http://www.ma.hw.ac....eformation.html


You are right. Scar tissue is abundant in collagen but there are many subtypes of collagen, plus proteins, firbroblasts, etc. that come into play. When thinking of atrophic scars, I tend to think tissue loss, more than collagen loss or I see it as degraded where the rebuilding process did not occur properly. I've always found this thread at realself helpful when trying to understand collagen production and how it relates to my scars:
http://www.realself....agen-production
I especially appreciate the straightforward, simplified answer by Peter A Aldea.

#20 dragonn

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Posted 16 August 2012 - 01:26 AM

So it seems like the consensus among doctors is that fractional CO2 lasers are enough of an injury to incite collagen formation but not enough of an injury to cause inferior forms of collagen to form (e.g. scar tissue). It seems like most of the results and unwanted side effects come from this tipping point. Perhaps those that see no results did not have enough damage done by the laser and those that claim further scarring, enlarged pores, etc. after the procedure suffered from a "greater injury" (to quote Dr. Aldea: "Injury = Collagen deposition. Greater injury = greater Collagen deposition = scar tissue.") **Great link, TokyoGirl**

What sucks about it is that no one can be sure of this tipping point as it varies with the individual, logically.

Also, going off of this debate, I have always wondered why rolling scars maintain the tethered down by scar tissue theory whilst boxcars and especially icepicks are said to be simply tissue or collagen loss. Wouldn't they too be bound down in the dermis? Why would one scar type be caused by fibers pulling it down and the others would just simply be missing something? Sorry so inquisitive! I don't know if anyone really knows the answers to these.