5 hours ago, Cluelessbrunette92 said:

I, like many on here, have been suffering from acne scars for years  I have my scars on the side of my face so it's easy to cover up with my hair (I'm a girl) but it's really sad b/c every time I meet / start dating a new guy I NEVER want to put my hair up b/c I'm scared he'll see my scars and not want to date me anymore. Ranting aside, I've been lurking on this website for quite some time and even started dermapen (3 treatments so far) but I'm not happy with the results. Maybe 5% improvement on my bad side. I'm interested in getting subcision and restylane fillers but I'm worried that it only works for rolling scars and not boxcars and I believe I mainly have boxcar scars. I'll attach my photos and please help me out to see which treatment would be best for my acne scar type! Thanks  

Hey firstly I think you have more ice pick than boxcar scars so the treatment of choice for you would be Tca cross you should be able to see a good improvement front this after multiple sessions.

I see box cars and ice pics

TCA cross is great for the ice pics. For box cars you or a med spa could do microneedling (which you have done already), and tca spot peels on the areas. A doctor could also subcise the tethered spots. Filler will not work for you as they are very superficial and not wide enough to fill. You can vacuum with a cupping device after your subcision. Some for this type of issue do Infini RF microneedle (this can be used on any skin type unlike laser), or picosure laser.I would call your issue more textural.

On 2/24/2017 at 3:34 AM, beautifulambition said:

I see box cars and ice pics

TCA cross is great for the ice pics. For box cars you or a med spa could do microneedling (which you have done already), and tca spot peels on the areas. A doctor could also subcise the tethered spots. Filler will not work for you as they are very superficial and not wide enough to fill. You can vacuum with a cupping device after your subcision. Some for this type of issue do Infini RF microneedle (this can be used on any skin type unlike laser), or picosure laser. Dermabration also works good with a facial plastic surgeon, there is big down time and you must do 3 of them.    I would call your issue more textural.

 

Hi, just wondering what you mean by textural. Aren't all acne scars a "textural" issue? Also should I alternate tca pees and dermapen or just get them done on the same day? Thx

@Cluelessbrunette92

Depends on what your doctor thinks, same day or separate treatments.
Textural means the skin is not smooth. Not everyone has surface scars. Some are wide rolling scars with smooth skin (minus the fat underneath), or tiny icepicks are not the same as surface box cars all over the skin / scarred macules. With large rolling scars you can fill and subcise them and the skin can be smooth. The hardest are surface box cars to deal with textually.

Ice picks and small box cares, like what you have, should be treated with TCA Cross. Resurfacing like with dermabrasion can actually make ice picks look worse from what I've read. That is because sometimes the base of an ice pick scar is wider than the opening of the ice on the skin surface. So if you sand down the top layers of skin, you may risk exposing the wider base of the ice pick scar, if that makes sense. In your case, dermabrasion would be really extreme and not worth the risk.

I disagree, these are superficial - box cars (textural issues), towards the middle of the scars and could be more level with acid peels, or laser. Look at the second pic there are more depressions noticed than "icpicks." Secondly TCA Cross by it's very nature raises the scar bed floor and widdens the scar to soften it ..." So if you sand down the top layers of skin, you may risk exposing the wider base of the ice pick scar " ... you raise and flatten, raise and soften again.