First of all you need 3-6 infini treatments, but they do not get rid of pores / icepicks, better for the box cars you have. If they did a chemical peel it was very weak as a sedated chemical peel can go down to the fat if it's strong enough. Yes you have skin prone to hyperpigmentation, you must do hydroquinone aka skin bleach ad retin a before you treatments for a few weeks and after you heal and recover from them. Have you looked into resurfacing with a Sciton profractional ablation and going underneath the pores. Pores are deep. Or you could do a sedated peel that is strong enough to go deep. Recovery will be long and possibility of hypierpigmentation again, why they are conservative. For the pores they could do high strength tca for tca cross, it will take several for you icepick / pores. For your red skintone I can see v-beam, or excel v, or 1064nm, or ipl working (several) for the reds.

I would do filler for the fat loss in your cheeks (after any energy device like Infini or Sciton).

@Obi wanMaybe he has some more advice.

Totally agree with BA, 3-6 Infini RF sessions with or whithout PRP. Probably with PRP in the over and under technique. The under technique gives a good doctor an idea of what is going on UNDER your skin as they are injecting in this plane. BA idea of Infini is sound as it gives your body's immune system to stimulatecollagenie. your own collagen . The PRP helps with healing, and for what it is worth - unproven studies, adds more growth factors. I heard some good specialist perform conservative subcision at the same time. Once you complete your Infini, its time to reflect back and see how your scars respond. If you have tethering, sure, subcision, lasers can help, erbium in your skin type less chances of skin darkening. What ever is left is super easy- fillers if totally atrophic or fat. Fat last longer = less predictable, not good if its in an artery. Fillers= better safety, more predicable and finesse, last 2 years or more. I came across a study in 2015 with fillers and subcision, will try to find it .. somewhere in my downloads. But must agree with BA , do your RF sessions first, once contours corrected then worry about pores.

Thanks for all your feedback. Are all the series of holes in my face more ice pick scars and pores or boxscars? Would a series of Infini RF mostly address the depressed area in the center or could it help with some of the small holes too? if i have to be somewhat money conscious, what would you recommend i do. I just feel like my face a has a bunch of holes and never looks smooth. I will try to schedule a few more RF Infini Treatments. Btwn Profractional and TCA Cross, which would u recommend?

You might find if you look in tight light just how smooth your skin is,the prob is you got small scars (regardless open pore or ice pick) they tend to lower the skin as its damage in the middle area of you skin that the scarring got to,the top layer never scars as its shed.so basicly you got tiny indents that make the smooth skin look like a little bulge,like a bump or puffy skin.

also add in any inflammation going on in your face and that creates more texture changes in form of bulging skin areas and lumps.

tca peel helped me with scarred pores but i used 25% which packs quite a bang so must have been getting deep into my skin.3/4 layers and frosting and after 3 tca cross and 4 peels its realy showing in my appearance what the effort and healing time has done for my skin,its all positive.

regardless you gonna have to do tca work to work the upper and mid layers of your skin,needling works in the collagen and the lower most parts of the skin.

@cowboyhorn

Q: "Are theymore ice pick scars and pores or boxscars? You have all scar types majority are icepicks

Q"Would a series of Infini RF mostly address the depressed area in the center or could it help with some of the small holes too? " TCS cross will address icepicks, Infini), the subcise and fill, then icepicks with tca cross. This will take several over a few years. Scars are never one and done.

Q: "Money", skip the filler and subcision and do tca cross.

Thanks @Quadboy,@Obi wan, @beautifulambition

I called many dermatologists, surgeons, and only a handful will do TCA cross. I called one dermatologist and she does TCA Cross + Dermapen on the same visit for $480. I don't know exactly what TCA strength she uses or how aggressive she is with TCA but is this a good price? Is it better to have a Dermatologist do this instead of having the risk of DIY TCA cross at home?? Also, does Profractional Laser help with Ice Pick Scars? I remember a dermatologist recommended that.

@cowboyhornI would not bother with the microneedling for your current issues.

Goto whatever derm allows you to skip that.

Ask what percentage of tca she uses, it's your face.

It's up to you on the home or dr tca cross. Some just aren't comfortable. I give you the info, don't make the choice.

No laser helps with icepicks, they go down to the bone, only tca cross. and multiple treatments.

I can give you a plan PM me.

if my problematic area is mostly my cheeks, is it a bad idea to only do tca peel on cheeks vs full face?

@cowboyhornThis is all covered in the "faq" first post locked at the top of the scar sub. Goto tca peels, and the link to all things peels. Its called spot peeling and it's fine you treat just your cheeks. BE aware because of your type of scarring, this will not fix all your issues, take many peels, and give you a small percentage a time of improvement. But worth a go if that's what you can afford.

Ice picks DO NOT go down to the bone. I see this has been repeated a few times and is simply not true. You would literally have a half inch deep pit if it went down to the bone. That's not even logical considering you'd have to pass through fat, fascia, and muscle to get to the bone. Ice picks, at most, go to the fat level.

Profractional laser are old technology and have not had good reviews at all. In general lasers do not get high ratings for effectiveness, and profractional lasers get even worse reviews. They are usually only recommended because the patient has ethnic skin, which would hyperpigment easily.

Like the others have mentioned, it is always wise to do spot test to see how your skin reacts. It is not a good idea to cross every single ice pick and large pore on your face. I had a dermatologist cross every single one of my ice picks once and the aftermath is very scary. It's better to start with the worse ones and gauge your skin's reaction.

@dazzed you must be mistaken on icepicks, while some "may" have scars not to the bone. Often our friend here has fat loss, they are definitely to the bone. Plenty of histograms in Google Scholar and other sources such as Doctors who respond with this information on Real Self.  Ask 3 doctors I know and they agree, they are to the bone and often tethered. Otherwise they would be scarred pores or scarred macules. Hair folices go into the fat, scarring and infection often make these icepick deeper. We will use the word "deep" for you. So it really does not matter where they are as long as a) we know they are deep (fat is just above bone), b.) he is fat deficient. The advice still stands TCA Cross is the method of choice for these.

Profractional has great reviews on ethnic skin because of  PIH, I would not do non-ablative in his case, I mentioned Infini RF as a substitution. He can do strong acid peels and do the same thing to ablate the skin. 

Fatloss (missing under diagram) /in acne scar suffers Hence my comment TCA cross raises these deep pits:

 

@beautifulambition@Quadboy- I just had my second Infini RF. First time they do 2 passes at 2.75 and 2.5 length. This time dr did it at 3.0 mm depth for 2-3 passes and then i think he lowered it on the last pass, not sure which. From your experience, what do you think it the appropriate level on depth to see improvements with my acne scars?

This is terrible! Do not go that deep your going into fat territory. I know you have ethnic skin. Have them stay in the 1-2mm range. ie. 1mm, 1.25mm, 1.75mm. If your daring .75mm ... that could potentially cause PIH that could be fixed with hydroquinone and retin a aka tretinorin cream.

If my skin doesn't hyper pigment as much, is there any benefit going down 3mm?
Is recommendation usually like 3 passes?

No 3mm is going into fat territory, you have "superfical" scarring. would be between again I said this 1-2mm. for your skin type.

Sure 3 passes are fine, more passes is better, not more energy.

Just wanted to give some ppl updates to Infini RF results. I just had my 2nd treatment and 2 weeks out. I actually do see results. First time i only have 2-3 passes on certain areas at 2.5-2.75 depth. Second time, i had 3-4 passes on certain areas at 2.75-3.0 depth. I'm actually noticing results on my mixed scars. Some of my rolling scars are evening out and my ice pick scars surprisingly look less deep. Thought some ppl may want to see these if they are on the fence on trying Infini RF. I'm planning to do one more treatment. The second picture on my first post is the after my first treatment..... Though I do need some advice. For my 3rd Treatment, should i continue to use the same passes and depth when i saw results from the 2nd treatment at 3-4 passes and 2.75-3.0mm depth??

Thank you for your update, I do see some improvement. I would not be doing that needle length. I think I mentioned that before. You should be in the 1mm to 2mm range. Farther down can lead to fat deficiency. She or he is going that deep to avoid hyperpigmentation but that can be at the cost of fat. Your scars are in the range ^ I said I would do that in a few smaller increments. Have her do extra passes over the actual pitting areas mid cheek.