Hi,

I am 29 and suffered severe acne scarring (very heavy rolling on cheeks and temples, boxcars scattered around, about 50 deep ice pics, massive pores (that I thought were ice pics for a long time)

I won't get into how devastating it was for my mental health because I'm sure we've all been there.  I have spent about 30,000$ on acne scar treatments over the last 7 years and despite many ups and downs,  I would say I got about 90% improvement.  Unfortunately I was so self conscious about my scarring before that I would just not be willing to upload pics.  But I can say for certain no one comments on my skin, it holds up well close up and strangers now actually look at me like I'm crazy in the few situations when I've commented that I bad acne scarring before.  There are some  very minors scars only slightly visible in the worst light (rolling) and some minor coloration differences from small stitches from excisions and punch grafts but what I have is more than I possibly could have expected to have.

TCA Cross for pores:

However, in the last couple years  I was more concerned about the massive amount of pores I had, especially next to and on my nose. For a long time I thought they were ice picks.  

Luckily, these can also be hugely improved by tca cross. 

I've modified a method that is effective for pores, even if they are small.

I saw a study by Korean dermatologists corresponding with the authors of the original TCA cross paper. Some of them have gone from the toothpick method to a "bent syringe method" so they could get the tca into the very bottom of scar or bottom of the pore opening more effectively. 

I've switched the technique a bit. last year  I started using a thin sewing needle instead due to its sharpness and because it doesn't dull.  Making sure to only get the tip of the needle in tca, I push HARD into the base of the pore, twist it like a lever around to abrade the base so ideally tca goes below the base and into the oil gland and around/below it.  With things like ablative lasers, if they don't reach the level of the gland and resurface around there, it will do nothing for pore size, so this is the same idea.  I often draw small amounts of blood with each pore treated. Sometimes I even do recross the same pore again if it is deep or non-responsive.       

Another thing with TCA - a reasonable, prepared person should have no trouble doing this themselves with 100% tca cross.  I have never had any mishaps over doing a dozen times. The key is to let only the tca get onto the tip of the needle. If you submerge 1/3rd of the needle in acid, after you push the needle into the pore, the area of the skin that has tca around the skin surface will bleed over onto adjacent skin and this is not ideal. When I do cross, I usually have barely any crusts because of the lack of the damage to the adjacent skin, just some white pus whereas a less poorly one would get a big crust. I am pretty certain I do it better than 90% of doctors do. If you keep the tca right near the tip of the needle only, you cannot have a tca disaster unless you stick it into your eyeball or something.  I have even done one tca cross this way on unscarred skin and the same thing happened and it healed in a week with a white pus and minor flaking.    

Pores seem to take longer to respond to CROSS than scars do, probably since the pore opening goes down into the skin deeper than is visible. This may be because it is difficult to get the tca into and below the oil gland on the bottom of the pore. This is why I think pushing hard abrading the bottom of the scar with the needle enables it to go deep enough work on even small pores. Larger, deep took about 5-6 sessions for me to go from big to small and norm looking.  I also use a strong 0.125 tretintoin gel, which does modestly shrink the size of small pores at higher strengths. 

I've attached a screenshot of where the Korea dermatologist expanded the method and the excellent results they got with 4 sessions on a patient's pores even though his pores were tiny compared to mine were initially.