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I have a super deep icepick scar on my forehead and I want to get rid of it. Should I try TCA Cross which I can buy myself and use a toothpick, Phenol Cross where I would have to travel and pay the dermatologist money, microneedling or get excision and just cut it out and stitch it back up. Years ago I went to a dermatologist and he said lasers will not fix it. I read a lot of posts about TCA Cross and some people say it helps fill in holes but I don't think their icepick holes are as deep as mine but they never totally fill in, some nothing happens and some say it makes their hole worse.
If I do TCA Cross would 30% be strong enough? Some people have said to go low and slow and not make it worse but I asked a dermatologist if 30% would work and he said the lowest he uses is 70% to see effective results. I have heard of people having success with 30% over many treatments and I have heard 30% is powerful. I also heard 15% helping someone but I don't know about 15% because some people use that for face peels so it's hard to imagine it would create a wound that would have collagen stimualtion. What percentage do you think I should use? I was thinking excision would get rid of the hole right away and save time but I heard the excision needs to be bigger than the scar I am trying to fix and if it goes wrong I would be trading a small scar for a bigger scar where as with TCA Cross I can hopefully keep the scar the same size even if it takes longer. Would it be possible for TCA Cross to fill lthe whole hole or will there always be a funnel look even if the hole gets filled as much as possible? What should I do?
My guess is it is too deep for CROSS or really anything for that matter. My guess is that laser or needling also won't do much. And I also hear your concern about if you got it excised, what if it just gets worse.
If it were me, I'd consult with at least 2 and maybe 3 scar revision specialists and ask about excision and how it could be done well and how you can avoid any complications. And of course, keep an open mind. Maybe one of them has a better option we aren't even thinking about like some kind of micro-filler or something.
It's great that you are proceed with caution though. You for sure don't want to just make it worse.
@dan Does CROSS not grow skin higher? Does it just make an icepick scar more flat looking by widening the walls around it so it's not so narrow and more wide but doesn't actually grow the skin higher? I was hoping that when people said icepick scars can get fixed that it meant the skin grew higher and then I could keep re applying to keep the skin growing higher and higher until it reached the height of the surrounding skin.
Yes, CROSS does help. Based on pictures in studies (I am NOT an expert in real life), what you are saying is what I have seen. TCA cross brings a scar up, and then again up, etc. But I haven't seen a scar as deep as yours in studies. And my gut tells me when a scar is that deep TCA might not do the trick. That's all I'm saying. But I could be wrong and it could work. I'd make sure to make an appointment with a few scar specialists and see as many before and after pics from their patients as you can with icepick scars. You want to see success with someone very similar to you. See some pictures of TCA and the results they got from that. And see a few pics of excision and results they got from that.
@dan Do you think I should try CROSS and see if it works before trying excision or is that risking making the hole wider which would then make the excision bigger than if I never tried CROSS before? I was thinking if I use a low percentage the chance of widening the scar is low and if I could heal it using CROSS that would be good because it would keep the scar the same size as the hole instead of bigger from doing excision. Does TCA Cross widen the scar often? because I have seen people report that. I wonder if using a low percentage and only applying it to the bottom of the scar and try and not touch the walls if it would keep it from widening. I don't think making it deeper would matter because it's already deep so I don't think it would make a difference visually. I hear people say TCA Cross makes their scar shallower but wider and I'm wondering how the skin on the sides gets eaten away to make it wider but not eaten away at the base of the icepick hole to make it deeper. Also the icepick hole I have might not have the same skin at the bottom of the hole as my normal skin surrounding the hole because it's deep so if I use the TCA on it then the skin might not react like a shallower icepick. Is that why your gut tells you that TCA Cross might not work on a hole this deep? The skin down that deep would react differently? Anyways what do you think? Would you try TCA Cross first to see if that works because if I did excision first I would never know if I could have done it with TCA Cross successfully. On the other hand if I do TCA Cross first and it is unsuccessful then obviously excision first would have been better since the scar would have been smaller. I can try lower percentage to try and get skin growth with making the chance of widening the scar lower and it would just take more treatments which is fine. I am wondering what the lowest percentage I could go with also making it effective enough to grow skin. On some facebook groups people claim that 30% works for them to fill big holes but I am wondering if they are just trying to sell their product by telling these stories because I have heard that 30% didn't help others.
I don't have good answers for you unfortunately. I just don't have enough real world experience with this. I have heard that TCA CROSS can widen scars, so that may be a legitimate concern. Also, the depth of your scar is also a valid concern on whether CROSS would do much. If you do decide to do it, do it professionally. I hate the idea of anyone doing it themselves. It's too big of a risk. For sure only get things done professionally by someone really good that you absolutely trust.