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max222

punch excision treatments?

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hi everyone, I am new to the forum and am from Toronto (Canada). I have been reading posts for several months off and on, should have joined sooner. My acne problems began when I was in my early teens, but it was a type of acne that would stay under the skin, so it would show only as slightly visible white bumps and only around my cheeks ( can't remember the medical term). I was on several

medications to help cure/extract it. The medications didnt take too long, but I was left with deep ice pick scars around my right cheek below the eye. I had only a few more incidents where I had to use the meds to get rid of the acne, but those did not really cause more scarring. Unfortunately, I took my time to finish the meds, which should have only been another year-year1/2. It's about 7 years later and I talked to my derm about treatments, since they wanted to make sure I was completely acne free and the derm told me nothing can really be done about the scarring. I was horrified to hear them say the least that their is no kind of effective treatment. When the scars formed after the first incident back in my teens, I was so shocked I immediately went to find a solution and the treatment place I went to told me glycolic peels would help smooth the scars. This only did not work, but left me with bright red skin under my eyes over the last 6 years. I use suntan lotion and some cream to smooth that problem out. This made me kind of withdrawn for several years. I would like to hear about any kind of solutions for ice pick scars, but the only thing I heard that might work is punch excision/graft. I would like to know more about it, please reply

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From what I am reading here too, excision and tca cross are quite effective for improving ice pick scars.

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yeah TOgirl I was wondering the same thing, but I'm guessing if any city in Canada offers these treatments it would be Toronto. I do remember reading a post in the forum several months ago there is an excellent derm/surgeon that performs punch excision for ice pick scars not too far outside Toronto. I cant remember which member of the forum added that post, but he said he was pleased witht the results. I'm sure there are a number of places to have it done here in Toronto though, punch excision or tca cross.

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hi people out there, please dont do excision..mine become more dented not just only a straight line..Excision is not succesful in dented scars..

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I'm sorry to hear that loneman, but would punch excision work for ice pick scars, or is that the same as dented scars. I was also wondering how different punch excision is from punch grafts, samething?

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perhaps punch "grafting" would be a better solution??? i'm not really sure of the differences between excision and grafting, but i think grafting involves the transplant of tissue from another part of your body, such as behind your ear, so maybe that helps to raise the scar??? i hope somebody will fill in the details. you should read the threads about tca cross. it seems like a promising method for treating ice-pick scars. i guess all of these procedures have risks, though. if not performed by the right physician or surgeon, or if the doctor makes a mistake, or if your body doesn't react well to the treatment, ...it might make your skin worse. i wish i could hear more success stories on here, but maybe people who have successful treatments don't surf through scar forums because they are happy???

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I had a punch excision done on one of my ice-pick scars as a test and it came out worse than the original scar. The area looks more indented (think gradual crater) whereas before it was just a hole.

I'm sure there are other scars on my face where it would have helped. Just want to let you know that it is not without risk (ie worse than before)

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I also had punch excision on a chicken poc scar. I should have never done it. It came unstitched twice and left a bigger scar. I could kill that derm.

I had the scar subcised but I see very minimal improvement.

I am looking into fillers now.

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thanks for the info everyone, it sounds like even punch graft/excision treatments only lead to more problems. I have looked into a filler that is new to canada(recently approved by our medical standards) called artecoll, which is supposed to be a permanent filler. It has been used in europe for along time and is a mix of collagen and another filler that is permanent and has been used for bone repair and dental work. I have heard of mixed results. Downside is it is supposed to be expensive ($700 approx a treatment) taking several treatments, but is done very quick and little recovery time. Problem is since it is a filler and may leave a bump, which would have to be fixed by smoothing out the skin layers.

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Max,

Beware of permanent fillers. There are many issue involved there, and risks. Also think about the fact that as your skin ages around the filler, it might look weird. God, I feel like I'm always saying beware of this and beware of that on these boards. All of this stuff is risky. I guess we have to try something though, but we should probably weigh the risks of each procedure with the potential benefits. I suggest risk-aversive decision making when it comes to cosmetic surgery, though. Sometimes in life, jumping out there and taking a chance can be a good thing...not sure that's a good approach here, though.

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tks for your support and advice guys. I think you may be right john about the treatments. I talked to a doctor at a cosmetic clinic, some old indian woman. She wasn't too friendly and didnt seem to care too much about my problem, but did answer a few things for me. fillers would not work for me because the scars are not wide enough and the filler would probably leave "weird" looking bumps. Punch excision might work but might leave a bigger scar. Punch graft might not work too. She wanted to give me laser resurfacing, but I told her about my peels and how my skin burns easy. She said it would burn the skin and its what she gives most of the people that ask for acne scar treatment, again she said there is no guarantee. She did give me the alternative of smoothbeam, which does not affect the top surface of the skin for the most part, minimal recovery time, and focuses the laser beneath the skin on the scar. She told me it breaks the tissues and raises the scar. I would appreciate to hear any advice on smoothbeam and also I have been hearing alot on tca cross, what is is exactly ?

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