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Acnomatic

What can I do against this Boxcar Scar?

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I hate acne, what can an ugly guy like me do about these boxcar scars?

I've tried things like Doxycycline, chinese herbal medicine(gave me some medicine that made me poop till I was numb), Acupuncture(needles that sent electrical pulses into my body), facialist, but the acne and cysts keep on coming.

I went to this chinese doctor, that did like needling on scars, but it didn't turn out that great. No change, with slightly worse -__-.

I have here pictures of how my face is, and I would like to hear what type of scar treatment would you recommend, so that my scars could become lighter or smaller, or miraculously disappear(>_<). I've read about apple cider vinegar and the taping method cause it sounds affordable and effective, but if I can get some experienced users opinion, based on how my skin looks, that would be great.

here is a little description of my skin, eating habits and lifestyle.

Skin- greasy, shiny, never seems to cease to produce oil

Eating habits- Protein(cause I like to workout), steamed food, eat out 2-3 times, but avoids fried greasy foods, limited to no snacks(snacking occurs once a month, or none).

Lifestyle- Part-timer worker, Full-time student, sleeps before 11:30pm-12am, play basketball and Work-out 3 times a week for at least an hour.

Thank you for reading, I look forward to comments.

I could only fit one attachment so I have a link to the other side of my face. <-- link is clearer.

post-111779-1301983506_thumb.jpg

post-111779-1301983506_thumb.jpg

Edited by Acnomatic

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You could try individual/single needling or TCA Cross. Excision is not ideal, at least at your right cheek because there are many scars very close to each other.

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deep boxcars, excision looks like it'd be your best bet, just don't do them all at once

find a facial plastic surgeon to give you his/her suggestion

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You're a good candidate for TCA cross. I would try that before excision because it is less invasive.

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i had 6 tca cross treatments on my boxcars which are less shallow than his, although they improved significantly, they are still there and i realize that the only way to get rid of them is through excision

so basically, if you are looking for a safe route that raises the scars approximately 70%, then go with tca cross

but if you want the scars to raise completely but with higher risk, go with excision

dont get tca cross and then excision as the excision would just cut out all of the improvement you got from tca cross.. meaning tca cross would have just been a waste of time and money (unless you're looking for immediate improvement while you're waiting for the time and motivation to do excision.. like me)

Edited by Brawn

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Is individual excision possible on these scars? I'm still wondering how much healthy skin is needed around the scar for it to be excised.

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From the look of my skin, there doesn't seem to be much healthy skin. Cause occasionally, once a month of so, another cyst or white-heads come up from underneath my scars, painful and ugly -__-. I'm guessing that would definitely affect my treatment process if I was to go into Cross.

Money is also a little tight for my family at the moment, so I thought of trying the lemon and vinegar, or tape method first. I'm hoping to try those self-help methods first before trying anything else, so if I can get some advice on which is preferred for my skin, that would be great.

Thank you everyone for reading and commenting.

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Guest Timehealsall
I find it hard to believe that excision is going to work for this guy. I would think cross would be a better option.

why would it not?

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Because excision is cutting 1 scar out for another. He has too many that are so close together. I think this might be a good treatment if he had less scars and not so close to one another.

Correct me if I am wrong.

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Excision removes the scar tissue that's underneath the top layer of skin. So with one of those indents, the walls and base of the indent have scarring underneath and that would be cut out, then the surrounding sides would be stitched together. I asked before it excision would be possible and now that I look at it again I don't see why it couldn't be if it was done one at a time and the resulting excision scar healed in a good way. jackiey your right but it could be done in a way where the trade between scars is a massive improvement. We need a plastic surgeon to come on the board!

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It's kind of a blurry picture but it looks like you have some active acne. After you get that under checK I would recommend some dermastamping with 1.5mm needles. There's a guy on here that had similar scars to you with some before and after pics after dermastamping, i'll try and find his thread for you.

Also, i'd be wary of people recommending excision. It has been suspiciously pushed on this board almost exclusively by members that have joined in the past few weeks. It's probably the same person. I'm not saying that I know if it works or not, but be wary of that.

Edit: This is the guy with the before and afters -

Derma stamping

Edited by Liquid_Ocelot

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It's kind of a blurry picture but it looks like you have some active acne. After you get that under checK I would recommend some dermastamping with 1.5mm needles. There's a guy on here that had similar scars to you with some before and after pics after dermastamping, i'll try and find his thread for you.

Also, i'd be wary of people recommending excision. It has been suspiciously pushed on this board almost exclusively by members that have joined in the past few weeks. It's probably the same person. I'm not saying that I know if it works or not, but be wary of that.

Edit: This is the guy with the before and afters -

Derma stamping

please note that this guy had boxcars with smooth edges and had subcision, which would be the most effective treatment for his problem and i suspect this was the main reason for his improvement

the reason subcision would not be as effective in this case is because acnomatic has boxcars with sharp edges, the subcision would raise the base, but would not get rid of the scar walls

this is why excision is better in his case

i have boxcars with smooth edges as well, just like now.or.never, and my dermatologist still believed that subcision wouldn't be the best course of action. i'm probably still going to go for subcision to see what improvement i can get out of it before resorting to excision (i'm also reluctant to have excision done, but i know that it is probably necessary)

again, in acnomatic's case, he clearly has boxcars with very sharp edges, meaning that although subcision would help, excision would be the only way to get rid of it completely

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It's kind of a blurry picture but it looks like you have some active acne. After you get that under checK I would recommend some dermastamping with 1.5mm needles. There's a guy on here that had similar scars to you with some before and after pics after dermastamping, i'll try and find his thread for you.

Also, i'd be wary of people recommending excision. It has been suspiciously pushed on this board almost exclusively by members that have joined in the past few weeks. It's probably the same person. I'm not saying that I know if it works or not, but be wary of that.

Edit: This is the guy with the before and afters -

Derma stamping

please note that this guy had boxcars with smooth edges and had subcision, which would be the most effective treatment for his problem and i suspect this was the main reason for his improvement

You must not have read the thread. He claims that the doctor that performed subcision only managed to hit one scar, so his improvement was primarily and almost exclusively due to derma stamping. I'm not saying subcision doesn't work, but his results were due to stamping.

again, in acnomatic's case, he clearly has boxcars with very sharp edges, meaning that although subcision would help, excision would be the only way to get rid of it completely

It would also leave a scar of its own and there are other potential complications with such an invasive procedure.

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nope, i read his thread, he underwent 2 subcision treatments, which he claims that the doctor "kept missing his scars and that there was 1 scar that the doctor did hit"

i highly doubt that after 2 sessions of subcisions that the doctor missed his scars, i haven't read his entire thread but i would assume that he was dermastamping during his subcision recovery periods (which are very long, definitely in excess of a month) and attributed the subcision results with his dermastamping

dermatamping has the same principles as an ablative laser, both poke holes in the skin, and both won't raise the skin completely

excision would leave a scar of its own, but this scar has the potential of being completely unnoticeable, and if it isn't, it is still much better than a partially raised boxcar as the resulting scar is thin and would no longer be depressed and cast a shadow

dermastamping/rolling and lasers also have potential complications, dermastamping probably has more than lasers because the needles are a lot wider in diameter than a laser "microtreatment zone", meaning there's a higher chance that the skin doesn't heal evenly

regardless, you could always try dermastamping/rolling, but if you want the scars to raise completely, you have to take the risks associated with excision

btw, here's a picture of excision so you know what to expect:

http://4.bp.blogspot.com/_Fba3qkNetDM/TTfR...ar_revision.jpg

Edited by Brawn

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I'm sorry but you're just reaching now. You're taking huge leaps to attribute his results to subcision.

i highly doubt that after 2 sessions of subcisions that the doctor missed his scars

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I'm sorry but you're just reaching now. You're taking huge leaps to attribute his results to subcision.

i highly doubt that after 2 sessions of subcisions that the doctor missed his scars

I'm sure he knows more about the competence of his own doctor than you. You're not basing these assumptions on anything other than your bias towards subcision.

excision would leave a scar of its own, but this scar has the potential of being completely unnoticeable

It can also potentially be worse. Much worse than anything a needle can cause. I see excision as a last resort, not something the OP should be considering at this point. Especially considering the nature of his scars.

as i pointed out, i made assumptions, but i don't see how they are huge leaps, i see them as reasonable. i think a larger leap would be to attribute his results solely to needling, as it sounds like you have from your last few posts

and a bias is not a bias if there is reasoning behind it

and yes, like i already mentioned, it has risks, but if he wants to have anything near completely raised scars, excision is the only way to go

unless he doesnt want completely raised scars, then he could definitely try needling, couldn't get worse than what he has right now

personally, i wouldn't even bother with needling, i'd just skip straight to an ablative laser

Edited by Brawn

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I'm sorry but you're just reaching now. You're taking huge leaps to attribute his results to subcision.

i highly doubt that after 2 sessions of subcisions that the doctor missed his scars

I'm sure he knows more about the competence of his own doctor than you. You're not basing these assumptions on anything other than your bias towards subcision.

excision would leave a scar of its own, but this scar has the potential of being completely unnoticeable

It can also potentially be worse. Much worse than anything a needle can cause. I see excision as a last resort, not something the OP should be considering at this point. Especially considering the nature of his scars.

as i pointed out, i made assumptions, but i don't see how they are huge leaps, i see them as reasonable. i think a larger leap would be to attribute his results solely to needling, as it sounds like you have from your last few posts

and a bias is not a bias if there is reasoning behind it

and yes, like i already mentioned, it has risks, but if he wants to have anything near completely raised scars, excision is the only way to go

unless he doesnt want completely raised scars, then he could definitely try needling, couldn't get worse than what he has right now

personally, i wouldn't even bother with needling, i'd just skip straight to an ablative laser

They're far from reasonable, your subcision theory requires ludicrous assumptions like now.or.never not realising his results were from another treatment that you assume (key word) he had at a particular time in order to create the confusion. Also simultaneously assuming that he is mistaken about his doctors competence despite the fact that he's the one with the first hand experience and you are simply making a guess. That is indeed a huge leap.

i think a larger leap would be to attribute his results solely to needling, as it sounds like you have from your last few posts

My words were primarily and almost exclusively due to needling.. Even if I did attribute his results solely to needling it would not be a larger leap than your subcision theory that requires so many assumptions that it boggles the mind.

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If this person was to do excision I surely hope he heals very very well. Anytime you cut skin to remove scar tissue the resulting scar will be longer than the original scar. I think there are just too many scars too close to each other that at best if he had excision his cheek would be full of surgical scars. I dont know if that would be a better solution. At worst, he would have bad healing surgical scars. And one never truly will know how ones scars will heal until after the damage has been done.

I havent had a huge success with cross treatment but I think this would be a better solution if it helped.

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liquid_ocelot,

we'll just have to agree to disagree then,

let's just let the original poster decide what he wants to believe

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If this person was to do excision I surely hope he heals very very well. Anytime you cut skin to remove scar tissue the resulting scar will be longer than the original scar. I think there are just too many scars too close to each other that at best if he had excision his cheek would be full of surgical scars. I dont know if that would be a better solution. At worst, he would have bad healing surgical scars. And one never truly will know how ones scars will heal until after the damage has been done.

I havent had a huge success with cross treatment but I think this would be a better solution if it helped.

i think what you mean by the resulting scar being longer than the original scar is in reference to fusiform excision, where an elliptical cut is made, which would result in a longer scar

however, fusiform excisions are performed on depressed scars with specific characteristics where other methods of excision would not be as efficient

what the original poster has are boxcar scars, which respond best to either punch excision or punch elevation, where a cylindrical punch biopsy tool is used to form a cylindrical hole as opposed to an elliptical cut.

there are various sizes of punch biopsy tools, in the case of scars, the surgeon uses the one with the smallest diameter that would fit the entire boxcar scar. therefore, the size of the punch excision is restricted to the size of the original boxcar scar and would therefore not result in a scar that is longer than the original scar, as would occur in the case of a fusiform excision

here is a picture of a fusiform excision and a punch biopsy, so you can see why a fusiform excision would result in a scar that is longer, albeit not as noticeable, as the original scar; whereas a punch excision / elevation would not result in this

fusiform excision: http://img.medscape.com/pi/emed/ckb/clinic...482-1818571.jpg

punch biopsy: http://www.siteman.wustl.edu/xmlfiles/Medi...R0000578083.jpg

further, the surgeon would probably do a test spot to see how he heals

and judging from the size of the scars from his picture, each one seems small, which should mean that they should respond well to excision since there is only a small gap to suture together, meaning there's less tension at the wound and therefore less risk of the wound reopening

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I personally have had punch excision. I had a cyst (not on my face) that was eventually just raised scar tissue so I had it removed with punch excision. At the time is was probably the size of a pea. The scar now is about the size of a quarter. I am okay with it only because it is flat.

I normally heal fine.

I have nothing against excision. I think you just have to be really careful. I also think that doing 20 (+ or - )excisions on one face is probably not such a good idea

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jackiey, what is your scar like? is it a different texture and color? certain lasers may help correct this

also, isn't the resulting scar a straight line?

but yeah, it's important for the original poster to ask for the surgeon's opinion, and if he decides to go ahead with it, that he does a test spot and goes slowly with treatments

for me, i have a lot medium-depth boxcars, which i had treated with tca cross, the results were amazing, but for me, i am still not happy with them

i'll opt for subcision, and only excision for the exceptionally noticeable ones

i would consider excision to be a last resort option, but looking at the original poster's pictures, it looks like excision is the only option

anyway, if the original poster has the time and money, perhaps go for tca cross first, maybe it'll soften some of the edges up so that subcision could work, and then have excision on whichever scars he's not satisfied with, that way it'll minimize the risks

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Thank you everyone for your thoughtful comments

I've read through all your comments and all of them suggest for an operation or a trip to a doctor. So I'll look into doctors that live around my city and ask for their opinion. I'll keep in mind that my boxcars have sharp edges and of the treatments you all suggested like Cross, excision, subcision, derma-stamping, and laser.

I'm worry about my healing capabilities as well as how much I can afford, so I'll definitely look for the best, quick and cheapest offer or settle with a small improvement, till I get a more steady job.

Thank you again for everyone's suggestion, but if there are other methods for cheap short-term success till I can get more money, I'll be watching as well.

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just one more note, there's also a new procedure that involves using your own body's cells, which i believe means that it would result in "scar-less" healing,

it's called "Acellular Stem cell stimulation" or "ASCeS"

here's a website with some info on it as well as before and after pictures of someone who has undergone the clinic's practice of combining ASCeS with other surgical methods: http://www.revivamd.com/news_view.php?news_id=1057

another person on this site has undergone subcision, fraxel repair, and ReCell (which i believe is the tool that they use to perform ASCeS), and the results are phenomenal

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