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Help me pick a scar treatment (pics)

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Hi, after a cystic acne bout during pregnancy I am sadly left with 1 linear excision scar from a cyst removal and some shallow boxcars.  A few saucer type indentations and  few ice picks++ pibmentation  It's the kind of scarring that no one has ever mentioned noticing, but I see it in bad lighting and up close pictures. Nevertheless, I have consulted with two doctors, Both cosmetic surgeons. One suggested tca cross and fraxel. The other uses c02re laser and believed one round should show enough improvement to satisfy me. Can anyone please elaborate on the differences and which treatment is more preferable? I will post before and afters as soon as i decide but I need help deciding! Thank you the top pic is my excision scar. Much worse in  person. Slightly atrophied. IMG_4386.JPGIMG_4409.JPGIMG_4413.JPG




Edited by malkamishka
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I cannot really see the scars from the pics as I need a flashlight and shadows the scars make to better determine. 

I would do TCA Cross for the icepics, so that dr sounds better. Fraxel is expensive and a name brand so that laser can be more costly. We do no advocate laser for your first treatment here as there can be side effects and your skin is in great shape, it's a gamble. I would start with he TCA Cross see how you do,possibly a acid peel for texture. I see some reds in the first picture, v-beam laser gets rid of this or IPL i great for browns, this is sometimes more effective than laser resurfacing (discolored skin). 

More about those procedures in the below official FAQ.

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Thank you! I had a feeling that a combination of treatments should be favorable to just one laser. And I am afraid the c02re might be too harsh with unknown results.
My concern now is that fraxel is apparently not permanent ? According to some real self users their scars were back within a few years.
Also, I have scars that are in the remodeling phase, they are new but they ARE indented. Is this a good time to pursue treatment or should I wait? Thanks. you seem so knowledgeable. 

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Your very welcome. I worked in the scar remodeling industry and have done many treatments myself including studying the data for treatments. 

I would wait if they are remodeling. Have you tried retin A cream this causes cell turn over. 

Any laser only lasts a few years, it basically only softens the borders of the scars. Same with acid. With the exception of TCA Cross (icepicks) which brings up the floor of the scar. Some of us do laser every year or a few years. Our skin ages and needs upkeep, as we age things shift and fat is lost.

Your scars are very minor and I don't want you to have complications, This is why I suggested just getting TCA Cross now. Tell him you will think about the laser and do not do it. TCA Cross is a spot treatment, and several, can be done at any time. Like now, even with other scars healing.   

In the very first pic I see discoloration, I would definitely do Vbeams after your TCA cross. It gets rid of the red, this will help lot. IT's a laser but only works on veins. Checkout the below FAQ and the section on "skin:reds" PIE and PIH for more on this. 

Don't worry about fraxel or CO2 laser for now while your healing. 

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That is so interesting. I don't even know where some of the scars came from but I lost a lot of weight rapidly after my pregnancy and there they were!  Some are new, from cysts but I only got like one at a time for about six months.  
But some are old and I wonder if they were there all along and the weight loss/aging/giving all my vitamins to my baby helped them to show.
Sorry to bug you, but I think I will take your advice and just do Tca. I am also interested in microneedling. Do you find that to be helpful? I was recently prescribed retin a,  tazorac.. and have not started yet because I was afraid the scars would get worse or I'd break out again. I'm glad you think it's worth trying. I'm going to give it a chance. 

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Yes definitely from fat loss this can happen. 

I do find TCA and Microneedle to be helpful. IT stimulates collagen and TCA resurfaces surface texture. TCA Cross will be very helpful for your icepics, and will take several. This is the major issue I see besides the reds from PIE. IT's all works together for improvement, we will never be 100% healed. We get percentages of healing. Acne scars are a journey, there is no perfect treatment. 

Always test retin a on a spot or area and see how you do before doing the full face. Same with TCA, thats your best bet. 

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i'm no expert but your icepicks look similar to scars that i have, and a recent TCA Cross has helped a lot, so i think that would definitely be a good first step to take. make sure you get it done by someone very experienced

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