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dragonn

Scar Treatment Help

I am at a loss. 
I didn’t think my scars were that bad. Other than a few that are deep, I thought most were rather shallow and would be amenable to resurfacing (like Dr. Lim suggests for shallow boxcar scarring). 

After sending these same pics to a doctor for a treatment plan, she said my scars are too deep for even fractional lasers to reach and far too deep to be smoothed by resurfacing. 

What do you guys think? Any help and insight into how deep they truly are and what treatments would work appreciated. 

 

 

 

 

Edited by dragonn

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These scars are not bad at all, the problem is that they are semi-deep. Luckily, they are all narrow, meaning they can easily be raised up with TCA cross. 

After finishing a few series of TCA cross, you could pursue erbium laser resurfacing or full-face TCA peels to polish things off. 

Laser resurfacing works best for smoothing out skin texture, but won't work for pitting like that. It doesn't mean your scars are bad, it just means they need a different treatment :) 

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Thanks Petsme!
The deep ice picks never really bothered me. But the boxcar scars do a lot. 
The doctor said too that I would need TCA cross but that I have so many scars so close together it would be too risky and instead recommended two deep 40% TCA peels. 

I just don’t know if that would raise up the ice picks since it would be treating the entire area? Has anyone done a deep peel for ice picks? 

Edited by dragonn

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38 minutes ago, dragonn said:

Thanks Petsme!
The deep ice picks never really bothered me. But the boxcar scars do a lot. 
The doctor said too that I would need TCA but that I have so many scars so close together it would be too risky and instead recommended two deep 40% TCA peels. 

I just don’t know if that would raise up the ice picks since it would be treating the entire area? Has anyone done a deep peel for ice picks? 


I don't think so, TCA cross is usually spot treated at 70-100%. A 40% TCA peel won't raise ice picks.

Your scars aren't bad at all, don't know why the doctor made out that they are that severe and untreatable?

Either way, you will have options. Good luck!! Edited by unbreakable1

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In general, your doc is correct in that lasers won't do much for icepicks and some of the boxcar scars. It's not that they're severe, it's just that they're not the right solution for your type of scars. You can probably go with the TCA peel suggestion. It would help with some of the shallower scars, though ideally you'd get TCA cross for your narrow scars first. 

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TCA peel takes forever. If you want instant satisfaction, get Infini or other RF microneedling. Moreover, I would advise that you get HA filler prior to Infini.

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They really can't use filler on these types of scars, and I think TCA cross would be the best treatment option for these scars

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Thanks for all the suggestions, guys!

She did say that any type of filler or microneedling would be useless for my scarring.

She suggested the two TCA 40% peels, and said THEN my scars would be shallow enough for fractional erbium laser and a final ablative laser to top it off. 

Maybe I should start with TCA Cross for some of the lone icepick scars. 

1 hour ago, Sirius Lee said:

TCA peel takes forever. If you want instant satisfaction, get Infini or other RF microneedling. Moreover, I would advise that you get HA filler prior to Infini.

I see that you’ve had good results with Infini, Sirius Lee. Have the results held up? Do we have similar scarring?

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1 hour ago, dragonn said:

I see that you’ve had good results with Infini, Sirius Lee. Have the results held up? Do we have similar scarring?


Mine's more severe than yours. I've had a pretty good result, about 50% improvement, if not more. The weird thing is most of that improvement came from the first treatment. Second one, which followed in 6 weeks, yielded very little. On that note, it would prudent to wait at least 3 months (personally, I would wait 6 months) before hopping to the next treatment.

Lastly, I think you will definitely benefit from filler because your scars are more of a round-shape than a v-shape that is so characteristic of icepick scars. While you can't use fillers for v-shaped scars, you definitely can fill round-shapes. However, the reason for filler (in this specific case) is not for cosmetic reasons. They are used more as a spacer to promote collagen. Since your scars are pretty mild, you likely would not need much. 




PS. And this is just my own opinion, but I think you should fire your dermatologist and seek a second opinion because I believe erbium ablative laser can indeed help improve your scars.

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On that note, I wonder if there's a treatment as good for "monomorphic scars" as fully ablative. I have the kind of scars that would be good for ablative lasers (shallow boxcars concentrated on the cheek). As someone living in a country that has no access to fully ablative, for someone in this situation, is there an alternative treatment that would provide similar (hopefully better) results?

Like will X number of TCA peels/fractional lasers/RF microneedling, etc. be good for the kind of scars that a fully ablative laser is ideal for?
 

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5 hours ago, dragonn said:

The doctor said too that I would need TCA cross but that I have so many scars so close together it would be too risky and instead recommended two deep 40% TCA peels. 

In this case, one option is to do them over time.  You can address some scars (not close together) in one visit and as those heal, treat other nearby scars.  If additional treatments are needed, continue in this manner, alternating the scars that are addressed so that scars that are close together are not treated at the same time.  

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1 hour ago, Sirius Lee said:

Mine's more severe than yours. I've had a pretty good result, about 50% improvement, if not more. The weird thing is most of that improvement came from the first treatment. Second one, which followed in 6 weeks, yielded very little. On that note, it would prudent to wait at least 3 months (personally, I would wait 6 months) before hopping to the next treatment.

Lastly, I think you will definitely benefit from filler because your scars are more of a round-shape than a v-shape that is so characteristic of icepick scars. While you can't use fillers for v-shaped scars, you definitely can fill round-shapes. However, the reason for filler (in this specific case) is not for cosmetic reasons. They are used more as a spacer to promote collagen. Since your scars are pretty mild, you likely would not need much. 




PS. And this is just my own opinion, but I think you should fire your dermatologist and seek a second opinion because I believe erbium ablative laser can indeed help improve your scars.

I’m glad you hear you’ve gotten great improvement! It seems from reviews that infini either works really well or no results. Does anyone know if it works well for icepick scars? 

I am definitely going to get another opinion. And will ask about filler.   
1 hour ago, Raster said:

On that note, I wonder if there's a treatment as good for "monomorphic scars" as fully ablative. I have the kind of scars that would be good for ablative lasers (shallow boxcars concentrated on the cheek). As someone living in a country that has no access to fully ablative, for someone in this situation, is there an alternative treatment that would provide similar (hopefully better) results?

Like will X number of TCA peels/fractional lasers/RF microneedling, etc. be good for the kind of scars that a fully ablative laser is ideal for?
 

That’s the word I was looking for. Really thought my scars were monomorphic and would be amenable to resurfacing, especially with shaving of the scar shoulders, etc  

I would think rather deep tca peels would be good for resurfacing if ablative laser is not available. 
57 minutes ago, motherofms said:
6 hours ago, dragonn said:

The doctor said too that I would need TCA cross but that I have so many scars so close together it would be too risky and instead recommended two deep 40% TCA peels. 

In this case, one option is to do them over time.  You can address some scars (not close together) in one visit and as those heal, treat other nearby scars.  If additional treatments are needed, continue in this manner, alternating the scars that are addressed so that scars that are close together are not treated at the same time.  
Good idea! I’m going to schedule an appointment with a dermatologist closer to home and see if he suggests cross and if so, if he will do it in steps this way. 

I will keep everyone updated as I figure out my options and go for treatment so anyone with similar scarring can hopefully be helped! 

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@Raster

 Peels can be done for "monomorphic" scarring or as you know fully ablative erbium resurfacing. Few I have found do this like Dr. Lim who overrides the Profile's settings and treats free-form by hand... Most doctors are doing fractional erbium or a "light preset peel" - which you need several of. This is why I think a strong sedated peel with a doctor weather Phenol or TCA is much better and more widely available for texture issues. They do the same thing for texture irregularity if performed by a expert (The point is you need it deep enough to get under the scars).

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