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Toni94

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Hi,

You have mainly Icepicks, box cars, and a few rolling scars. Your main treatment will be TCA Cross.

You can subcise any of the larger pits, I would use saline and or cupping method after having this done as they are pretty superficial on the skin.

I would get RF needling done (many brands), you do them around your subcision appointments. This will work especially well on your temples, etc.

You have alot of TCA Cross work that needs doing. They will raise your scars by treating the scar bed.

Finally you will do A few TCA peels for texture or get erbium laser resurfacing done. Most of your scars are monomorphic and superficial so this could take care of alot of them but doing more things could give you better outcome.

If you want to learn about subcision, tca cross, etc... Goto the Top post of the scar treatments sub, called FAQ, find those sections, read the link for TCA peels firt page. Acne scars take time to heal between treatments, usually a few months, as you have time and money. Stop at any time. TCA Cross should be a definite.  

Your scars will improve a lot, as they are extremely superficial. Stop the dermapen, ... RF microneedling would be a better choice. 

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28 minutes ago, beautifulambition said:




 

Thank you for the reply.

How much do you think could my scars improve? 30%? 50? 100!!!!? Haha I guess it is impossible to have our skin as  if we had never had acne.

I'd never heard of RF needling. I've look it up and it says it is radio frequency needling and google shows big devices which If I'm not mistaken can just be used  by a doctor. Am I right or can I get something (rf needling) to treat my skin at home? 

Dou you recommend me to get a device like terminator to use at home?  

Subcision, TCA cross, RF needling, lasers...you've given me a lot of different treatments. Are all of them "compulsory" if I want to improve a lot? 

Edited by Toni94

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I don't give percentages as I don't feel it's fair to the patient or myself. We all heal differently. That being said your scars are very minor and expect great results if you heal well. 

RF Microneedling is done by a doctor, subcision is done by a doctor. IF you are telling me you do not want to goto a doctor or you have no money to goto a doctor, ... the results will not be as good of course but you can do the TCA Cross at home and peels at your own risk. We have a full guide of how to stay safe in the FAQ as I mentioned above. This will take many months to accomplish, the body does not heal quick and needs months in between. 

No don't get the derminator, you have / had the dermapen done. Your scars respond best to Cross. Microneedling will do very little for you. RF Microneedling is not at home microneedling, it's a stronger treatment. 

No Just tca cross and peels are necessary, everything else is optional. 

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39 minutes ago, beautifulambition said:

I don't give percentages as I don't feel it's fair to the patient or myself. We all heal differently. That being said your scars are very minor and expect great results if you heal well. 

RF Microneedling is done by a doctor, subcision is done by a doctor. IF you are telling me you do not want to goto a doctor or you have no money to goto a doctor, ... the results will not be as good of course but you can do the TCA Cross at home and peels at your own risk. We have a full guide of how to stay safe in the FAQ as I mentioned above. This will take many months to accomplish, the body does not heal quick and needs months in between. 

No don't get the derminator, you have / had the dermapen done. Your scars respond best to Cross. Microneedling will do very little for you. RF Microneedling is not at home microneedling, it's a stronger treatment. 

No Just tca cross and peels are necessary, everything else is optional. 

Ok thank you very much.

I understand you don't wanna give percentages but, could you tell me the number of TCA cross-TCA peeling sessions I'll need to get great results? 

I didn't even know TCA cross procedure. I knew about TCA peels but not putting it just in the scars. What's the % of TCA that you personally recommend for both cross and peeling procedures?

Now I do have the money to undergo these treatments. The problem is that here in Spain the treatments are a bit different. Subcision is not famous unless you go to a big city. I guess TCA cross is not widely available either. My choices when I visited my doctor were:

-Acid peels, with a range of acids to choose (TCA, glycolic, etc...)
-Dermapen
-Microdermoabrasion
-Laser (Co2, Fraxel, pixel, etc...) This one not recommended by the doctor because of the price, downtime, risk of side effects while healing up, etc...

I'm asking you this so that I can go to my doctor and even if she doesn't use TCA cross, I can tell her to do it as she just has to use high concentration TCA filling my skin and cleaning it afterwards. 

Besides my icepicks, will I notice any improvement in my other type of scars if I undergo TCA cross and peelings?

And finally, do you think I should continue using the gel I use at nights or would It be better to start using retin-a whilst I receive the other treatments?


Could you tell me how many sessions and the time between treatments you recommend me? I think you know more than my doctor as her expertise is more related to anti-aging procedures, liposuction, etc...
  Edited by Toni94

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With tca cross the dr should just clean your skin and apply tca at a high % into the correct scar.a scab will form of some type and drop off or go away within 7 days,then the scar is red,this is healing,you need to wait the required time between treatments,6 weeks to 3 mo ths then repeat.you will see improvement but takes more than one treatment usualy.

after them scars are healed,tca peels at a 30%ish after working up from lower will even out the texture if your skin.
:)

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45 minutes ago, Quadboy said:

With tca cross the dr should just clean your skin and apply tca at a high % into the correct scar.a scab will form of some type and drop off or go away within 7 days,then the scar is red,this is healing,you need to wait the required time between treatments,6 weeks to 3 mo ths then repeat.you will see improvement but takes more than one treatment usualy.

after them scars are healed,tca peels at a 30%ish after working up from lower will even out the texture if your skin.
:)

I didn't know TCA was so effective to improve acne scars. Such a simple and relatively cheap treatment with that results is amazing, isn't it? No needles, no devices, short downtime...too nice to be true hahaha. :)

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Tca cross is the definative absolute best method for certain scar types,i have done it on many ice pick and smaller deeper boxcar with great success.some scars can be stubborn but they will budge so you gonna probably need a minimum of 2-3 treatments in the right scar type,just to get the scar level out to the rest of skin,then resurfacing can be done with a better outcome.
:)

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2 hours ago, Quadboy said:

Tca cross is the definative absolute best method for certain scar types,i have done it on many ice pick and smaller deeper boxcar with great success.some scars can be stubborn but they will budge so you gonna probably need a minimum of 2-3 treatments in the right scar type,just to get the scar level out to the rest of skin,then resurfacing can be done with a better outcome.
:)


Thanks!!

How much do you pay (average) in the US for either a TCA cross or peeling. I've noticed that prices vary a lot there from one doctor to another. I paid 150€ for each dermapen session, whereas in the US doctors charge from 150$ to 600-700$.

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7 hours ago, Toni94 said:

Thanks!!

How much do you pay (average) in the US for either a TCA cross or peeling. I've noticed that prices vary a lot there from one doctor to another. I paid 150€ for each dermapen session, whereas in the US doctors charge from 150$ to 600-700$.
How much a doctor charges for TCA cross or a TCA peel is a telltale sign of the doctor's ethics in my opinion.  You're absolutely right: some doctors will charge $100 for a TCA peel and others will charge close to $600.  Some in Beverly Hills charge close to $1000 for a full-face peel.   There's really no rhyme or reason for the procedure to cost so much especially when a bottle of TCA is so cheap to purchase.  It's extremely hard to determine averages when this is based on a doctor's ethics, location of the office or practice,  and whether the doctor is choosing to charge more based on the necessities of the practice.  If any sedation is required, this increases the price as well.  Edited by UpliftingCat

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I do not believe in International price shopping. I know your curious. Our currencies are all different and universal healthcare / medicare supplements vs out of pocket aesthetics fees.  you have general practitioners and med spas charging high fees and doctors charging low fees. Get a scar expert who does this often, they do several peels a month and especially for scarred patients.  Experience does cost more. Dr. Rullan is very honest for instance. His sedated deep peel feel is over $2500, so you see anesthesia  and the staff and operating room cost money. This is the average fee I have found for sedated peels. If you want to price shop or get a aprox, ...goto realself.com, treatments, and click the average cost for the treatment. A light tca peel at a med spa is going to be cheaper again than a sedated deep peel by a experienced doctor. 

Laser ... some in Europe only spend a few hundred dollars on laser resurfacing, ... in The US this is thousands $$$$ out of pocket and you need a few. See we cannot compare. These laser machines are over 100K most of the time, so they pay of the cost before something new comes out.

If you live somewhere were these treatments are not offered, I would suggest the doct is not very good. They don't have the experienced with scar patients and are not a expert. You get what you pay for. Will they say they can treat you yes $$$$. Goto a city or travel to someone with experience. Otherwise your at the mercy of their profit not of the befit to fix your issues.

Your Dr sounds like a standard laser Dr who does not do peels, so she probably wants to do laser. In that case you can do whatever machine she or he has. Erbium is substituted by some doctors for peels but the results cannot be as good with unskilled Drs who are not experienced with scar settings and treatments. 

It's up to the patient to find who does the treatment close to you that meets your budget and time constraints. I gave you basic advice from peer journals that are specialized to your scar issues. Many have had improvements here with these treatments. What you decide or don't decide to do is up to you.

Everything about TCA again is in the Scar  Treatments, goto the top of this post and click on that word above your post, first post, faq, tca section, click the link and read the long first page about peels. 

OF course you need both cross and tca peels. One works on the scars and the other blending the surface texture. 

If they have subcision and peels in the city then go there. Some travel to other countries on a cheap flight. 

Dermapen will do nothing for your scar type, microderm will be a waste of time and money, fraxel will do little for your scar type.  They have tca peels. I do not know if they have rf miconeedling ie. intracel, intensif, vivance, infini, secret, etc...

Yes you will notice improvements, with other scar types with peels / cross (you will need several). Subcision before will give you results as well. RF microneedling more. 

Stop the gel while treating / healing. Talk to a dermatologist regarding this and treatment. You can try tretinorin or retin a, ... sold OTC in Spain at the pharma. 


3 months between treatment, no rush, do what you have time and money for . You can start you first cross and subcision sooner or at once.


 

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6 hours ago, UpliftingCat said:
How much a doctor charges for TCA cross or a TCA peel is a telltale sign of the doctor's ethics in my opinion.  You're absolutely right: some doctors will charge $100 for a TCA peel and others will charge close to $600.  Some in Beverly Hills charge close to $1000 for a full-face peel.   There's really no rhyme or reason for the procedure to cost so much especially when a bottle of TCA is so cheap to purchase.  It's extremely hard to determine averages when this is based on a doctor's ethics, location of the office or practice,  and whether the doctor is choosing to charge more based on the necessities of the practice.  If any sedation is required, this increases the price as well. 
Is a numbing cream (like the one used before dermapen) enough to undergo TCA cross sessions? Obviously such a high % needs sedation but I don't know if the doctor just uses a cream before the procedure or if I need sth more serious...

EDIT: I guess by saying sedated you meant that I'll need to go to the OR... not tu use a simple anaesthetic cream.

Thanks. Edited by Toni94

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6 hours ago, beautifulambition said:

I do not believe in International price shopping. I know your curious. Our currencies are all different and universal healthcare / medicare supplements vs out of pocket aesthetics fees.  you have general practitioners and med spas charging high fees and doctors charging low fees. Get a scar expert who does this often, they do several peels a month and especially for scarred patients.  Experience does cost more. Dr. Rullan is very honest for instance. His sedated deep peel feel is over $2500, so you see anesthesia  and the staff and operating room cost money. This is the average fee I have found for sedated peels. If you want to price shop or get a aprox, ...goto realself.com, treatments, and click the average cost for the treatment. A light tca peel at a med spa is going to be cheaper again than a sedated deep peel by a experienced doctor. 

Laser ... some in Europe only spend a few hundred dollars on laser resurfacing, ... in The US this is thousands $$$$ out of pocket and you need a few. See we cannot compare. These laser machines are over 100K most of the time, so they pay of the cost before something new comes out.

If you live somewhere were these treatments are not offered, I would suggest the doct is not very good. They don't have the experienced with scar patients and are not a expert. You get what you pay for. Will they say they can treat you yes $$$$. Goto a city or travel to someone with experience. Otherwise your at the mercy of their profit not of the befit to fix your issues.

Your Dr sounds like a standard laser Dr who does not do peels, so she probably wants to do laser. In that case you can do whatever machine she or he has. Erbium is substituted by some doctors for peels but the results cannot be as good with unskilled Drs who are not experienced with scar settings and treatments. 

It's up to the patient to find who does the treatment close to you that meets your budget and time constraints. I gave you basic advice from peer journals that are specialized to your scar issues. Many have had improvements here with these treatments. What you decide or don't decide to do is up to you.

Everything about TCA again is in the Scar  Treatments, goto the top of this post and click on that word above your post, first post, faq, tca section, click the link and read the long first page about peels. 

OF course you need both cross and tca peels. One works on the scars and the other blending the surface texture. 

If they have subcision and peels in the city then go there. Some travel to other countries on a cheap flight. 

Dermapen will do nothing for your scar type, microderm will be a waste of time and money, fraxel will do little for your scar type.  They have tca peels. I do not know if they have rf miconeedling ie. intracel, intensif, vivance, infini, secret, etc...

Yes you will notice improvements, with other scar types with peels / cross (you will need several). Subcision before will give you results as well. RF microneedling more. 

Stop the gel while treating / healing. Talk to a dermatologist regarding this and treatment. You can try tretinorin or retin a, ... sold OTC in Spain at the pharma. 


3 months between treatment, no rush, do what you have time and money for . You can start you first cross and subcision sooner or at once.


 

Thank you. 

Are TCA peels-cross so strong that you require an OR? I'd thought a numbing cream would be enough lol. 

Do you recommend me getting the derminator to use it around other treatments? You told me above that micronnedling will do nothing for me and therefore it is not recommended to treat my scars. But, if I have TCA peels and cross (and maybe subcision too) as main treatment, could be needling at home an extra to get even better results? It is quite cheap (130€) and I can use it once in awhile as an accessory, focusing on the other treatments which you said.

Do you really think my scars are very shallow?hahaha maybe it's an obsession but I see them quite deep :(
  Edited by Toni94

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TCA Cross does not require anesthesia as it's in a extremely small spot.  For your comfort they can use a topical numbing cream if you wish or you can buy one Over the Counter. 

When I say a sedated peel at the end, I mean the doctor gives you laughing gas or other anesthetic for a deeper peel. This is only done at the end. The RF microneedling also requires a painpill and topical anesthetic. 

TCA cross can be done in any doctors office or med spa, ... no special space is needed. Even normal peels it's the same thing. For a deep peel to really get under the scars at the end of treatment yes sedation is required. Otherwise you can do a few medium strength peels with standard numbing cream, it just takes more / longer period of time... 

I would recommend RF microneedling, ...  But sure the derminator , ...They work completely different. 
If you wish to do the derminator as a at home treatment you can. I just don't see it giving you a ton of change. It would be more for upkeep than remodeling. It would be fine to do needling and peels at home if you wish, many do that to save some money. 


I have have helped thousands of scar suffers, ... yes your scars are quite minor and you can get good results with the right Doctors / treatments. Don't let them sell you other things that don't work. You can do miconeedling at home.   

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57 minutes ago, beautifulambition said:

TCA Cross does not require anesthesia as it's in a extremely small spot.  For your comfort they can use a topical numbing cream if you wish or you can buy one Over the Counter. 

When I say a sedated peel at the end, I mean the doctor gives you laughing gas or other anesthetic for a deeper peel. This is only done at the end. The RF microneedling also requires a painpill and topical anesthetic. 

TCA cross can be done in any doctors office or med spa, ... no special space is needed. Even normal peels it's the same thing. For a deep peel to really get under the scars at the end of treatment yes sedation is required. Otherwise you can do a few medium strength peels with standard numbing cream, it just takes more / longer period of time... 

I would recommend RF microneedling, ...  But sure the derminator , ...They work completely different. 
If you wish to do the derminator as a at home treatment you can. I just don't see it giving you a ton of change. It would be more for upkeep than remodeling. It would be fine to do needling and peels at home if you wish, many do that to save some money. 


I have have helped thousands of scar suffers, ... yes your scars are quite minor and you can get good results with the right Doctors / treatments. Don't let them sell you other things that don't work. You can do miconeedling at home.   

Yeah I'll go with TCA peels and cross, that's for sure and I'll consider to have subcision. I'll give a shot to the derminator too. As you said, maybe it is not useful to remove scars but it will help with my skin overall, which is important too. 

Last of all, is it a good idea to have both TCA peel and cross together the same day, (focusing first on the scars with 75-100% and then all over the face with 30-50%), or better to have them on different days?



btw beautifulambition, how did you tell apart my acne scars? I looked on the internet before opening this thread and I struggled to find out which are the type of scars I suffer. 

When we google "icepicks" we can see very deep holes, which seem pits with no end. I don't see those holes on my skin. The same with boxcars and rolling scars... Imposible to differentiate anything... I just see lots of scars. Please, could you tell me where I have each kind of acne scars? (temples, cheeks and forehead which are the parts where I suffer them).

On the internet icepicks are shown as deep, endless pits. Rolling scars are mere ripples and boxcars have different shapes depending on the image we click on.

Edited by Toni94

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Hello dear friend,can you take photos under a bright light or using a flashlight too?I know that this will be depressing but will help these expert members here to give you better directions about your scars.

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@Toni94'

Toni, I agree w/ Tashinhoooo I cannot judge your scars from the posted extra pics, ... scars make shadows. Please use a directional light to show me the shadows in various angles. I can then further asses your scars better. I was simply going off the first pic(s) you posted. 3,4,8,9 pics posted down from the top show icepick like marks. No you don't do tca peels on the areas of concern and tca cross the same day, ... different days is better ( if you want to heal better, some do it all at once but I have seen some messed up patients who did combo treatments - but yes it can be done at the same time if you wish).  You can also treat only some areas of your face of concern and rotate to get them all. Again as I said above the body heals very slowly, you need some months in between treatment. You tca cross and then you heal and do it again, don't rush things (this is from experience of again people doing mega treatments - they are possible but should we do them is the point I make, time and money is always a factor here - traveling). Icepick's and even some box cars work with tca cross if they have defined borders and are of a smaller diameter.

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20 hours ago, Toni94 said:
Is a numbing cream (like the one used before dermapen) enough to undergo TCA cross sessions? Obviously such a high % needs sedation but I don't know if the doctor just uses a cream before the procedure or if I need sth more serious...

EDIT: I guess by saying sedated you meant that I'll need to go to the OR... not tu use a simple anaesthetic cream.

Thanks.
You shouldn't need numbing cream for a TCA peel.  It's painful but the pain is short-lived. An assistant should use a hand-held fan to cool your face after the doctor has applied the acid.  Cold compresses can also relieve any burning sensation.   I would get TCA cross at the same time you get a full-face peel; there's no need to schedule two separate procedures.  My doctor treats my pits first with TCA cross and then treats specified areas with a medium depth peel but still goes over the areas that frosted from the CROSS.  

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23 hours ago, tasinhoooo said:

Hello dear friend,can you take photos under a bright light or using a flashlight too?I know that this will be depressing but will help these expert members here to give you better directions about your scars.

7 hours ago, beautifulambition said:
@Toni94'

Toni, I agree w/ Tashinhoooo I cannot judge your scars from the posted extra pics, ... scars make shadows. Please use a directional light to show me the shadows in various angles. I can then further asses your scars better. I was simply going off the first pic(s) you posted. 3,4,8,9 pics posted down from the top show icepick like marks. No you don't do tca peels on the areas of concern and tca cross the same day, ... different days is better ( if you want to heal better, some do it all at once but I have seen some messed up patients who did combo treatments - but yes it can be done at the same time if you wish).  You can also treat only some areas of your face of concern and rotate to get them all. Again as I said above the body heals very slowly, you need some months in between treatment. You tca cross and then you heal and do it again, don't rush things (this is from experience of again people doing mega treatments - they are possible but should we do them is the point I make, time and money is always a factor here - traveling). Icepick's and even some box cars work with tca cross if they have defined borders and are of a smaller diameter.
5 hours ago, UpliftingCat said:
On 25/1/2018 at 0:58 PM, Toni94 said:
Is a numbing cream (like the one used before dermapen) enough to undergo TCA cross sessions? Obviously such a high % needs sedation but I don't know if the doctor just uses a cream before the procedure or if I need sth more serious...

EDIT: I guess by saying sedated you meant that I'll need to go to the OR... not tu use a simple anaesthetic cream.

Thanks.

You shouldn't need numbing cream for a TCA peel.  It's painful but the pain is short-lived. An assistant should use a hand-held fan to cool your face after the doctor has applied the acid.  Cold compresses can also relieve any burning sensation.   I would get TCA cross at the same time you get a full-face peel; there's no need to schedule two separate procedures.  My doctor treats my pits first with TCA cross and then treats specified areas with a medium depth peel but still goes over the areas that frosted from the CROSS.  
@tasinhoooo  @beautifulambition In the pics I've posted my scars look more or less as if taken with bright light. I took them searching an angle that shows my scars. 

l will try to get some more with other different perspectives to see if your opinion changes...

@UpliftingCat That's what I'd thought. If TCA cross is with 80 or 100%, using right after 20 or 30% all over the face shouldn't produce any damage as the concentration is much lower than the first used. Anyway, beautifulambition says it is not always recommended. I'll ask my doctor to see what she thinks.


Thank you all!!

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Ok lets go full circle. The treatments I offered above will work. They all work on different layers and different issues.  
 

Quote
You can subcise any of the larger pits, I would use saline and or cupping method after having this done as they are pretty superficial on the skin.

I would get RF needling done (many brands), you do them around your subcision appointments. This will work especially well on your temples, etc.

You have some TCA Cross work that needs doing. They will raise your scars by treating the scar bed.

Finally you will do A few TCA peels for texture or get erbium laser resurfacing done. Most of your scars are monomorphic and superficial so this could take care of alot of them but doing more things could give you better outcome.

If you want to learn about subcision, tca cross, etc... Goto the Top post of the scar treatments sub, called FAQ, find those sections, read the link for TCA peels firt page. Acne scars take time to heal between treatments, usually a few months, as you have time and money. Stop at any time. TCA Cross should be a definite.  

Your scars will improve a lot, as they are extremely superficial. Stop the dermapen, ... RF microneedling would be a better choice. 

The only change with the additional pics you provided is I feel you need subcision. 

* Subcision with or without filler... Chinese cupping (3 treatments)
* Rf microneedling (done around subcisions).
* TCA Cross
* TCA sedated deep peel, or many medium strength tca peels, or erbium laser ablative resurfacing to get under scars



IF you want to do peels and cross together that's fine, the doctor will do it more $$$$ at one time for them. It's all about logistics, how your body heals, and your Dr's experience. 

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18 hours ago, Toni94 said:
@tasinhoooo  @beautifulambition In the pics I've posted my scars look more or less as if taken with bright light. I took them searching an angle that shows my scars. 

l will try to get some more with other different perspectives to see if your opinion changes...

@UpliftingCat That's what I'd thought. If TCA cross is with 80 or 100%, using right after 20 or 30% all over the face shouldn't produce any damage as the concentration is much lower than the first used. Anyway, beautifulambition says it is not always recommended. I'll ask my doctor to see what she thinks.


Thank you all!!
No, it will not produce any damage because 20-30% will not even come close to the depth icepick scars need to be treated at and will not produce any scar tissue. The goal of 100% TCA is actually to create scar tissue to cause the icepick scars to begin to raise overtime.  You are essentially trading one scar for a better looking scar.  With a 20-30% TCA peel you are only getting down to the papillary dermis. 

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10 hours ago, beautifulambition said:

Ok lets go full circle. The treatments I offered above will work. They all work on different layers and different issues.  
 


The only change with the additional pics you provided is I feel you need subcision. 

* Subcision with or without filler... Chinese cupping (3 treatments)
* Rf microneedling (done around subcisions).
* TCA Cross
* TCA sedated deep peel, or many medium strength tca peels, or erbium laser ablative resurfacing to get under scars



IF you want to do peels and cross together that's fine, the doctor will do it more $$$$ at one time for them. It's all about logistics, how your body heals, and your Dr's experience. 
 Thank you very much for all your help. It's been very useful. I've search for practices which perform those treatments and there is a lot of them in Valencia, just 50 km from where I live. 

I'm going to contact them. I'll ask the price of subcicion+ tca peel and cross. They also have RF but I'm afraid all the treatments will be too expensive and I do not want to spend that much.

EDIT: I've read on this forum that subcision+TCA cross can be performed the same day. Then, around sessions TCA peels. 

1-tca cross+subcision
2-tca peeling
1
2
1
2
etc


How much time (estimate, I know we all are different :P) will this take? Let's say I start in February. 

The climate here is like in LA. From February to November the sun will burn around the midday. From May to September the sun will always burn. Obviously I'll use solar screen but maybe I have to take a break during the summer... Edited by Toni94

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You don't have to do a mega treatment, you can only do parts at a time. RF microneedling is affordable if you space out your treatment when you have time to heal and the funds. 

Many take 3 years to heal. The minimum people do is 1 month between treatments when they are healed from the last one. But the body does not heal like this it takes about 3 months minimum. 

You can stop at any time if you need to take summer off etc... The choice is yours when to do things. 

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