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Scars after 2 TCA Cross procedures

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Hey everyone,

I've been a lurker for many years but decided to reach out and ask your opinion on what I should do for my scars. I've had 2 TCA CROSS treatments within the last 8 months.

Session 1: Dec, 20th 2017
Session 2: March 2nd, 2018

I'd say I got maybe 15% improvement. The pits don't really look much better. I'm planning on doing a 3rd TCA CROSS next week. If anyone has any other ideas I should try please let me know. Apologies that the last pic is in dark lighting, I'll update the pics soon.

I've done micro needling in the past (years ago) with no improvement. I'm also considering doing a full face TCA peel of roughly 20-25%. I've done one in the past on my ethnic skin with no further hyper-pigmentation issues, and my skin texture was great for about 2 weeks.

January 23rd, 2017

[Media removed]

Feb 28th, 2017, before my 2nd TCA CROSS

[Media removed]

July 20th, 2018

[Media removed]

Edited by MadsKeystone
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Thank you for posting.

As you probably know you have surface boxcars and rolling scars with some icepicks. IT's mainly a textural problem. No major fat loss.

I would continue to do TCA Cross sessions. It takes many and as you know gives a small percentage with each treatment of improvement. 

I would in your case do 4 cannular subcision under all the areas of scarring, space them 3 months apart or whenever the filler runs out. You could do the subcision with a bit of HA filler or sculptra, PRP, or saline. Sculptra is helpful in a case like yours with widespread scarring as it stimulates collagen.  

I would do RF microneedling between your subcision sessions. If you do Sculptra it will also stimulate further collagen. 3-4 Sessions are needed 3 months apart. Or you can do 3-7% density CO2 at the highest power setting only on the scarred areas. RF needling is better in ethnic patients as the epidermis is protected.

Continue your tca cross sessions for the smaller icepicks and do paint on tca a.k.a. spot  peels (30% 3 coats - only inside of the "larger" boxcars, no drips or excess, you can use a makeup brush or q-tip). 

Finally you will resurface fully ablative erbium for texture or multiple medium strength tca peels, or a deep acid peel.

Treat as you have time and money. 

Because of ethnic skin use differin / tretinorin / retin-a nightly and a konjac albutin cream to prevent hyperpigmentation. Stop one week before treatments.


Edited by beautifulambition
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I can only see the before picture from your left side and the after is from the right side?  Is it only me or how can we see the difference if you post different before (left side) and after pics (right side)? 

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