Hard to tell with the facial hair. I see large pores and some icepicks / smaller linear scars. I would do several sessions of tca cross to the pores/icepicks/linerar scars.

Fraxel, or clear and brillant for the pores or... rf microneedling.

If you wish to try microneedling or the derminator at home you can do so to start. You will also need to alternate with peels. There is a guide in the FAQ, top post of the acne scar sub, first post, then goto the acid section, mega post.

Please note over exfoliation can make the pores/ icepicks look bigger.

I visited Dr Monique Wilson at California Skin Institute, Sunnyvale.
She suggested TCA Cross for Ice Pick and Fraxel for overall.
Given the heavy tag of $4500 for fraxel per session, wary of trying it.

I have scheduled my TCA cross with her and thinking of starting derminator along with it.

Hi @cali_scarsI would just do microneedling with her, ... that price is crazy but it is the bay area. Shop around for prices. Socal is cheaper if you fly down there. Med spa's are also a option. Good stay with TCA cross first, ... will take several sessions. CA - skin institute is price fixing the bay area, hence the high prices. They get a cut as well and boost the price. Shop around even Modesto.

BA

@beautifulambition
Thanks for the recommendation.

She suggested other options like micro needling, subcision based on Fraxel + TCA results. She was more pushing for fraxel.
My major concerns are the big ice picks, will get TCA session based on results.
For TCA, she is charging me $300 per session. I know many people do that at home. will look more into it.

Should I get a derminator too?

@cali_scarsSure I would get the demrinator, ... it's cheaper than these places doing the treatment.

I think you will benefit most from tca cross, and fraxel or co2 3-7% low density and the highest power . IT will take many sessions of tca cross. Allow proper healing time. Before delving into a home tca, perhaps have her do it ocne to see how you react, etc... We have a full guide in the FAQ - top post of the acne treatments sub, first post, goto the tca section, the mega link for peels.

TCA work is based on skill, hopefully she is good as there are many methods of application. Dr Rullan is excellent and in SD if you can fly down for a few hrs, ... as a option if needed.

Worry about laser once you try cheaper at home treatments or your tca cross with the doc.

BA

So, Just back from TCA cross session. She just did it for 5 scars, saying others would benefit more from laser.

She also said we can combine TCA + micro needling, I have read other way round here.

Planning to get one more TCA session done. Then start Derminator at home. 

Booked appointment with Dr Rullan on 11/28. He suggested TCA + microneedling + subcision. Gonna be bit of a drive, but fingers crossed.

Excellent decision!

Just back from Dr Rullen.

He started with carbolic cross, he covered small ice pick scars which Dr. Wilson suggested cant be benefitted from cross.

Second step was subcision after numbing. I was not in favor of subcision, but he said It would benefit my overall texture.

Then finally microneedling with 36 pin 'Collagen Pin'pen. Will post my pics are swelling/scabs gone.

Any tips to recover from swelling? I need to get back to work on Monday.

Recovery and swelling tips are in the FAQ, first post of the scar treatments sub. Prop your head up while sleeping, sunscreen, you can use a occlusive like vaseline over the spots until they heal, be gentle, no scrubs and light on the skincare. Overall there is not much to worry about after a procedure if you live a healthy lifestyle and are not hard on the healing areas.Because of your skintone, once the spots heal, use your retin-a/tretinorin/differin nightly with the konjac licorice cream again.

@beautifulambition'thanks for the reply. Did you meant kojic acid licorice cream? can you please tell the brand name or similar products.

do Ineed to useretin-a/tretinorin/differin nightly as I dont have active acne,

Amy from Dr Rullan office advised to use Hydrocortisone with aloe.

@cali_scarsYou do need a active form of retinoid. Hence I said retin-a/tretinorin/differin this is not for acne, that is only one usage, your using it because you have ethnic skin and you need cell turnover or you will hyperpigment, this prevents that. It's a vitamin A derivative most people use for anti aging purposes over acne purposes.

Konjac and Kojic acid are the same thing, one is the constituent of the ingredient ;-). They are considered whitening creams.

I would not use hydrocortisone, ... do you know this thins your skin and if used over a week or two can lead to damage, the recommendations I gave are the international standard for ethnic skin. There are a ton of brands on Amazon with licorice and kojic acid for whitening, that work, just look at the reviews .

Dr Rullan is your derm follow his directions, I only provided general guidance.

Since he mentions what I have said for years, especially for ethnic skin and prep/compliance ;-P... @12 mins 20secs

Update since my November visit:

I see difference in lower cheeks, maybe bcos of subcision.

Big Ice pick scars have reduced a little. Next session scheduled in May.

Dr Rullan suggested using Tazorac gel and maybe getting on low dose Accutane to control oil which can cause the pores to look bigger and the orange peel effect

He will be doing the same procedures again and maybe erbium laser instead of the microneedling.

I received my derminator 2. Will start needling in march and will look into peels too.

Thanks,

J.S

dude your scars improved tremendously

congratulation for your results

Just back from 2nd appt with Dr Rullan. Started with Cross, then Subcision and Erbium laser. This time it was pretty quick. I was out of the clinic in 1 hour, less swelling and pain. Will post pictures after scabs fall off.

On 10/13/2018 at 8:36 AM, cali_scars said:

I visited Dr Monique Wilson at California Skin Institute, Sunnyvale.
She suggested TCA Cross for Ice Pick and Fraxel for overall.
Given the heavy tag of $4500 for fraxel per session, wary of trying it.

I have scheduled my TCA cross with her and thinking of starting derminator along with it.

4500$ for a sessione of Fraxel? What a scammer, barely can believe it. I would have laughed in her face.

On 5/25/2019 at 3:44 PM, SimpleMutton said:

4500$ for a sessione of Fraxel? What a scammer, barely can believe it. I would have laughed in her face.

Yes, Just for fraxel.

She charged me $300 for just three ice pick scars. I thought its for whole face , but was really disappointed when she didnt'do for other scars.After my objection she did 2 more. She was pushing more for just laser, no 2nd TCA.

In general, I didn't enjoyed talking to her, she was not interested in my scarsor me.

With Dr Rullan and staff you can talk for hours and discuss. Hesaid new doctors are trained for Lasers and thats what they just recommend. He also did micro-needling for forehead stitch scarfor no extra charge.

Update:

Almost a month since last session with Dr Rullan.

My left cheek is lot smoother,  right is getting there.

I notice few ice picks bigger after this session. I am thinking of trying out my Derminator/peels for 6 months before deciding for another session with Dr Rullan.

@beautifulambitionHi, How long should I wait to start Derminator ? There was some pain in my upper cheeks when you press them for few weeks.

@cali_scarsYou can derminator 3-4 weeks after your subcision. Once your fully healed. The pain is your body healing from the subs.