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rina22

Boxscar/icepick. Please advice guys

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Hi guys, 

 

I'm a new forum member seeking for some advice. My acne scars are pretty old - around 15 years (please see a pic). I've done 2 co2 lasers, PRP, dermapen and collagenases. The result is barely noticeable. Shall I continue with laser treatments or try a subcision/excision? I'm also thinking about dermabrasion, but heard it can be way too aggressive for me. 

 

What would you recommend in my case? Any advice would be much appreciated. 

 

Thanks, 

Rina 

IMG_0352.jpg

Edited by rina22
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Looks very mild, but for these type of scars, icepick , narrow boxcar/linear, gold standard treatments are TCA Cross or punch excision followed by laser 

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Look into TCA Cross before you shell out more money for laser treatments. Cross is more suited for ice pick and narrow boxcar scars. Consult with a doctor who is experienced with this.

Subcision is not the treatment for your scars. It's mainly for rolling scars and wider boxcar scars. 

I had Dermapen done once and my skin ended up being worse. You can buy your own microneedling kit and do it yourself cheaply.

Dermabrasion has fallen out of favor for many doctors because of the risk of hypopigmentation. However, if you have fair skin, you're at a much lower risk to experience this. Not many doctors perform dermabrasion as far as I know.

Excisions are a bit tricky. They're like a box of chocolates... results are unpredictable. You might end up with a linear scar that looks worse than your original scar. If you had a huge scar, the risk is much more worth it. But your scars are not big.

CO2 laser treatments (I've only done fractional) are very operator-dependent. Most doctors don't know the right settings so you really can't say every CO2 treatment is the same. It's not like microneedling where the doctor or nurse just has to run over your face with the tool. Or fillers where they just inject under the skin and the results will be pretty close. 

I've never done PRP. For me personally, I would invest the money in other things. A dermatologist was going to charge me a ton for Infini and PRP. I went to my plastic surgeon who said PRP was BS and I ended up doing Infini with him. I think PRP is more for  recovery rather than scar improvement.

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Hey, but please start slow. If you follow the advice of the users and try TCA Cross; then start with a low percentage of TCA Cross. TCA Cross can also damage your skin and I think your skin looks good. So please be careful. I wouldnt do anything about the scarring because it's so mild.

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3 hours ago, Ndwscar said:

Looks very mild, but for these type of scars, icepick , narrow boxcar/linear, gold standard treatments are TCA Cross or punch excision followed by laser 

Thanks a mil for your advice!

3 hours ago, Amanda Hall said:

Look into TCA Cross before you shell out more money for laser treatments. Cross is more suited for ice pick and narrow boxcar scars. Consult with a doctor who is experienced with this.

Subcision is not the treatment for your scars. It's mainly for rolling scars and wider boxcar scars. 

I had Dermapen done once and my skin ended up being worse. You can buy your own microneedling kit and do it yourself cheaply.

Dermabrasion has fallen out of favor for many doctors because of the risk of hypopigmentation. However, if you have fair skin, you're at a much lower risk to experience this. Not many doctors perform dermabrasion as far as I know.

Excisions are a bit tricky. They're like a box of chocolates... results are unpredictable. You might end up with a linear scar that looks worse than your original scar. If you had a huge scar, the risk is much more worth it. But your scars are not big.

CO2 laser treatments (I've only done fractional) are very operator-dependent. Most doctors don't know the right settings so you really can't say every CO2 treatment is the same. It's not like microneedling where the doctor or nurse just has to run over your face with the tool. Or fillers where they just inject under the skin and the results will be pretty close. 

I've never done PRP. For me personally, I would invest the money in other things. A dermatologist was going to charge me a ton for Infini and PRP. I went to my plastic surgeon who said PRP was BS and I ended up doing Infini with him. I think PRP is more for  recovery rather than scar improvement.

Hi Amanda, 

 

Thank you for your feedback. I've started looking for the dermatologist who can do Cross. By the way, many doctors have advised me to look into RF needling procedures combining with some collagen injections. I personally don't think it will make a big difference. What would you think about this option? 

3 hours ago, getsmart121 said:

Yes tca cross seems the best solution in your case.

Thanks a lot! 

2 hours ago, SalientDouble said:

Hey, but please start slow. If you follow the advice of the users and try TCA Cross; then start with a low percentage of TCA Cross. TCA Cross can also damage your skin and I think your skin looks good. So please be careful. I wouldnt do anything about the scarring because it's so mild.

Thanks so much for your kind advice, I will definitely be careful. 

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10 hours ago, rina22 said:

Hi guys, 

 

I'm a new forum member seeking for some advice. My acne scars are pretty old - around 15 years (please see a pic). I've done 2 co2 lasers, PRP, dermapen and collagenases. The result is barely noticeable. Shall I continue with laser treatments or try a subcision/excision? I'm also thinking about dermabrasion, but heard it can be way too aggressive for me. 

 

What would you recommend in my case? Any advice would be much appreciated. 

 

Thanks, 

Rina 

IMG_0352.jpg

Your skin looks great, if you would have asked me to guess from your skin how old you were I wouldn't have said you were much older than a teenager. Are you from the UK if you are I can recommend some good physicians.

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Do not do excision - please don't risk it. It has cost me 6 months of my life. I had a perfectly deep pinhole ice pick and gave that up for a gash across my cheek that then did not heal and dented my whole cheek. It is just too unpredictable. It is a surgery - a scalpel going after your skin and you give up one scar, which may be smaller for a much bigger problem. If I could go back, I would. I would have just tried to fill up around my ice pick scar that had sunken a bit with age and called it a day. It was a 20 year old scar that I just thought well it is COVID, working from home - let's excise it. Hah, what a mistake. Please try other less invasive treatments. Trying a CO2 fractional laser to try to blend in the coloring, edges and look somewhat 'normal' again. 

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Although her scars are indented to me that is not the worth to take excision risk. Since they are not deep but they have narrow prominent edges tca cross seems best. Try doing cross at lower percent first. start with 30 enough to get the ball rolling and avoid any complications.

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On 9/2/2021 at 11:17 PM, Scarsmakemewanttodie said:

Your skin looks great, if you would have asked me to guess from your skin how old you were I wouldn't have said you were much older than a teenager. Are you from the UK if you are I can recommend some good physicians.

Thank you for your compliment, so sweet of you. Yes I'm from the UK, would love to get recommendations. 

On 9/3/2021 at 2:42 AM, perfectskin_dreamer said:

Do not do excision - please don't risk it. It has cost me 6 months of my life. I had a perfectly deep pinhole ice pick and gave that up for a gash across my cheek that then did not heal and dented my whole cheek. It is just too unpredictable. It is a surgery - a scalpel going after your skin and you give up one scar, which may be smaller for a much bigger problem. If I could go back, I would. I would have just tried to fill up around my ice pick scar that had sunken a bit with age and called it a day. It was a 20 year old scar that I just thought well it is COVID, working from home - let's excise it. Hah, what a mistake. Please try other less invasive treatments. Trying a CO2 fractional laser to try to blend in the coloring, edges and look somewhat 'normal' again. 

Thank you for your kind advise and sorry to hear the excision didn't help. I will definitely try something else. Thank you again! 

On 9/3/2021 at 5:50 AM, getsmart121 said:

Although her scars are indented to me that is not the worth to take excision risk. Since they are not deep but they have narrow prominent edges tca cross seems best. Try doing cross at lower percent first. start with 30 enough to get the ball rolling and avoid any complications.

Thank you for your advise, I'll try Cross indeed. 

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6 hours ago, rina22 said:

Thank you for your compliment, so sweet of you. Yes I'm from the UK, would love to get recommendations. 

Thank you for your kind advise and sorry to hear the excision didn't help. I will definitely try something else. Thank you again! 

Thank you for your advise, I'll try Cross indeed. 

If you are sure on getting excision, I would recommend Dr David Dunaway if you can my mother had a neck injury and he's considered the best craniofacial surgeon in the UK, and he would probably charge approximately a thousand for it he is an expert it scar and would revision and would be much better than seeing a dermatologist for any surgical procedure, then for treatments such as cross and subcision I would recommend the Marylebone clinic the physician is the trained pupil of Dr Chu who has just retired, there you can get subcision and cross for approximately 350 pounds. 

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1 hour ago, harmlessboy1441 said:

You're scars look similar to mine, after a Dermabrasion and some failed TCA cross. You see those little ones in the middle of your cheek, for me I had a dr put TCA in them and it widened them into boxcars for me. Yet other people have swore TCA works wonders. So I don't want to scare you out of TCA nor do I want to encourage it. I would just say talk to doctors carefully first and try to do ONE area first. If you do TCA do not do 3 or 4 spots like me, where every spot increased. Try 1 spot. Pay more if needed to try it. That's my best advice. Don't do like me and try to save money and do 4 spots, do one and try it. It's literally a toothpick dipped in TCA acid by a doctor, it costs them nothing to do 1 first.

Dermabrasion is an option but I agree with the hypopigmentation "risks". For me it feels and looks some days like the area is lighter underneath but I truly can't tell. I only see it in extreme sunlight in a mirror. I'm fair skin like you but whiter/fairer. Dermabrasion helped me by 80-85% it doesn't remove the scars but it basically made them look like the faintest "stretch marks" aka scars with little sign of them, mostly even layer, until environmental aggravates them and they kind of dilated so-to-speak. I seem to have some "rolling texture" issues might be from the Dermabrasion but my doctor sucked he screwed up an excision 7 years later.

One dermatologist at Rutgers told me maybe my pores "dilated" when I asked him why over the day and environment they became uncomfortable and 2x more visible. I think that happens with scars but it might also be more prone with Dermabrasion. But I will attest that no matter what, improvement was vast for me even with that. I'm way too afraid to try lasers. God bless whoever lasers works on though.

I know scars are tougher for a woman but they are very mild, take some solace in that. Feel free to ask me any questions if you need but I mostly explained all my experiences/suggestions.

 

Yup agreed tca can enlarge scars as well depends how you heal. So better to start small and grow from there.

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does anybody here know who does dermabrasion in australia?  have googled everywhere cant find someone if not will consider internationally?

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3 minutes ago, pleasehelp321 said:

does anybody here know who does dermabrasion in australia?  have googled everywhere cant find someone if not will consider internationally?

https://www.drwarwicknettle.com.au/face/dermabrasion-dr-nettle-sydney/

https://www.whatclinic.com/beauty-salons/australia/dermabrasion

Edited by getsmart121
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thanks getsmart121...i just cant get it how i cant seem to find someone who could make these bigger scars of myn cicrcled on LHS into thin line scars??? I really just dont get it how they cant

Inkedthumbnail_20210625_173944 (3)_LI.jpg

I see them in the day in any lighting they are just so big and disfiguring to me...I can live with my RHS but cant stand these on LHS...the sadness this crap has brought me

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If you can see in all lights then maybe you go for excision. I just hope you are not confusing it with a deep rolling scar. Anyways I think user catharis did pretty well in her excision. Apply mini Botox on day of excisin and laser one week after.

did excision cause this in the first place?

If your theory is right about your scar and the excision converts into thin line and you can go all in for the procedure.

the way dermabrasion works it sand down the healthy skin closer to u abnormal skin. Seems your scars are not deep in normal lighting. So it seems like doing this is also a good option again test...

Edited by getsmart121
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yes your right i did do excision to them and this is what happened still the same if not worse maybe didnt heal well or doctor wasnt good...i think excision made them worse?  

 

so if its deep rolling scar what do you do?

 

my dream is if only i could make those scars circled much less smaller and visible

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dermabrasion is the most aggressive treatment. It comes with big risk but with big returns. Like I said it will trim down the healthy skin that it will be harder to differentiate between normal and scarred skin. Similar principle of ablating the edges with laser but just more aggressive as it is a manual device. You seem skin type 1 or 2 so you are good for most risky treatments  only thing is that the skin quality should not detoriate that is where the experience of the operator comes in.

 

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yes getsmart121 problem is i emailed the dermabrasion guy u sent and to find a competent laser/dermabrasion is impossible to find and an acne scar one at that...

all of them dont do acne scars and those that state they do well 99 percent of them dont specialize or do it well

so if its a deep rolling scar as u possibly said what does one do?  if excision is not possible?  unfortunately i have ALOT of acne scars not just 3-5 scars

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and btw this was my day photo i am so sad and depressed because of these scars really really sad

LHS_scars.jpg

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Yes I had juvederm voluma like 4-5 times and it doesnt even last 1 month!

 

And I went to plastic surgeons and they said fat transfer/injection not to do?

 

I am at a loss what to do?

In Australia we dont have bellafill or silikon 1000 so havent tried those treatments before?

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35 minutes ago, pleasehelp321 said:

Yes I had juvederm voluma like 4-5 times and it doesnt even last 1 month!

 

And I went to plastic surgeons and they said fat transfer/injection not to do?

 

I am at a loss what to do?

In Australia we dont have bellafill or silikon 1000 so havent tried those treatments before?

Did you get filler 4-5 times at the same plastic surgeon?

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Hey Kay24 no I got them at different ones at different times during the course of 20 years

 

Do you think that if I got it say once every 6 months to 1 year consistently my scars especially those deep ones could improve and go flush with the skin?  dont forget I am 45 years old male and skin and scars get worse when skin sags etc....your scars very minor wish I had that scars but off course its something you dont like and I really hope you get good improvement

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