Subcision
Subcision of acne scars is a technique utilized to release the deep bands of acne scars. If warranted, this may be performed at the same session of a TCA peel or SkinPen microneedling session.
Intralesional Steroid Injections for Keloid Scars
A keloid scar is a thick raised scar. It can occur wherever you have a skin injury but usually forms on earlobes, shoulders, cheeks or the chest. Keloid scars may result from untreated acne, a former laceration or previous cosmetic procedure.
Types of Acne Scars
If you’re prone to developing keloids, you might get them in more than one place. A keloid scar isn’t harmful to your physical health, but it can cause emotional distress. When they cause pain, discomfort, or are bothering you in appearance, intralesional steroid injections offered specifically at E&G Aesthetic Institute can help to relieve these symptoms and improve the appearance of your keloids.
What is TCA Cross for Acne Scars?
Acne Scars are a common skin condition that affects millions of people worldwide. As the physical and emotional toll of acne can be significant, the remaining acne scars can be bothersome to some people. If you are bothered by your acne scars, a deep peel can help improve the appearance of your skin texture and deep scars.
TCA CROSS is the Chemical Reconstruction of Skin Scars (CROSS) using Trichloroacetic Acid (TCA). TCA is a medium to deep chemical peel that has been used extensively to treat acne scars, wrinkles, and photoaging. It is used to elevate atrophic or depressed scars and has demonstrated phenomenal results for the right candidates.
Scars Types and their Characteristics
Icepick Scars
Ice pick scars are small, deep holes in the skin caused by tissue loss. The most common type of scarring can occur on the face, chest, back, or other body areas. Icepick scars are usually the result of acne or another type of injury. While they can be difficult to treat, there are several options available. TCA cross-chemical peel is the most effective treatment for icepick scars.
Boxcar
This type of scar is a type of atrophic scar that commonly presents on the face. It is characterized by depressed areas of skin with sharp vertical edges. Various factors, including acne, a history of chickenpox, and mechanical trauma, can cause boxcar scars. Treatment options for boxcar scars include microdermabrasion, laser resurfacing, punch excision, and filler injections. While boxcar scars can be difficult to treat, many effective options are available to improve the appearance of the skin.
Rolling Scars
Rolling scars are a type of scarring that can occur after an injury. They are usually caused by the skin being stretched or torn, which damages the underlying tissue. Rolling scars typically appear as raised, reddish lines on the skin. However, over time, they may become less visible. If you have rolling scars, you can improve their appearance with laser therapy, microdermabrasion, skin resurfacing treatments and dermal fillers. Talk to one of our skin specialists to determine the best treatment option for you.
Hypertrophic Scars
Hypertrophic scars are the most difficult types of Acne Scars. They are a type of scar that can occur after injury or surgery. They are raised and thickened and often appear red or purple. Hypertrophic scars differ from keloids, which are raised scars extending beyond the original injury’s boundaries. Although hypertrophic scars are not usually harmful, they can be unsightly and cause psychological distress. Treatment options for hypertrophic scars include intralesional corticosteroids which are offered here at E&G Aesthetic Institite, silicone gel sheeting, pressure dressings, and laser therapy. In some cases, surgery may be necessary to remove the scar tissue. With proper treatment, hypertrophic scars can be minimized and even prevented.
Keloid Scars
Keloid acne scars are raised scars that can occur after any skin injury, including surgery, burns, and Piercing. An overgrowth of collagen causes keloids at the site of the injury. They can vary in size and shape and can be itchy or painful. In some cases, keloids can interfere with joint movement. While keloids are more common in people with darker skin tones, they can occur in anyone. There is no guaranteed way to prevent keloids, but treatment options are available if they do occur. Surgery is typically used to remove keloids, but injections and topical treatments can also be effective. The decision to treat a keloid is usually based on its size, location, and symptoms. Treatment options will be discussed with you if you decide to reduce the appearance of your keloid scar.
Macular Scars
Macular acne scarring is characterized by areas of increased and decreased pigmentation in the affected area. This type of scarring has a flat texture, and although there are no indentations or raised acne scars present, many patients still consider this to be a form of scarring. Rolling scars, on the other hand, appear as undulations or waves in the skin, which give it an uneven texture. These types of scars can sometimes appear deeper than macular acne scars and may require more intensive treatment, such as laser treatment or intensive chemical peels, to reduce their appearance. In some cases, dermabrasion may also be used to help smooth out the surface of the skin and reduce the visibility of the rolling scar. The best way to treat macular acne scars is through the use of topical treatments such as retinoids or alpha hydroxy acids, which can help even out skin tone, increase cell turnover, and fade discoloration over time. Additionally, light therapy or lifestyle changes such as avoiding smoking and protecting skin from sun damage are recommended to help prevent further scarring.
Frequently asked questions
Who is and who is not a good candidate?
Granted you are a generally healthy individual you are likely a good candidate for a medium depth chemical peel from the VI Peel product line.
Considerations to keep in mind that will exclude you from treatment include having the following:
1. Hypersensitivity or allergies to hydroquinone, salicylates like aspirin, phenol or any known active ingredient in VI Peels.
2. Having a present rash, or skin reactions; vitiligo, autoimmune disease (rheumatoid arthritis, psoriasis, lupus, multiple sclerosis, etc.), liver condition, or any condition that may weaken your immune system.
3. Being Pregnant or breastfeeding.
4. The presence of infection or any other inflammatory condition at the proposed treatment site including (sunburn, open wounds, warts, sores, excessively sensitive skin).
5. Use of accutane or isotretinoin in the last 6 months.
6. Dermal filler administration in the last 14 days.
7. Administration of a photofacial (IPL) in the last 10 days,
chemical peels (VI Peels) administration in the last 7 days, hydrafacial or facial in the last 7 days.
8. Electrolysis, Depilatory Creams, Waxing, Laser Hair Removal in the last 7 days.
Consult with our expert clinicians to confirm you are a good candidate for this treatment.
How many treatments do I need?
The number of treatments you may need will depend on the severity of your scarring and your healing response to the treatment. On average four to eight TCA CROSS acne scars treatments may be required over a 3-6 month period for better results.
Interval between TCA CROSS treatment is about 6 weeks to allow optimal healing.
What are potential side effects?
While TCA CROSS is considered safe and effective for most skin types, and is generally a well tolerated procedure, some individuals may experience:
- Temporary skin redness/swelling
- Skin colour changes (Hyperpigmentation or Hypopigmentation which is rare)
- Poor response to the treatment (This may be due to delayed or inadequate collagen synthesis)
- Infection (rare)
What should I expect and what should I avoid afterwards?
The frosting (white areas) will remain for up to 12 hours, and the surrounding skin will appear red and swollen for up to 24-48 hours. A scab will develop in a few days, which typically falls off within 3-7 days. It is important not to pick at the scab to allow healing and prevent further scarring.
An antibiotic ointment is applied regularly until healing is complete, and strict sun avoidance is necessary to prevent pigmentation around the treated area.