Subcision
TCA CROSS Peel
Microneedling
Subcision
TCA CROSS Peel
Treatments for acne scarring
Multiple treatment options are available at Craig Singer MD Dermatology for the treatment of acne scarring. As most scars are multifactorial, a combination approach is usually indicated.
CROSS: “Chemical reconstruction of skin scars” uses a high concentration of acid (either carbolic or TCA) to break down old scar tissue and regenerate new collagen to fill-in the scar. Cost: $350 to $450
Subcision©: “Subcutaneous incisionless surgery” uses a needle, Nokor, blunt tip cannula, or Taylor Liberator to release tethering bands that pull the skin down, thereby elevating the scar. Cost $1000-$1500 (depending upon number of areas to be treated and instrument used).
Fractionated ablative laser: A wavelength of energy in microscopic columns vaporizes the tissue in what is known as “microscopic thermal zones.” The zones are directed through abnormal scarred collagen. The body then naturally repairs these zones with newly regenerated collagen and elastic fibers. Cost is $1000 (depending on extent of involvement). Lumenis Ultrapulse, Deka CO2, Fotona sp Dynamis.
Full Ablation: Full ablation is used under several situations: Lowering and blending the edges of shallow boxcar scars, full ablation and epithelialization of tiny acne pits that are less than 1 mm in diameter, and then full ablation over an area of severe continuous scarring. This is performed using either the Fotona SP Dynamis Erbium laser or Lumenis Ultra Pulse CO2 laser.
Microneedling: uses an automated device to break horizontal bands of collagen, leading to the release of growth factors and production of new collagen. Cost $275/session
Vivace RF Microneedling: Vivace is an FDA cleared device that uses radiofrequency to heat the dermis, stimulating collagen and elastin production. Cost: $600 session
Peels: soften appearance of new scars by regenerating a fresh layer of skin. Cost varies depending upon type of peel.
532 KTP laser/IPL: lightens red acne scars by targeting hemoglobin in the skin and helps regenerate a mild amount of collagen. $250/session
Fillers: injected into rolling and atrophic scar to elevate the surface and contour. Cost: $550 for 1/2 syringe of Juvederm Vollure
Punch excision/elevation: surgical technique to remove a tiny scar or elevate a box car scar. Cost: $250/excision for first. Discount applied for multiple scars.
Linear Surgical excision of larger acne scars $500 for first and $400 for second/third
Most people need 2-4 sessions of combination treatments to achieve results.
We offer an “acne trio” appointment to combine multiple treatment modalities in the same session.
Available treatment options at Craig Singer MD Dermatology
Ice Pick Scars <1mm pits and large pores | • CROSS using either Carbolic acid or TCA • Punch excision • Fotona 0.5mm full ablation |
| Rolling Scars | • Subcision • Vivace RFMN • Filler • Fotona Fractionated Ablative Erbium 2940 • DEKA CO2 fractionated ablative laser •Ultrapulse CO2 |
| Box Car Scars | • TCA CROSS (narrow and boxcar) • Fotona SP Dynamis Erbium or Lumenis Ultrapulse CO2 Full Ablation to shallow box cars • Vivace RFMN • Pen Microneedling • Chemical Peels (Brody’s Peel) |
| White Atrophic Scars | • Fillers • Excision |
| Red Scars | • 532 KTP laser/IPL |
Sources
A Combination Approach to Treating Acne Scars in All Skin Types: Carbolic Chemical Reconstruction of Skin Scars, Blunt Bi-level Cannula Subcision, and Microneedling-A Case Series. J Clin Aesthet Dermatol. 2020 May;13(5):19-23. Epub 2020 May 1.
Acne scarring: a classification system and review of treatment option C I Jacob 1, J S Dover, M S Kaminer J Am Acad Dermatol. 2001 Jul;45(1):109-17.
Combined to treatment of rolling acne scars and ethnic skin using extensive subcision, trichloracetic acid peel, and fractional ablative erbium laser. Mark E. Taylor, MD, Dermatologic Surgery April 2021 volume 47 #4.