Long time lurker, first post. I have primarily what I believe to be rolling scars and some superficial icepick/boxcar scars but I'm happy to be corrected on that. Currently seeing a derm who told me that my scars are too shallow for subcision and has instead put me on a series of PicoWay Resolve and Tixel treatments. Under normal lighting I can see how this assessment was made, but with angled lighting I have some deeper atrophy so I'm going to follow up on that.
I'm based in New Zealand and unfortunately there aren't many great acne scar specialists over here - and if there are, I haven't found them. I have a tentative appointment with Dr Lim and this will be dependent on border restrictions. I'm thinking of continuing my existing treatment over here until then and see what it does.
The plan I have in my head beyond this based upon my research would be continuing tixel+picoway, subcision, TCA cross for some of my icepicks, and then an erbium resurfacing treatment. Maybe throw in a bit of micro needling for kicks? I am however entirely open to suggestions from some of the incredibly well informed members we have.
I would first start with subcision and see how much actual tethering there is. Not all rolling scars are tethered and just because there are signs of atrophy, it does not mean they will be filled with subcision.
Wait 2 weeks or until the swelling subsides and get Sculptra. Be sure to present the same picture showing the areas of volume loss (undulation).
Wait another 2weeks and get a low-density CO2laser. Sculptra and laser has been shown to have synergistic effect on skin volumization.
For the icepicks, TCA cross is recommended.
I think Lim would be the best for you in this case, is the doctor in my opinion shouldn't be recommending you pico and tixel. The thing with subcision is that your scars are either tethered or there not, in my opinion multiple depth subcision and few sessions of tca with a fractional co2 to just polish things off and generate some collagen and your scars will be basically invisible.
i was writing mine at the same time as sirus.
Thanks, I appreciate the input. I weary of doing fillers as I don't want temporary results - even if that means I don't quite get the 'maximum' results possible. I'm definitely pushing for subcision now and am researching other derms in the area who might be able to do it.