Is TCA CROSS with subcision or Intracel RF more effective for severe acne scars? (photo)

Doctor's Answers (4)

You are right in that you will need a combination of several modalities to attain the best results for your scarring - the presence of the different types of scars here necessitate that.

You appear to have possibly tethered rolling scars, with several ice pick scars, so the choice of TCA Cross with subcision and fillers would do you well. The use of lasers after the initial TCA/subcision can further improve the undulations in the skin. 

The use of radio-frequency needling does have its place, but each practitioner will have his preference in managing various issues.

Do have you skin examined in person if you would like the best advice on the management of the scars.

Cheers, and Merry Christmas,
Dr Shane Abucewicz Tan

From your photo, you do have different types of scars (Ice picks, Box, Rolling) that will require a combination of different treatments to treat each of them. 

Each scar type respond differently to each treatment which is why a combination of treatments is necessary to produce optimal results.

Personally in my practice (for a case like yours), I would recommend a combined regime of:


2)  Subscision

3)  Fractional CO2 Laser then +/- Intracel/ Microneedle RF if required

Fillers can also be considered but results are not permanent.

(Note:  The Duet RF does not penetrate as deep and would not be my 1st line treatment of choice.)

A sequence of sessions will be required and downtime/ redness is to be expected.

Hope that helps.

All the best!

Dr Justin Boey

"Doctor with interest in Aesthetics and Lasers"


Your severe acne scars are definitely treatable with the correct combination of acne scar treatments.

Type of Acne Scars. 

You have all 3 types of atrophic acne scar types: Ice-pick acne scars, Rolling Scars, Box-car Scars.

Acne Scar Treatments in Singapore

I combine several types of acne scar treatments - lasers, manual subcision, chemical peels and micro-needling RF (INFINI) to target each and every acne scar.

To answer your question directly, 

Subcision, TCA Cross and Micro-needling RF are all effective for you. 

However, I would like to caution you that TCA Cross might cause prolonged redness for up to 2 weeks. Hence, sun protection and post-treatment recovery instructions have to be followed closely. 

For you, subcision would be one of the key treatments as your scars appear to be tethered down. 

My preferred method of Subcision is Subcision + Biostimulator. The biostimulator can be in the form of HA filler, Rejuran or Radiesse. This biostimulator also acts as a buffer to prevent "re-attaching" of fibrous tissues after each session of subcision - (20% chance). 

Before you invest in any acne scar treatment, it'll be good for you to check out this guide to acne scar treatment costs in Singapore.

Hope this helps!

Warmest regards,

Dr Justin Boey

I would recommend subcision and TCA Cross. I like the results for my patients and frankly, I feel that treatments by your doctors should be recommended based on experience rather than just following the latest fads or machinery.

Your tethered scars will only respond well to subcision, and using the blunt cannula subcision, there is virtually NO downtime and is acceptable to most people. Seek an experienced practitioner today!


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