Subcision, TCA CROSS, Fraxel FTX and more, matched to each scar type
Most faces have more than one kind of acne scar, and each kind responds to a different treatment. Dr. Nawas maps your scars by type and builds the plan around them.
What it treats
Three kinds of acne scars. Acne scars come in three main shapes: narrow, deep ice pick scars; wider boxcar scars with sharp edges; and soft rolling scars tethered from below.
Why rolling scars dip. Rolling acne scars are soft, wavy dips. Beneath each one, bands of scar tissue tether the skin down to the deeper layers, like stitches pulling from below.
What sun and time leave behind. Years of sun and time leave fine lines, uneven pigment, scars and worn collagen, in both the surface layer and the deeper dermis.
An acne scar is the mark left where inflammation destroyed collagen, and its shape shows what holds it down. Rolling scars are tethered to the deeper tissue by bands of scar tissue, so they are released from beneath. Icepick scars are narrow tracts too deep for resurfacing to reach, so they are rebuilt from the bottom with TCA CROSS. Boxcar scars are wider and shallower, so fractional laser resurfacing softens their edges and builds new collagen around them.
Most faces have more than one kind, which is why one treatment rarely finishes the job and a plan usually combines two or three. Red marks and raised scars are different again: they are blood vessels and excess collagen, treated with the Vbeam laser and a steroid injection.
Treatment options
Most plans combine two or three of these over several months. Each price is per session and matches the treatment's own page.
Non-ablative fractional laser
Best for boxcar scars, texture and the pigment around scars
Treats microscopic columns of skin at two depths and leaves the skin between them intact, so it heals in days. Its 1550 nm wavelength is FDA-cleared for acne scars. Usually a series, about four weeks apart.
Best for deeper boxcar and rolling scars
An ablative CO2 or erbium laser removes skin rather than heating it beneath the surface, so each session does more for deep scars, with more healing time than Fraxel. It arrives at ZN Dermatology in early 2027.
Pulsed dye laser
Best for red marks and red, raised scars
Targets the small blood vessels that keep a mark or a scar red, and helps flatten raised scars.
Focal trichloroacetic acid
Best for icepick scars and narrow, deep boxcar scars
A drop of high-strength TCA placed at the base of each scar prompts new collagen that fills it from the bottom up, over a few sessions.
Salicylic acid, Jessner's or TCA
Best for shallow scarring, rough texture and brown marks
A peel at a depth chosen for your skin evens out the brown marks breakouts leave and refines shallow scarring and texture between other treatments.
Release from beneath
Best for rolling scars
Under local anesthetic, a fine needle passed beneath the scar divides the bands that tether it, and new collagen fills the space over two to three months.
Placed in the released space
Best for rolling scars and the volume lost beneath them
Placed beneath scars released by subcision, often the same day, to support the lift while your own collagen builds.
Kenalog
Best for thick, raised and keloid scars
A small injection into a raised scar flattens it over a few sessions, alone or with the Vbeam laser.
Your visit
Dr. Nawas examines your skin in raking light, which throws every scar into shadow, and stretches it to tell tethered rolling scars from icepick and boxcar scars.
She matches a treatment to each scar type and confirms the order, the number of sessions and the price with you before anything starts.
Subcision can often be done at the same visit. Fraxel is scheduled as its own session because of the numbing time.
Photographs at each visit track the change, and the plan is adjusted as the scars respond.
Before and after your appointment
Pricing
Every price is per session and matches the treatment's own page. A typical plan combines two or three treatments.
| Service | Price |
|---|---|
| ConsultationNew patients, with a map of your scars | $250 |
| Subcision | |
| One areaOne cheek, one temple, or a single tethered scar. Per session. | $500 |
| Both cheeks or the full facePer session. Most people may need 2 to 3 sessions, 6 to 8 weeks apart. | $1,000 |
| Filling the released space, same day (optional, chosen with you) | |
| SculptraPer vial. Usually one vial for scars. | $1,100 |
| Hyaluronic acid fillerPer syringe | $800 to $1,250 |
| PRPYour own platelets, per session | $900 |
| Resurfacing | |
| TCA CROSSPer session | $250 to $500 |
| Chemical peelPer session, depth chosen for you | $250 to $500 |
| Fraxel FTX, scarsPer session, priced by size | Up to $1,000 |
| Fraxel FTX, full facePer session | $1,800 |
| Red and raised scars, Vbeam Pro | |
| One scar or keloidUp to about 5 cm, per session | $250 |
| Several scars or a larger areaPer session | $500 to $1,000 |
| Steroid injection for raised scarsKenalog, an add-on for keloids and raised scars | $250 |
Estimates for planning. Dr. Nawas confirms your exact plan and price at the consultation, and you pay only for what is used. Cosmetic care is not billed to insurance. How insurance, superbills and financing work here.
Good to know
The one that matches the scar. Rolling scars respond to subcision, icepick scars to TCA CROSS, and boxcar scars to fractional laser resurfacing such as Fraxel FTX. Most people have more than one type, so the best plan combines them.
It depends on the scars. Subcision is often two or three sessions six to eight weeks apart, and Fraxel for scars is usually a series about four weeks apart. Dr. Nawas gives you the number at your consultation.
Active acne is treated first, because every new breakout can leave a new scar. Prescriptions are sent to your pharmacy with a GoodRx coupon, which brings most of them to about $35.
Yes, with the right choices. Fraxel and peels are set for your skin type, deeper skin tones are prepared with a lightening cream first, and Dr. Nawas recommends another approach when it would be safer.
In early 2027. Until then, subcision, TCA CROSS and Fraxel FTX treat the same scars, and its price will be published on this page when it arrives.
Related procedures
Next step
Rolling, icepick and boxcar scars, each treated with the tool that suits it, in one plan.
New to ZN Dermatology? Book a consultation: Dr. Nawas maps your scars by type and plans the treatments with you. Subcision can often be done at the same visit; Fraxel is scheduled as its own session.
