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Suggested treatments for a few moderate box scars and lots of big pores

fraxel phenol tca

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#1 Doug in Calgary

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Posted 14 August 2011 - 12:03 AM

Hi. I'm a 40 year old, caucasian guy. My acne scarring is somewhat unique in that I suffered most of it as an infant. I had severe acne as a newborn that caused box car scarring on my cheeks. Teenage acne gave me a few more scars, but in general they weren't as deep. Finally, as I've gotten older, I've gotten big pores on my forehead, cheeks and nose, as well as some small bumps which have been diagnosed as sebacious hyperplasia.

Three years ago I had 5 Fraxel sessions, followed up with 3 times per week Tazorac application ever since. I had about 10 sebacious hyperplasia lesions treated by laser last year and then about 10 more treated this year by cautery. The cautery was more effective.

First the good news: I have a very oily and dark skin type for a guy of mostly nordic ethnicity (I have blue eyes and dark blond hair, my skin is darker than my hair). I have no discoloration, freckles or moles and practically no wrinkles. I have never been sun burned even though I spend lots of time in the sun. The sebacious hyperplasia treatments have been about 75% effective. The Fraxel improved my scarring by about 50% and the Tazorac seems to have provided a small, but noticeable incremental improvement. The bad: at my age, I still get acne like a teenager. It doesn't scar, but I have lots of whiteheads and black heads. I have tried accutane and minocycline to some success, on and off for going on 25 years. I have lots of expanded pores on my cheeks, forehead and nose. Finally, I seem to be very prone to sebaceous hyperplasia legions. The dermatologist that treated the sebacious hyperplasia suggested I try either TCA or phenol peels. I am very reluctant to go the phenol route as I am afraid it would cause hypopigmentation with my skin type, increase suseptiblity to sun burns and finally because phenol peels aren't usually recommended for men. I am looking for some advice about TCA or maybe more Fraxel.

#2 Guest_Timehealsall_*

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Posted 14 August 2011 - 01:33 AM

QUOTE (Doug in Calgary @ Aug 14 2011, 01:03 AM) <{POST_SNAPBACK}>
Hi. I'm a 40 year old, caucasian guy. My acne scarring is somewhat unique in that I suffered most of it as an infant. I had severe acne as a newborn that caused box car scarring on my cheeks. Teenage acne gave me a few more scars, but in general they weren't as deep. Finally, as I've gotten older, I've gotten big pores on my forehead, cheeks and nose, as well as some small bumps which have been diagnosed as sebacious hyperplasia.

Three years ago I had 5 Fraxel sessions, followed up with 3 times per week Tazorac application ever since. I had about 10 sebacious hyperplasia lesions treated by laser last year and then about 10 more treated this year by cautery. The cautery was more effective.

First the good news: I have a very oily and dark skin type for a guy of mostly nordic ethnicity (I have blue eyes and dark blond hair, my skin is darker than my hair). I have no discoloration, freckles or moles and practically no wrinkles. I have never been sun burned even though I spend lots of time in the sun. The sebacious hyperplasia treatments have been about 75% effective. The Fraxel improved my scarring by about 50% and the Tazorac seems to have provided a small, but noticeable incremental improvement. The bad: at my age, I still get acne like a teenager. It doesn't scar, but I have lots of whiteheads and black heads. I have tried accutane and minocycline to some success, on and off for going on 25 years. I have lots of expanded pores on my cheeks, forehead and nose. Finally, I seem to be very prone to sebaceous hyperplasia legions. The dermatologist that treated the sebacious hyperplasia suggested I try either TCA or phenol peels. I am very reluctant to go the phenol route as I am afraid it would cause hypopigmentation with my skin type, increase suseptiblity to sun burns and finally because phenol peels aren't usually recommended for men. I am looking for some advice about TCA or maybe more Fraxel.



theres a tca cross thread on here from sam something, who is logging his experience, maybe check that out?

I am sorry to hear about your experience man... that must have been devastating suffering since an adolescent? Howd you deal with that

#3 Reeja

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Posted 14 August 2011 - 03:03 PM

he said he's suffered from scarring since the time he was a baby. That is definitely unique; did they know what was causing the acne at such a young age?

Anyway, I think TCA cross might be your best bet for enlarged/scarred pores.

If tazorac can't treat your acne, I'm stumped as to what could. That is by far the most potent retinoid on the market. Could you consider bumping up your use to every night? I hope you're using sunscreen if you are on the taz!

#4 Patrick

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Posted 14 August 2011 - 05:17 PM

You could try some blue light therapy for the acne.

I've been using a Palovia laser on my sebacious hyperplasia and the results seem promising. So far 1 lesion gone and 4 others receding. I zap them once per day. Took about 3 weeks for the first one to give in.

#5 Doug in Calgary

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Posted 14 August 2011 - 06:59 PM

Seems to be genetic. My mother also has dark, very oily and acne prone skin. In her mid 60s she still gets whiteheads, but has almost no wrinkles. My two brothers also had some scarring from infantile acne, but barely noticeable and nowhere near as bad as mine. Their skin tones are much lighter. The dermatologists I have seen have told me that my skin is about as oily as it gets and that as a consequence I will always be prone to clogged pores. All have remarked that I have a very dark skin tone for a white guy of 100% germanic heritage. I've been checked for endocrine, metobolic and environmental disorders and all the tests had normal results. I spent a couple of weeks down in Arizona a few months back and came back with such a tan that I was darker than some of my friends who are of Asian and African heritage.

I've tried bumping up the Tazorac to every day, and it doesn't seem to make any difference. At 3 times per week or 7 times per week, I get only a small amount of peeling and irritation. Going down to less than 3 times per weeks results in blackheads almost over my entire face whithin a few weeks. I do use sunscreen, but don't think it is as essential as in most people using tazorac as even without I never burn. Suncreen or any moisturizer usually makes the acne worse.

I was very self concious about it when I was young. I'd get asked why I had holes in my face. I've had blackheads for as long as I can remember and had bad teenage style acne from about ages 10 through 25. The good thing is that I think my scarring and acne in general were already improving as I got older and the Fraxel and Tazorac have helped. Most guys my age are starting to show signs of wrinkles, sun damage, discoloration etc. and I have none of that.

The dermatologist is recommending an entire facial peel with TCA or phenol. I'm going to stay away from the phenol. To my knowledge, no dermatologist or spa in Calgary offers TCA CROSS. Are the home kits worth trying? Would I be best to try the TCA CROSS in advance of the whole face TCA peel? I'll look into the Palovia laser.

#6 Guest_Timehealsall_*

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Posted 14 August 2011 - 07:00 PM

thought about accutane??

#7 Doug in Calgary

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Posted 14 August 2011 - 08:31 PM

QUOTE (Timehealsall @ Aug 14 2011, 06:00 PM) <{POST_SNAPBACK}>
thought about accutane??



I've been on Accutane 9 time since I was 15. I get improvement for a few months, and then the effectiveness seems to decline.

Most recently, I used it for back acne. While my facial acne has been gradually improving, that on my back was getting worse. I fortunately don't have any scarring on my back, but am always ruining clothing as the whiteheads pop and bleed. Last year my body acne was so bad, I was getting it on my arms, hands, legs and chest. I did four months of Accutane plus topical AHA lotion alternating with a gel of clindamycin plus benozyl peroxide. I had already been scrubbing daily with Tersaseptic. That cleared up all the body acne except for on my back, which probably improved by 75%. In January, I had a glycolic acid peel on my back and that seemed to take care of the rest. Since then, I've been using the clindamycin plus benozyl peroxide gel and AHA lotion each once a week for maintenance, and continued with daily Tersaseptic. I also get a body exfoliation at a spa every few months, mostly using a sea salt scrub.

The previous outbreak of bad body acne was about 4 years previous. I spent three months in a humid climate and that seemed to encourage breakouts. Humidity has always bad my facial acne worse.

The most recent round of Accutane only had modest improvement on my facial acne. I've never had any side effects from Accutane, even only minimal dry skin and peeling, but am worried about longer term liver damage.

I can live with the acne I have now as it doesn't contribute to scarring and the Tazorac keeps it manageable. I'm mostly interested in treating existing scars, particuarly the ones I got as an infant.

Edited by Doug in Calgary, 14 August 2011 - 08:37 PM.


#8 Guest_Timehealsall_*

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Posted 14 August 2011 - 08:42 PM

QUOTE (Doug in Calgary @ Aug 14 2011, 09:31 PM) <{POST_SNAPBACK}>
QUOTE (Timehealsall @ Aug 14 2011, 06:00 PM) <{POST_SNAPBACK}>
thought about accutane??



I've been on Accutane 9 time since I was 15. I get improvement for a few months, and then the effectiveness seems to decline.

Most recently, I used it for back acne. While my facial acne has been gradually improving, that on my back was getting worse. I fortunately don't have any scarring on my back, but am always ruining clothing as the whiteheads pop and bleed. Last year my body acne was so bad, I was getting it on my arms, hands, legs and chest. I did four months of Accutane plus topical AHA lotion alternating with a gel of clindamycin plus benozyl peroxide. I had already been scrubbing daily with Tersaseptic. That cleared up all the body acne except for on my back, which probably improved by 75%. In January, I had a glycolic acid peel on my back and that seemed to take care of the rest. Since then, I've been using the clindamycin plus benozyl peroxide gel and AHA lotion each once a week for maintenance, and continued with daily Tersaseptic. I also get a body exfoliation at a spa every few months, mostly using a sea salt scrub.

The previous outbreak of bad body acne was about 4 years previous. I spent three months in a humid climate and that seemed to encourage breakouts. Humidity has always bad my facial acne worse.

The most recent round of Accutane only had modest improvement on my facial acne. I've never had any side effects from Accutane, even only minimal dry skin and peeling, but am worried about longer term liver damage.

I can live with the acne I have now as it doesn't contribute to scarring and the Tazorac keeps it manageable. I'm mostly interested in treating existing scars, particuarly the ones I got as an infant.


Nine times?! Wow... and still did not cure you? that is so shitty man..

if you can post pictures, i am sure the org can give you some advice


#9 whoartthou1

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Posted 10 October 2012 - 04:18 AM

bump hows it going?