I've been doing my usual late night research and I've come across something that seems really interesting.
I came across a new medicine called Pirfenidone. It's an antifibrotic agent that's being researched for potential use in idiopathic pulmonary fibrosis. It's also being researched to see if it can be used for other illnesses/diseases as well and the results thus far seem really promising.
It sounded familiar so I did a search on this forum to see if it's been discussed before and I found that it was discussed in the Kitoscell thread as it is the main active ingredient in Kitoscell gel. I think it has been researched for quite some time but it is only recently that we are understanding more about how it works, and what it could potentially help with.
It still hasn't been released in the USA as the FDA said they want more clinical trials done but it is already being sold in India under the name PIRFENEX (released in October 2010). It has just been approved by the European Commission under the trade name Esbriet as stated in the following link:
http://finance.yahoo.com/news/ITMNs-Esbrie...ml?x=0&.v=1
What really interested me was the following research paper:
http://www.iovs.org/content/50/8/3763.full
I read pretty much all of it and it was extremely interesting. Everything in the paper seems to apply to regular scarring on the skin.
According to wikipedia: "Pirfenidone slows tumor cell proliferation by inhibiting fibroblast growth factor, epidermal growth factor, platelet-derived growth factor, and transforming growth factor beta 1"
In the research paper it states it inhibits TGF-B1 substantially, as well as TGF-B2 and it can even decrease the levels of TGF-B3 but only at higher doses, at lower doses TGF-B3 isn't effected much where as the other 2 are.
It seems to do a hell of a lot more than enalapril and from what I've read in research papers, enalapril doesn't decrease TGF-B1 by that much. It does decrease it but not massively like Pirfenidone does.
Of course the research done so far on Pirfenidone isn't done on the skin but on various organs, but it seems logical that it would help our scars. It has been researched for multiple different conditions effecting multiple different organs and it's done the same in all organs, so why not skin as well?
Maybe kitoscell has more potential than we thought. I originally dismissed it after it took so long for people to see results but maybe the oral Pirfenidone could work better, or maybe if we could find a way for kitoscell to be absorbed better, like a strong chemical peel or needling. Maybe it's under dosed. I can't find out how much Pirfenidone is in it. In the kitoscell thread someone said that when applied to fresh wounds that should scar, the wounds don't scar at all, or only a little bit. This could be because Pirfenidone stops many of the processes that causes scarring in the first place (plus it's an anti-inflammatory). If Pirfenidone really does stop wounds from scarring than maybe causing trauma to our existing scars then applying kitoscell would help the kitoscell work much faster.
It's really late and I can barely string a sentence together but I'd be really interested to see what seabs thinks of this. To me it seems promising.
______________
quotes from the research paper about Pirfenidone:
"Pirfenidone is an anti-inflammatory and antifibrotic agent that exhibits its inhibitory effects on a host of cell types in vitro." (We've known about inflammation being a problem for a long time when a wound is first created, if we can stop that swelling than we have a smaller scar if any at all.)
"pirfenidone has been applied in several clinical trials of fibrotic disorders, including hypertrophic cardiomyopathy, pulmonary fibrosis, neurofibromatosis, uterine leiomyoma, and focal segmental glomerulosclerosis." (With positive findings from what I gather)
"Despite the widespread application of pirfenidone, its underlying mechanisms are not fully understood. The antifibrotic mechanisms of pirfenidone have been attributed to signaling regulation of several cytokines, such as TGF-I1, PDGF, TNF-I, and CTGF. In a bleomycin-induced model of lung fibrosis, pirfenidone has been shown to downregulate overexpression of TGF-I transcription, the lung procollagen I and III genes, and heat shock protein (HSP). In a rat liver fibrosis model of dimethylnitrosamine treatment, the antifibrotic effects of pirfenidone have been attributed to attenuation of procollagen I1(I), TIMP-1, and MMP-2. Pirfenidone has also been demonstrated to alter expression of interleukin(IL)-6 in rat models with acute pulmonary inflammation and to inhibit expression of intercellular adhesion molecule (ICAM)-1 in cultured human synovial fibroblasts." (Pretty much everything Pirfenidone effects is involved in scarring in one way or another)
I've been doing my usual late night research and I've come across something that seems really interesting.
I came across a new medicine called Pirfenidone. It's an antifibrotic agent that's being researched for potential use in idiopathic pulmonary fibrosis. It's also being researched to see if it can be used for other illnesses/diseases as well and the results thus far seem really promising.
It sounded familiar so I did a search on this forum to see if it's been discussed before and I found that it was discussed in the Kitoscell thread as it is the main active ingredient in Kitoscell gel. I think it has been researched for quite some time but it is only recently that we are understanding more about how it works, and what it could potentially help with.
It still hasn't been released in the USA as the FDA said they want more clinical trials done but it is already being sold in India under the name PIRFENEX (released in October 2010). It has just been approved by the European Commission under the trade name Esbriet as stated in the following link:
http://finance.yahoo.com/news/ITMNs-Esbrie...ml?x=0&.v=1
What really interested me was the following research paper:
http://www.iovs.org/content/50/8/3763.full
I read pretty much all of it and it was extremely interesting. Everything in the paper seems to apply to regular scarring on the skin.
According to wikipedia: "Pirfenidone slows tumor cell proliferation by inhibiting fibroblast growth factor, epidermal growth factor, platelet-derived growth factor, and transforming growth factor beta 1"
In the research paper it states it inhibits TGF-B1 substantially, as well as TGF-B2 and it can even decrease the levels of TGF-B3 but only at higher doses, at lower doses TGF-B3 isn't effected much where as the other 2 are.
It seems to do a hell of a lot more than enalapril and from what I've read in research papers, enalapril doesn't decrease TGF-B1 by that much. It does decrease it but not massively like Pirfenidone does.
Of course the research done so far on Pirfenidone isn't done on the skin but on various organs, but it seems logical that it would help our scars. It has been researched for multiple different conditions effecting multiple different organs and it's done the same in all organs, so why not skin as well?
Maybe kitoscell has more potential than we thought. I originally dismissed it after it took so long for people to see results but maybe the oral Pirfenidone could work better, or maybe if we could find a way for kitoscell to be absorbed better, like a strong chemical peel or needling. Maybe it's under dosed. I can't find out how much Pirfenidone is in it. In the kitoscell thread someone said that when applied to fresh wounds that should scar, the wounds don't scar at all, or only a little bit. This could be because Pirfenidone stops many of the processes that causes scarring in the first place (plus it's an anti-inflammatory). If Pirfenidone really does stop wounds from scarring than maybe causing trauma to our existing scars then applying kitoscell would help the kitoscell work much faster.
It's really late and I can barely string a sentence together but I'd be really interested to see what seabs thinks of this. To me it seems promising.
______________
quotes from the research paper about Pirfenidone:
"Pirfenidone is an anti-inflammatory and antifibrotic agent that exhibits its inhibitory effects on a host of cell types in vitro." (We've known about inflammation being a problem for a long time when a wound is first created, if we can stop that swelling than we have a smaller scar if any at all.)
"pirfenidone has been applied in several clinical trials of fibrotic disorders, including hypertrophic cardiomyopathy, pulmonary fibrosis, neurofibromatosis, uterine leiomyoma, and focal segmental glomerulosclerosis." (With positive findings from what I gather)
"Despite the widespread application of pirfenidone, its underlying mechanisms are not fully understood. The antifibrotic mechanisms of pirfenidone have been attributed to signaling regulation of several cytokines, such as TGF-I1, PDGF, TNF-I, and CTGF. In a bleomycin-induced model of lung fibrosis, pirfenidone has been shown to downregulate overexpression of TGF-I transcription, the lung procollagen I and III genes, and heat shock protein (HSP). In a rat liver fibrosis model of dimethylnitrosamine treatment, the antifibrotic effects of pirfenidone have been attributed to attenuation of procollagen I1(I), TIMP-1, and MMP-2. Pirfenidone has also been demonstrated to alter expression of interleukin(IL)-6 in rat models with acute pulmonary inflammation and to inhibit expression of intercellular adhesion molecule (ICAM)-1 in cultured human synovial fibroblasts." (Pretty much everything Pirfenidone effects is involved in scarring in one way or another)
I have the kitoscell of 90gram today in a 50% charged, Just as applied in my skin every 4 or 5 days...i tired to use every day.
why dont more of you look into bee venom therapy.
In June-July i give chance to the bee venom.
Now i am in the last part of the experiment of enalapril. After 4 months to use enalapril as one therapy, without seeing positive result now i focus in the final stage.
The last week ,I did a peeling tca 35% and im gonna use 2 months more enalapril to give chance to see if acts in this way.
This makes a total of 6 months of enalapril, giving chance to act also after a medium peeling.
The May 5 met 6 months and if i see no improvement, im gonna leaves definitively enalapril, but if I come to see a slight improvement, back to make another peeling and continue with enalapril.
indeed, every 5 days i applied once kitoscell over my skin.
On May 5 after 6 months of enalapril i say here my final verdict on the drug.
...Maybe kitoscell has more potential than we thought. I originally dismissed it after it took so long for people to see results but maybe the oral Pirfenidone could work better, or maybe if we could find a way for kitoscell to be absorbed better, like a strong chemical peel or needling.
Needling with a fibrosis inhibitor is something that I'd imagine could work. I think the key in most types of scarring is to begin with breaking up the scar tissue. If it's done fractionally, then the risk fibrosis is minimized. Add to that something like an ECM or kitocell and you might actually have something that could work.
...Maybe kitoscell has more potential than we thought. I originally dismissed it after it took so long for people to see results but maybe the oral Pirfenidone could work better, or maybe if we could find a way for kitoscell to be absorbed better, like a strong chemical peel or needling.Needling with a fibrosis inhibitor is something that I'd imagine could work. I think the key in most types of scarring is to begin with breaking up the scar tissue. If it's done fractionally, then the risk fibrosis is minimized. Add to that something like an ECM or kitocell and you might actually have something that could work.
Also I've seen it cited recently that wounds under 2mm, along with early embryonic healing do not over proliferate fibroblasts. There is a lot of logic in what you are saying IMO.
...Maybe kitoscell has more potential than we thought. I originally dismissed it after it took so long for people to see results but maybe the oral Pirfenidone could work better, or maybe if we could find a way for kitoscell to be absorbed better, like a strong chemical peel or needling.Needling with a fibrosis inhibitor is something that I'd imagine could work. I think the key in most types of scarring is to begin with breaking up the scar tissue. If it's done fractionally, then the risk fibrosis is minimized. Add to that something like an ECM or kitocell and you might actually have something that could work.
Also I've seen it cited recently that wounds under 2mm, along with early embryonic healing do not over proliferate fibroblasts. There is a lot of logic in what you are saying IMO.
I'd be interested to hear what you think about Pirfenidone seabs, especially after reading the research paper I posted ( http://www.iovs.org/content/50/8/3763.full )(maybe just the discussion part if you don't have a lot of time). To me it seems really promising.
I also found this link: http://www.patentstorm.us/patents/5518729/description.html
It's a patent that has something to do with Pirfenidone being used as a treatment. Maybe that's why we haven't seen any products in the countries we live in - it's patented. It says "The present invention relates to medical compositions and methods for the reparation of fibrotic lesional tissues and the prevention of fibrotic lesions"
"Patent 5518729 Issued on May 21, 1996. Estimated Expiration Date: May 16, 2014."
What seems quite interesting is that it goes on to say "Inhibition of excessive scar formation by direct application of pirfenidone ointment to skin lesions in 10 cases. Mild to moderate skin laceration or lesions failed to generate skin scars, or caused only minimal scarring when pirfenidone ointment was directly applied to the lesion."
I think the best time to use pirfenidone ointment would be directly after a wound is made. As it says above when pirfenidone is applied to a new wound there is little to no scarring. Maybe the reason kitoscell takes so long to work is because the scar is already there. With a new wound, all Pirfenidone has to do is inhibit the processes which cause scarring, allowing the skin to regenerate by stopping the over proliferation of the fibroblasts. When the scar is already there the scar tissue has to be broken down which takes time. There is no scar tissue in a fresh wound, so you bypass the long process of breaking down the scar tissue.
Obviously we all have existing scars. This is why I think an extremely strong chemical peel (I mean multiple layers of TCA where your literally burning through to the dermis) could help. Or needling. If you can break down the scar tissue using either method, you could then use pirfenidone ointment/kitoscell to inhibit the processes that cause scarring in the first place, allowing for regeneration. Of course this is all just in theory, I don't know if it would work simply as it hasn't really been done before but I think it's worth a shot. Needling would be the safer option as with a strong chemical peel you're risking replacing your existing scar with a burn scar. To me I wouldn't mind as I'm completely covered in scars already.
I'm just thinking out loud guys but I'd be interested in hearing your thoughts.
Edited: proof here of regeneration and healing of a scar were there is even an explanation of how mild to moderate lesions failed to generate skin scars (as spotted by Pepe btw)...
"Inhibition of excessive scar formation by direct application of pirfenidone ointment to skin lesions in 10 cases. Mild to moderate skin laceration or lesions failed to generate skin scars, or caused only minimal scarring when pirfenidone ointment was directly applied to the lesion."
IMO, along with insulin which has been shown to remove a scar completely, the stem cell spray which healed a burn in two days, and more like decorin which stops the thing that causes scar etc... This is another cite that shows scar removed from various tissues.
You saying that this would be better being used after removing the scar with a peel, or needling makes sense to me too. I get the impression when you use this on solely settled scars, you'd solely depend on micro manipulating the skin shedding, were when it sheds you block of the fibroblasts in a scar and you slightly knock the balance in favour of regenerating slowly over time etc. The problem is that depending solely on the skin shedding is that one skin shed probably takes weeks, making this process slow. Whereas if you needle, you may be braking down the scar faster and at the same time you have the fibroblasts proliferation and collagen formation under control with it etc.
...Maybe kitoscell has more potential than we thought. I originally dismissed it after it took so long for people to see results but maybe the oral Pirfenidone could work better, or maybe if we could find a way for kitoscell to be absorbed better, like a strong chemical peel or needling.Needling with a fibrosis inhibitor is something that I'd imagine could work. I think the key in most types of scarring is to begin with breaking up the scar tissue. If it's done fractionally, then the risk fibrosis is minimized. Add to that something like an ECM or kitocell and you might actually have something that could work.
Also I've seen it cited recently that wounds under 2mm, along with early embryonic healing do not over proliferate fibroblasts. There is a lot of logic in what you are saying IMO.
I'd be interested to hear what you think about Pirfenidone seabs, especially after reading the research paper I posted ( http://www.iovs.org/content/50/8/3763.full )(maybe just the discussion part if you don't have a lot of time). To me it seems really promising.
I also found this link: http://www.patentstorm.us/patents/5518729/description.html
It's a patent that has something to do with Pirfenidone being used as a treatment. Maybe that's why we haven't seen any products in the countries we live in - it's patented. It says "The present invention relates to medical compositions and methods for the reparation of fibrotic lesional tissues and the prevention of fibrotic lesions"
"Patent 5518729 Issued on May 21, 1996. Estimated Expiration Date: May 16, 2014."
What seems quite interesting is that it goes on to say "Inhibition of excessive scar formation by direct application of pirfenidone ointment to skin lesions in 10 cases. Mild to moderate skin laceration or lesions failed to generate skin scars, or caused only minimal scarring when pirfenidone ointment was directly applied to the lesion."
I think the best time to use pirfenidone ointment would be directly after a wound is made. As it says above when pirfenidone is applied to a new wound there is little to no scarring. Maybe the reason kitoscell takes so long to work is because the scar is already there. With a new wound, all Pirfenidone has to do is inhibit the processes which cause scarring, allowing the skin to regenerate by stopping the over proliferation of the fibroblasts. When the scar is already there the scar tissue has to be broken down which takes time. There is no scar tissue in a fresh wound, so you bypass the long process of breaking down the scar tissue.
Obviously we all have existing scars. This is why I think an extremely strong chemical peel (I mean multiple layers of TCA where your literally burning through to the dermis) could help. Or needling. If you can break down the scar tissue using either method, you could then use pirfenidone ointment/kitoscell to inhibit the processes that cause scarring in the first place, allowing for regeneration. Of course this is all just in theory, I don't know if it would work simply as it hasn't really been done before but I think it's worth a shot. Needling would be the safer option as with a strong chemical peel you're risking replacing your existing scar with a burn scar. To me I wouldn't mind as I'm completely covered in scars already.
I'm just thinking out loud guys but I'd be interested in hearing your thoughts.
i still dont understand why more of you dont jump on bee venom. i mean if it works, you wouldnt need the extremely strong peels or basically anything else.
Aren't you the guy who received third degree burns from using 100% TCA? Why are you telling people to "jump on"? People need to be careful about what they do with their skin. Don't encourage people to try something that hasn't been professionally proven to be safe.
Reading your previous experience/posts, I'd imagine you learned that the internet isn't the place to get serious advice from.
To everyone else- please take the advice on the forums with a grain of salt, even if you are desperate. I don't care how many hours of online research you've done. Be cautious.
Hey guys,
I have found an article from 2009. Maybe it wasn't posted before. It's about
Nanotechnology for surgery. The Text mentions that you will get no scars when
using it: http://www.nanowerk.com/spotlight/spotid=11947.php
Neo
I'm currently trying to get hold of some Kitoscell. I emailed them and they said they would send it out for $160 (USD) plus shipping which is around $36. This is for the 90g tube. I think this is how some people got hold of it in the Kitoscell thread (sltn). So it's expensive but worth a shot. It's the only thing that could work that we can actually get hold of for now.
I agree that the key is to break down the scar tissue first.
Just another quote from a site I read:
"The anti-fibrotic activities of pirfenidone have been demonstrated in vivo in laboratory animals with fibrotic lesions, in vitro with human lung fibroblast (WI38) cell cultures, and observed through pilot open trials in patients with severe pulmonary fibrosis, benign prostate hypertrophy, or keloids. Pirfenidone may selectively arrest scar enlargement, and remodels or removes scar tissue or fibrosis. The dysfunction caused by fibrotic lesions may be ameliorated by the reduction or removal of the fibrotic lesion following pirfenidone treatment. Apparently organ and tissue function can be restored, even after the presence of fibrosis for several years. When given immediately after an insult, such as trauma, infection, or allergy, to a tissue, pirfenidone also may prevent formation of excessive scar tissue, or fibrotic lesions, and thus help retain normal function and appearance of the tissue."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2944211/ A study done on Kitoscell. Down toward the bottom is the part on scars.
http://www.facebook.com/KitosCell?v=info#&...276&theater Click on the pixs to enlarge. They have a few with acne scars, doesn't look impressive.
http://www.facebook.com/KitosCell?v=info#&...276&theater Click on the pixs to enlarge. Thay have a few with acne scars, doesn't look impressive.
Nobody as yet has included kitoscell treatment with strong needling or a strong chemical peel.
We discussed this in just the last few posts.
http://www.facebook.com/KitosCell?v=info#&...276&theater Click on the pixs to enlarge. Thay have a few with acne scars, doesn't look impressive.
Nobody as yet has included kitoscell treatment with strong needling or a strong chemical peel.
We discussed this in just the last few posts.
I wonder if they just put Kitoscell on direct or if they tried a method of damaging the skin before. If you are going to try this please keep us updated.
Don't know if it's been posted, but here's a quite interesting approach to fibrosis inhibition using gene therapy:
Inhibiting scar formation in vitro and in vivo by adenovirus-mediated mutant Smad4: a preliminary report
http://onlinelibrary.wiley.com/doi/10.1111...1186.x/abstract
Thanks for the link, rimram.
It still amazes me that so many things pop up all the time. Now, they've also got this other thing called Yap1 which they claim controls some trigger which gets skin growth going. I mean honestly, where does it end? In the year 4000? I bet 1000 years from now you'd still get these articles saying "Up until now we've always thought that it was like this and this...but now we've got this breakthrough which is truly game-changing!". It weird to me. How all these scientists are all coming up with a zillion different things independently from each other saying that what they discovered is a crucial piece of the puzzle.
Also read this thing where people said apparently in 1971 that if you put... Nevermind I'll copy the text as there's a lot to it.
Phenol (Anhydrous) 100.0 grams Olive Oil, U.S.P. 114.0 grams Retinol (Vitamin A) 92,000 U.S.P. Units Ergosterol (Vitamin D) 9,200 U.S.P. Units Oleaginous diluent as linseed oil 80.0 grams ____________________________________________________________ ______________
The above ingredients are mixed together to provide a homogeneous lotion. Chemical analysis of the U.S.P. Olive Oil disclosed: 10 percent palmitic acid, 2 percent stearic acid, 8 percent linoleic acid, and 80 percent oleic acid as glycerides.
The homogeneous lotion is utilized as an abluent medicament in the following manner. The lotion is applied daily with a chicken feather onto the lacerated flank of a horse. While the lacerated wound may be covered with a protective bandage, the skin is not drawn tightly together so as to close the gash. It is essential that the laceration, during the healing process, be left open so that the lotion may be applied daily. Upon completion of the healing process within approximately 2 weeks, there is no scar formation even though the broken skin has not been drawn together during the interim.
Yeah. Right. That's why it's 2011 right now and I'm writing this post.
Seriously, I don't know if that approach is legitimate (i.e. the authors had their hearts in the right place) but it probably wouldn't work if doctors were to test it now, I think.
Anyway, there's a bunch of approaches out there which are actually candidates for "clinical development" and they appear promising. But hey, so did Juvista at first. Interesting stuff to read about, though.
Here's the latest lengthy Hitzig audio interview regarding hair restoration which ties into scar prevention in a way.
http://www.baldtruthtalk.com/showpost.php?...p;postcount=120
There's one caller coming in at one point saying he's fed up with the fact there's no cure for hair loss. Hitzig replied and said he expects there to be a cure in two years which I thought was a pretty bald bold statement.
Yeah. Right.That's why it's 2011 right now and I'm writing this post.
Seriously, I don't know if that approach is legitimate (i.e. the authors had their hearts in the right place) but it probably wouldn't work if doctors were to test it now, I think.
If it did work then, and you used it exactly the same way now, it would work now, unless the ingredients differed, as time does not change facts.
BTW I dont know if legitimate is the right word here but if it is, then to me, being fair, it is just as legitimate as anything else. BTW, who says or tells you what should be ignored? who says or tells you what should be ridiculed? who says or tells you what is authoritive? who says or tells you the way things are interpreted? Why are you ridiculing it and trying to get a reciprication? Why do you want to assume it has no authority? Why do you want people to ignore it? Why are you forcing an interpretation outside of critical thinking?
Yeah. Right.That's why it's 2011 right now and I'm writing this post.
Seriously, I don't know if that approach is legitimate (i.e. the authors had their hearts in the right place) but it probably wouldn't work if doctors were to test it now, I think.
If it did work then, and you used it exactly the same way now, it would work now, unless the ingredients differed, as time does not change facts.
BTW I dont know if legitimate is the right word here but if it is, then to me, being fair, it is just as legitimate as anything else. BTW, who says or tells you what should be ignored? who says or tells you what should be ridiculed? who says or tells you what is authoritive? who says or tells you the way things are interpreted? Why are you ridiculing it and trying to get a reciprication? Why do you want to assume it has no authority? Why do you want people to ignore it? Why are you forcing an interpretation outside of critical thinking?
Hey, I see where you're coming from but I wasn't trashing it or anything, ok? Sheesh.
Anyway, I also said I think it wouldn't work. I mean I wouldn't be surprised. Look at the ingredients; it's so very simple where we have aaalllllll these scientists now racking their brains over this thing. I mean it's just kinda unlikely to me is all I'm saying.
Yeah. Right.That's why it's 2011 right now and I'm writing this post.
Seriously, I don't know if that approach is legitimate (i.e. the authors had their hearts in the right place) but it probably wouldn't work if doctors were to test it now, I think.
If it did work then, and you used it exactly the same way now, it would work now, unless the ingredients differed, as time does not change facts.
BTW I dont know if legitimate is the right word here but if it is, then to me, being fair, it is just as legitimate as anything else. BTW, who says or tells you what should be ignored? who says or tells you what should be ridiculed? who says or tells you what is authoritive? who says or tells you the way things are interpreted? Why are you ridiculing it and trying to get a reciprication? Why do you want to assume it has no authority? Why do you want people to ignore it? Why are you forcing an interpretation outside of critical thinking?
Hey, I see where you're coming from but I wasn't trashing it or anything, ok? Sheesh.
Anyway, I also said I think I wouldn't work. I mean I wouldn't be surprised. Look at the ingredients; it's so very simple where we have aaalllllll these scientists now racking their brains over this thing. I mean it's just kinda unlikely to me is all I'm saying.
BTW I wasn't having a go personally, heh, heh, I was just trying to get some balance.
I have bought some kitoscell (90g). It cost me A120 so I hope it works.
I've done a strong TCA peel and have been applying the kitoscell as often as possible. I only did the peel a couple of days ago so we will have to wait and see how it turns out.
If there is no improvement then I will do another TCA peel but it will be even stronger than the last.
If that doesn't work then I will try heavy needling along with the kitoscell.
I really hope this works.