@SaraDHi Sara, Welcome ... your it's your lucky day, normally take 24-hrs to respond(volunteer here), answer 50+ emails a day from the worst scar cases.

Ok let me try to analyze this post.

I would never do rf needling and tca cross together. This is not the way we do treatment. Drs love multi treatments $$$$$$, and patients think they will get some quick treatment this way. Your not addressing the pit's before rf needling.

You always do manual methods first, ... rf needling would come latter on in your treatment plan.

You need subcision, this should be your goal. That should have been the first treatment, not a energy device. Of course you would see no results with Tixel as it's for light surface textural issues and not even as strong as a laser. Marketing says it can do all these things which is not true.

Your scars are mild, lots of areas of perfect skin. Because of your lighter skin they will use lower settings to avoid side effects.

I do not know this Dr' your seeing, he/she may be ok, but they are not a acne scar specialist so make sure you only do manual methods with them to start.

You have some box cars, rolling scars, and ice picks.

I never tell anyone how much they will improve from treatment, ... some don't heal well, some take years of treatment to get 50%, and some have magical results. Expect 50% after many treatments, if more great.

Hi There, you have [box car, rolling, and ice pick], scars with fat loss, you need filler in some of those pits with the subicisons.

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Disclaimer: Information and support is not meant to diagnosis, treatment, or cure any health or mental condition and is not a substitute for professional face to face medical care (consult with a few Dr's and pick your favorite one). Posts are for informational purposes only, please consult your personal health care practitioner before engaging in anything discussed.

Hi @beautifulambition

Thanks for getting back to me. So I just had my phenol cross 88% with Tixel Sublative. He also was not comfortable doing RF at the same time as the Cross, so he did a sublative session in order to tackle the mild textural issues.

as for subcision, he said that I don™t have any tethered scars, only volume loss. So I asked about HA fillers but he said to wait until I™ve had several sessions of the tixel and phenol cross combo, since he™s noticed an increase in volume since my last treatment 2 months ago. 

The pharmacy has ordered tretinoin 0.05% and am currently using HA sheet masks as post-op care. I will upload more pictures In the coming days. In fact I may very well post some right now as I am freshly post-op.

Can™t wait to see the results, when it™s healed Hope it goes well! It™s good to know there are more doctors in the UK treating scars. 

@SaraDI will have to see how you heal. The pic is unusual - provided, "Phenol" cross on you. Some of the scars seem to be widened or were a bit wide to begin with that he did them on,be prepared you may need a few phenol sessions and widening may occur... I don't know that I would have treated some of them with Phenol. So we have to see how you heal.

@acne_skin_queenWe have several UK Dr's in the FAQ pinned to the top of the scar treatments sub - I added a bunch more be aware they are $$,$$$ and mainly laser derms as this Dr is, the problem w/ general dermatologists who dabble in these things. Their main treatments are not scars. As you know any general derm, cosmetic med spa, or even neighborhood clinic can treat some general energy device aesthetics in UK/EU. We just have to watch the results, ...

.

@acne_skin_queenCool let me know his name and we can add him as well. Always good to have more subcision Drs, ... this is the hardest thing to find.

@beautifulambition

hey so some of my scars were wide. In fact my scars are more wide than they are deep. Here™s a little progress pic since the day of the initial procedure. You™ll notice that he missed 2 little scars but we™ll get them next time

@beautifulambition

Hi, just an update on how I™m healing from the phenol cross 

juat curious, you said you wouldn™t have done the phenol cross given my scars. What treatment would you have me do instead ?

@SaraDHi Sarah, you seem to have some rolling scars with PIE or discoloration(wounding) and some wide box cars. the red discoloration is the biggest issue that stands out.

I would have not done tca cross on them as they are wide to begin with.

I would treat the redness with multiple rounds of vascular laser or picosure.

Do some subcision on some of the spots as they are pitted, and perhaps use a soft filler like beletero or volbella.

Do some fractionated co2 specifically to the borders of the scars in low densitymode or rf needling (like you already said - get Infini rf).

Then some fully abaltive erbium laser to resurface the pits, vascular laser. The reason your fully ablative laser treatment did not work to begin with is that is supposed to be at the end for texture.

Your using retin-a or tretinorin right nightly and a cream to prevent hyperpigmentation like PCA hydroqunone free pigment gel on Amazon.

@beautifulambition

hey the wide box scar along my jawline is healed, meaning the scar is completely raised and gone. What Confuses me about the other shallow ice picked scars is that they havent healed in the same way. Its as if the Phenol Cross has had no effect on them. The doctor told me that Id see the effects up to 6 weeks after the treatment.

im very opened to doing subcision, but Ive been to two dermatologists who perform the procedure,but they refuse to do it on me. They say that I dont need it that my scars are not tethered.

Well it's too early to see, it takes around 3 months to heal. Also with phenol or tca cross we are trying to raise the scar floor gradually over many treatments, not make the scar disappear. Then your resurface when it becomes more shallow. If you have had bad results it could be his technique was not good or healing has not occurred yet.

IF they won't subcise you, then get filler done underneath the scar,s something soft as described above.

You do need some energy work as well.

IF tca cross is not successful you might have to discuss punch excision with him. But I always advise this as a last ditch- surgery thing.

@beautifulambition

finally was able to get subcision + HA fillerwith a second treatment of phenol cross today. I got it done today.

Oooh just saw this, just want to say I had Infini done at the same clinic, but not by Dr Harryono, by one of hissenior therapists.

I found it eye wateringly painful, bled severely and looked like something out of a horror film for days after lol. Seemed I had a more extreme reaction than most...

Unfortunately saw no results despite being told I'd only need 2 treatments, I'm likely just a poor healer.

Please keep us updated! I'm on Accutane right now but will be seeking treatment again after a year of comingoff it.

@SaraDSounds good, keep us updated on your progress after you heal a bit.

@unbreakable1 hi, thanks for popping in.

So I spoke to Dr. Harryono about Infini during my appoitment. Initially I was set on trying it out, but, because of the type of scars I have, he suggested a second Phenol Cross procedure coupled with Subcision with a cannula needle as I was afraid to do it with a Nokor. 

He said Inini is great but only after the scars have been well treated. Of course it can be used in combination but I personally think that™s too harsh for my skin at the moment. 

@beautifulambition during the subcision procedure I could hear the fibrous bands beeing broken. The sound was very noticeable as both the Dr and I could hear them snap. It was actually pretty cool. 

Here™s a pic of what I look like 3 days post-procedure. I have a vitamin C cream on.

I also did sub+filler+TCA Cross 4 days ago! Could also hear the fibrous bands pop loudly during the whole procedure. It was 50/50 fascination and unconvenience imo. but somehow it felt good hearing it because I could visualize all my scars disappearing. 

I wish you good progress and fast healing!  

16 hours ago, SaraD said:

@unbreakable1 hi, thanks for popping in.

So I spoke to Dr. Harryono about Infini during my appoitment. Initially I was set on trying it out, but, because of the type of scars I have, he suggested a second Phenol Cross procedure coupled with Subcision with a cannula needle as I was afraid to do it with a Nokor. 

He said Inini is great but only after the scars have been well treated. Of course it can be used in combination but I personally think that™s too harsh for my skin at the moment. 

@beautifulambition during the subcision procedure I could hear the fibrous bands beeing broken. The sound was very noticeable as both the Dr and I could hear them snap. It was actually pretty cool. 

Here™s a pic of what I look like 3 days post-procedure. I have a vitamin C cream on.

I hope you see a good results,keep updating please!

16 hours ago, SaraD said:

@unbreakable1 hi, thanks for popping in.

So I spoke to Dr. Harryono about Infini during my appoitment. Initially I was set on trying it out, but, because of the type of scars I have, he suggested a second Phenol Cross procedure coupled with Subcision with a cannula needle as I was afraid to do it with a Nokor. 

He said Inini is great but only after the scars have been well treated. Of course it can be used in combination but I personally think that™s too harsh for my skin at the moment. 

@beautifulambition during the subcision procedure I could hear the fibrous bands beeing broken. The sound was very noticeable as both the Dr and I could hear them snap. It was actually pretty cool. 

Here™s a pic of what I look like 3 days post-procedure. I have a vitamin C cream on.

I hope you see a good results,keep updating please!

@beautifulambition hey, I™m not sure if I™m responding well to the acid. I know it™s only been my second phenol cross but it only seems to be working for one of my scars, the really red one along my jawline. That scar is completely leveled but of course I have PIH. I™m not sure what else to do. Maybe it™s time to try CO2 resurfacing?

@SaraDThis is a completely normal response. I do not know your ethnicity but be aware that ethnic skin types will hyperpigment and get red for sometimes months to a year, ... this is the trade off for treatment that we address after. What did you Dr say about the results?

Also phenol typically does not get wider but tca cross does and raises the scar floor, ... redness is part of healing and makeup is put over it.

What concerns me is your mid upper cheek does not look treated, ... the jawline just has some PIE or redness from healing.

I would treat the PIE or redness lastly as more treatments will potentially cause more.

Address those rolling scars, were they subcised mid upper cheek?

I would cross some more on your icepicks as I see many more. Is Dr -using a lower percentage of acid or what is his technique, ... what are his thoughts on treatment.

I would be doing dermastamping or derminator(google it) between Dr's treatments every 3 months, alternating with glycolic peels at home, ... I would be using a retinoid / or tretinorin nightly for cell turnover. The PCA hyperpigmentation hydroquinone free gel to work on some disoloration.

Dr's treatments, RF microneedling would be helpful to your case. You need 4 or 5 of those.

Then I would do fractional co2 if you don't get results.

Finally I would do a laser peel(Ablative) or a mid to deeper peel to work on the texture.

Start with those at home procedures monthly.

@beautifulambitionYea so the Dr has been using88% Phenol. The scar on my jaw has responded very well too it, the small ice picked scars are just stubborn. I also had one session of subcision with him. I will be having my second sub very soon.

Would it be a good idea to do subcision and Infini at the same time, during the same session? Or should I do Infini after Ive completed about 5 Phenol cross sessions?

Or should I do subcision, Cross and erbium during the same session?

any ideas for combination treatments?

<3

@SaraDNo I would separate out your sub and rf needling. You can do Sub and phenol cross together though.

Regarding when you can start rf needling, you can alternate between your other sessions of manual work and that works ok, or do the 4 in a row.

I would never do laser in the same session. We do this at the end.

Combination treatments make bad side effects and stunt collagen growth. IF you must do something, ... at home monthly between do dermastamping or the derminator(google it) especially the single needle attachment to the borders of the scars alternate with glycolic peels, between the Dr's sessions done farther apart.

rf needling is not the same as dermastamping.

@beautifulambitionhey,

so im not sure if its due to the redness but the scars look more apparent. Its not to say that theyre deeper or wider, but they appear more noticeable/visible. Is that normal at this stage?

@SaraDThis will always be a factor with your skin type and treatment, every time you treat. This is normal. Are you using your retinoid nightly and a skin lightener like pca pigment hydroquinone free gel with ingredients like licorice, arbutin, kojic ... many products out there, ... do this before and after treatments. Secondly a very real part of treating with your skin type is dealing with the hyperpigmentation and longer healing from treatments. Pulse dye laser is often needed and it can just take longer to heal. I suggest getting some concealer or a tinted suncreen. We have some patients who take months to heal. Do glycolic peels at home monthly, it's a slow process. Finally try Niacinamide by a company like the ordinary.

@beautifulambition I had ordered tretinoin 0.05, I have it but I haven™t been applying it yet, I was a bit on the fence about using it during my treatment, but it seems like it™s safe to do so.

My skin type seems to heal very slowly but I do see some changes. On another note, would it be possible to do Infini RF if I have an HA filler?

@beautifulambition my scars really get me depressed sometimes. They just look so awful. And the worst part about it is that its only on one side of my face, so it contrasts greatly with the other healthy side. Sometimes I think people really notice them