Hi, for folks familiar with Dr. Rullan, you must have at least done Trio or Quatro with phenol CROSS, subcision, erbium and maybe filler. If you have done or are familiar with phenol peel as well, do you think doing a few rounds of Trio or Quatro can achieve the same result as phenol peel? Since the downtime for phenol peel is significant, it really would be great if doing Trio or Quatro for 3 times can achieve comparable result as phenol peel. It seems Dr. Rullan has the method of "abrasion" for Trio/Quatro, in which he abrades scar edges with repeated CROSS and erbium. That sounds to be solid for shallow scars. Anyway, please let me know if anyone know about this. Thanks in advance.
There is no abrasion during trio/quadro. He's using gauze to wipe away dead skin cells from the laser, it's called debriding and is supposed to improve wound healing. https://pubmed.ncbi.nlm.nih.gov/18513293/ The laser is a fractional laser that hits like 25% of your skin at a given area.
I had the quadro with him with the Erbium laser. It felt like he did a quick pass with phenol, only on large scars, not icepicks, and did some passes with Erbium. Didn't improve skin texture at all. The swelling looked good for 5 days, then skin texture is bad again. Felt like a waste of money. Maybe if I only booked phenol cross + erbium he might spend more time on icepicks.
The phenol peel day 1 is phenol peel of the skin. Day 2 your skin melts and turns into like a liquid, he uses a tongue depressor to wipe away the dead skin cells, i.e. debride them. There's no dermabrasion imo.
In his paper from 2004, he says he curettes deep scars (use some kind of metal surgical tool to scrape at it) and adds more phenol to those scars, then phenol all over. Not sure if he's currently doing this, I don't see others mention it.
The crucial part to smoothing out our skin is dermabrasion, physically damaging both healthy and scarred tissue to make them blend together and be smooth. I don't see any good doctors for this though.
For shallow scars I'd book only phenol cross and erbium. And maybe use this Duoderm wound dressing on it. . The subcision and fillers are a waste of money unless it's deep pitted scarring
Have you asked him yet? I've gone to him a hand full of times now and one time he brought up the phenol peel and something that people do, but he said he didn't recommend it for me.
I've done phenol peel, but I really want to have further improvements. But having a second peel is probably too much (and I probably don't have that much downtime), so I am wondering how good Trio/Quatro can go, especially for residuals after phenol peel.
I've done 3 Trio's (erbium, CROSS, subcision) and 2 Duo's (CROSS + erbium as he thought I didn't need more subcisions). I have a few deep rolling scars and wide spread shallow boxcars + icepicks. Honestly I don't see huge improvements on the shallow scars and thus am considering the phenol peel. That said, I don't think it would achieve an improvement as dramatic as phenol peel. How's your phenol healing so far?
I've done 3 Trio's (erbium, CROSS, subcision) and 2 Duo's (CROSS + erbium as he thought I didn't need more subcisions). I have a few deep rolling scars and wide spread shallow boxcars + icepicks. Honestly I don't see huge improvements on the shallow scars and thus am considering the phenol peel. That said, I don't think it would achieve an improvement as dramatic as phenol peel. How's your phenol healing so far?
It's been a few days past 3 months since I did phenol peel. Realistically speaking, it's a great procedure and I've seen decent amount of improvements. I've tried a lot of lasers and microneedling before, all in pretty aggressive settings (e.g., Ultrapulse kept my skin red for over 2 months). Honestly, no other single treatment can achieve what a phenol peel produces, not even close. I think one of the reasons is that anything fractionated can never hit 100% of the scar, thus cannot completely change the scar. Also, phenol works in cell's level, it's like tagging every single cell and make it regenerate. I imagine this process can take a long time, maybe that's why Dr. Rullan kept saying your skin will keep improving over the next 2-3 years. So, I think protecting skin is very important during this process.
On the other hand, I can't say phenol peel just evaporate scars. Every single scar is still there. It just changes scars. Even the shallowest scars, I do not see them going away. It just becomes a very tiny thing, something like a light wrinkle. So tiny narrow ice picks, it becomes like an enlarged pore. The overall change is pretty good. It lights up the entire face and skin tone and makes my skin not look that "dirty". For scars with atrophy, they are still craters. I wouldn't say they did not change any, it's just becoming more round. Overall, I don't regret doing the procedure. I regret I didn't do it earlier, so that I might probably have the chance to do it twice.
Also, I need to mention, the healing time is very brutal. My skin is still pretty red. And it's only until the recent 3 weeks I start to see significant improvements. It's so frustrating in the past 2.5 months that I kept looking at the mirror 100 times a day and kept questioning why the improvement is so little? I've seen people saying that they can still see noticeable improvements after 5 or even past 6 months. I may believe so, at least before the redness is completely gone. As long as the skin is still red, it's still changing. So, I might hope the redness stays longer 🙂
I will (try to) be patient to wait at least 8-10 months to judge the overall improvements.
I've read this research paper and I am amazed that phenol can penetrate so much deeper than anything else. Nothing else can do it. Ultrapulse CO2 might be able to, but can only with very low density. You cannot hit every entire scar even you do it 10 times. So that also makes me think, as long as the CROSS technique can brush the entire scar with enough amount of phenol, it may still be able to reach the scar base? That's why I was asking if doing some Trio/Quatro can achieve somewhat comparable result, at least on individual scars?
I've done 3 Trio's (erbium, CROSS, subcision) and 2 Duo's (CROSS + erbium as he thought I didn't need more subcisions). I have a few deep rolling scars and wide spread shallow boxcars + icepicks. Honestly I don't see huge improvements on the shallow scars and thus am considering the phenol peel. That said, I don't think it would achieve an improvement as dramatic as phenol peel. How's your phenol healing so far?
It's been a few days past 3 months since I did phenol peel. Realistically speaking, it's a great procedure and I've seen decent amount of improvements. I've tried a lot of lasers and microneedling before, all in pretty aggressive settings (e.g., Ultrapulse kept my skin red for over 2 months). Honestly, no other single treatment can achieve what a phenol peel produces, not even close. I think one of the reasons is that anything fractionated can never hit 100% of the scar, thus cannot completely change the scar. Also, phenol works in cell's level, it's like tagging every single cell and make it regenerate. I imagine this process can take a long time, maybe that's why Dr. Rullan kept saying your skin will keep improving over the next 2-3 years. So, I think protecting skin is very important during this process.
On the other hand, I can't say phenol peel just evaporate scars. Every single scar is still there. It just changes scars. Even the shallowest scars, I do not see them going away. It just becomes a very tiny thing, something like a light wrinkle. So tiny narrow ice picks, it becomes like an enlarged pore. The overall change is pretty good. It lights up the entire face and skin tone and makes my skin not look that "dirty". For scars with atrophy, they are still craters. I wouldn't say they did not change any, it's just becoming more round. Overall, I don't regret doing the procedure. I regret I didn't do it earlier, so that I might probably have the chance to do it twice.
Also, I need to mention, the healing time is very brutal. My skin is still pretty red. And it's only until the recent 3 weeks I start to see significant improvements. It's so frustrating in the past 2.5 months that I kept looking at the mirror 100 times a day and kept questioning why the improvement is so little? I've seen people saying that they can still see noticeable improvements after 5 or even past 6 months. I may believe so, at least before the redness is completely gone. As long as the skin is still red, it's still changing. So, I might hope the redness stays longer 🙂
I will (try to) be patient to wait at least 8-10 months to judge the overall improvements.
Hey @froyosh thanks for sharing, and congrats on the progress! Glad that you are happy with the result already! Hope you see even more progress in the next 3 months.
Yes, I hear you. Sharp scar edges and hyperpigmentation make my face look dirty and make me look older than I actually am :(. That's why I want to give it a last shot with phenol. I'd done a lot of laser treatments too (3 halo + 3 or 4 fraxels? + 4/5 IPL) prior to the Trio/Duo's. Little to no progress from the $$$ laser, only left my skin red and irritated. The shallow scars didn't even respond very well to CROSS + erbium imo. I will see if I can find any before&after pics to show later this week, maybe starting my own thread?
BTW, other patients reported waxy skin after phenol, are you experiencing the same?
I've done 3 Trio's (erbium, CROSS, subcision) and 2 Duo's (CROSS + erbium as he thought I didn't need more subcisions). I have a few deep rolling scars and wide spread shallow boxcars + icepicks. Honestly I don't see huge improvements on the shallow scars and thus am considering the phenol peel. That said, I don't think it would achieve an improvement as dramatic as phenol peel. How's your phenol healing so far?
It's been a few days past 3 months since I did phenol peel. Realistically speaking, it's a great procedure and I've seen decent amount of improvements. I've tried a lot of lasers and microneedling before, all in pretty aggressive settings (e.g., Ultrapulse kept my skin red for over 2 months). Honestly, no other single treatment can achieve what a phenol peel produces, not even close. I think one of the reasons is that anything fractionated can never hit 100% of the scar, thus cannot completely change the scar. Also, phenol works in cell's level, it's like tagging every single cell and make it regenerate. I imagine this process can take a long time, maybe that's why Dr. Rullan kept saying your skin will keep improving over the next 2-3 years. So, I think protecting skin is very important during this process.
On the other hand, I can't say phenol peel just evaporate scars. Every single scar is still there. It just changes scars. Even the shallowest scars, I do not see them going away. It just becomes a very tiny thing, something like a light wrinkle. So tiny narrow ice picks, it becomes like an enlarged pore. The overall change is pretty good. It lights up the entire face and skin tone and makes my skin not look that "dirty". For scars with atrophy, they are still craters. I wouldn't say they did not change any, it's just becoming more round. Overall, I don't regret doing the procedure. I regret I didn't do it earlier, so that I might probably have the chance to do it twice.
Also, I need to mention, the healing time is very brutal. My skin is still pretty red. And it's only until the recent 3 weeks I start to see significant improvements. It's so frustrating in the past 2.5 months that I kept looking at the mirror 100 times a day and kept questioning why the improvement is so little? I've seen people saying that they can still see noticeable improvements after 5 or even past 6 months. I may believe so, at least before the redness is completely gone. As long as the skin is still red, it's still changing. So, I might hope the redness stays longer 🙂
I will (try to) be patient to wait at least 8-10 months to judge the overall improvements.
Hey @froyosh thanks for sharing, and congrats on the progress! Glad that you are happy with the result already! Hope you see even more progress in the next 3 months.
Yes, I hear you. Sharp scar edges and hyperpigmentation make my face look dirty and make me look older than I actually am :(. That's why I want to give it a last shot with phenol. I'd done a lot of laser treatments too (3 halo + 3 or 4 fraxels? + 4/5 IPL) prior to the Trio/Duo's. Little to no progress from the $$$ laser, only left my skin red and irritated. The shallow scars didn't even respond very well to CROSS + erbium imo. I will see if I can find any before&after pics to show later this week, maybe starting my own thread?
BTW, other patients reported waxy skin after phenol, are you experiencing the same?
How long has it been since your Trios? For shallow scars, you really need to wait a long time to see something. Probably one full year. Phenol works very slowly. But it's changing.
I've done 3 Trio's (erbium, CROSS, subcision) and 2 Duo's (CROSS + erbium as he thought I didn't need more subcisions). I have a few deep rolling scars and wide spread shallow boxcars + icepicks. Honestly I don't see huge improvements on the shallow scars and thus am considering the phenol peel. That said, I don't think it would achieve an improvement as dramatic as phenol peel. How's your phenol healing so far?
It's been a few days past 3 months since I did phenol peel. Realistically speaking, it's a great procedure and I've seen decent amount of improvements. I've tried a lot of lasers and microneedling before, all in pretty aggressive settings (e.g., Ultrapulse kept my skin red for over 2 months). Honestly, no other single treatment can achieve what a phenol peel produces, not even close. I think one of the reasons is that anything fractionated can never hit 100% of the scar, thus cannot completely change the scar. Also, phenol works in cell's level, it's like tagging every single cell and make it regenerate. I imagine this process can take a long time, maybe that's why Dr. Rullan kept saying your skin will keep improving over the next 2-3 years. So, I think protecting skin is very important during this process.
On the other hand, I can't say phenol peel just evaporate scars. Every single scar is still there. It just changes scars. Even the shallowest scars, I do not see them going away. It just becomes a very tiny thing, something like a light wrinkle. So tiny narrow ice picks, it becomes like an enlarged pore. The overall change is pretty good. It lights up the entire face and skin tone and makes my skin not look that "dirty". For scars with atrophy, they are still craters. I wouldn't say they did not change any, it's just becoming more round. Overall, I don't regret doing the procedure. I regret I didn't do it earlier, so that I might probably have the chance to do it twice.
Also, I need to mention, the healing time is very brutal. My skin is still pretty red. And it's only until the recent 3 weeks I start to see significant improvements. It's so frustrating in the past 2.5 months that I kept looking at the mirror 100 times a day and kept questioning why the improvement is so little? I've seen people saying that they can still see noticeable improvements after 5 or even past 6 months. I may believe so, at least before the redness is completely gone. As long as the skin is still red, it's still changing. So, I might hope the redness stays longer 🙂
I will (try to) be patient to wait at least 8-10 months to judge the overall improvements.
Hey @froyosh thanks for sharing, and congrats on the progress! Glad that you are happy with the result already! Hope you see even more progress in the next 3 months.
Yes, I hear you. Sharp scar edges and hyperpigmentation make my face look dirty and make me look older than I actually am :(. That's why I want to give it a last shot with phenol. I'd done a lot of laser treatments too (3 halo + 3 or 4 fraxels? + 4/5 IPL) prior to the Trio/Duo's. Little to no progress from the $$$ laser, only left my skin red and irritated. The shallow scars didn't even respond very well to CROSS + erbium imo. I will see if I can find any before&after pics to show later this week, maybe starting my own thread?
BTW, other patients reported waxy skin after phenol, are you experiencing the same?
How long has it been since your Trios? For shallow scars, you really need to wait a long time to see something. Probably one full year. Phenol works very slowly. But it's changing.
I started my treatment with Dr.Rullan from Oct 2021 or so, it's been quite some time. Maybe my scars are too old (10-15 years) to respond.
@grimacingblob Hi Thank you so much for sharing, do you mind sharing your scar photos? I am also considering going to Dr Rullan for treatment, I have done several pricey lasers and even subcisions with pricey doctors in LA but seeing 0 improvement.
BTW hearing rumors regarding dr rullan's retirement, that make me feel anxious. do you hear anything from him given you recently visit him? thanks
I've been thinking about this. If you do 2nd phenol, you don't have to get the full face peel. The first time they do full face in case there are pigmentation problems, your face is the same color. The second time you can do a regional peel on the cheeks only. You can cover up with makeup like CC cream (color correct) or foundation after 2 weeks and wear a mask. Also the touch up is cheaper, I think half price.
I've been thinking about this. If you do 2nd phenol, you don't have to get the full face peel. The first time they do full face in case there are pigmentation problems, your face is the same color. The second time you can do a regional peel on the cheeks only. You can cover up with makeup like CC cream (color correct) or foundation after 2 weeks and wear a mask. Also the touch up is cheaper, I think half price.
Are you sure? Ive heard two things: 1) Dr.Rullan usually does not recommend regional as it more or less can cause pigment difference; 2) Is it really only half price? Where do you get this?
