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WaterFountain

TCA applied on a Rolling scar

A scar looks like a mix between a rolling and box scar. Upon stretching, it doesn't entirely flatten like let's say an enlarged pore would. It looks a lot better, like it's almost gone, but it doesn't look likr normal skin when stretched.
What would happen if tca 50% is applied to it? Normally, ,such a scar would be treated with subcision.

The reason why I'm asking is because I want to know the risks of using the wrong method on a scar due to misclasification.

Are there any other ways to distinguish a scar from another, except by having a general idea? Some examples from the internet use pictures that leave no room for doubt, but every person's scars are different...

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I'm questioning about the same thing. I have some wide boxcars, what would happen if i apply let's say 50 percent tca on it? 

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This is confusing without a pic. Are you saying there is a texture issue. TCA helps with texture issues. Are you saying it's a scar with fat loss thus needing filler, or are you saying it's tethered. So many variables. If 50% TCA is applied to texture it widens the spot and with repeated treatment blends out the scar to soften it, TCA Cross of course raises the scar bed (floor) by re wounding the bottom surface and letting the body heal it. 

At 50% application this is cross for a at home user. It would depend on the scar photo you share and it's characteristics. Cross works with well defined walled scars (has to have a wall) and the closer together the wall the better, you never touch the wall just the bed of the scar. Otherwise you are doing TCA spot peels with a high percentage of acid which can be done on other types of scars at lower percentages. 

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The first 2 marked pictures are from afar and the other two are from closer up. 
To me it looks like I should just do resurfacing with dot peel.

Edited by WaterFountain

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23 minutes ago, Robertitoo said:

Those look like boxcar scars and ice pick. I see no rolling scars


Cool! Wide and narrow box scars are treated the same I suppose?
I'm so excited to do some TCA 50% next week!!!

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Go slow.  Do only test spots first.   An entire face of wider red spots after TCA Cross will not look pretty.  

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How many days would it take approximately to get a crust, heal and peel off...?
Most information online says it takes about 4-5 days for the skin to get a crust and then it takes about 10 days to 2 weeks for it to completely peel off.
Check this out :| http://www.sciencedirect.com/science/article/pii/S2352241015000444
I'll do small dots obviously, but my skin if a little lighter and more sensitive... Should I dilute the peel? I really don't want to waste my 5 days off!!! 

 

Edited by WaterFountain

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@WaterFountain  People always want to know about crusting, ... one person's 10 days is another persons 2 days healing period. Your testing a small tiny spot to see how you heal. 

Read this please (full instructions below)  , it's all on page one. I say test spot, dilute, see how you respond, and never put 50%-100% on your skin without testing diluted on a "small" spot! Especially since you have "sensitive" skin, you need to dilute or you will hyperpigment. Do one tiny spot and test at a diluted amount (under 20% for cross, 12-15% for tca spot peels).

That link is ridiculous (I put the Onus on the Amazon Chinese company who sells TCA car part cleaner at that strength and people just slap it on, what's next a sand paper rub down), putting 50% full face / spot peel is a NO NO. Most people don't go over 25-35% Spot Peel MAX after building up to it, lots of people can't can't go over 20%.

For TCA Cross your going to have to go lighter on your percentage (dilute), and test that.

http://www.acne.org/messageboard/topic/366754-discussionallthingsacidpeelsforscarstcafullfacepeeltcacrossphenolglycolicsalicylicmethodsandtechniques/?page=1

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Apparently it's completely safe to do those high TCA Cross sessions (50-70%) 2 weeks apart:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3800288/  (w/pics) This study gave me some hope for my box scars. Here, chicken pox scars, which are much wider than my scars, are being successfully treated.

https://www.ncbi.nlm.nih.gov/pubmed/25899884 (no pics)

https://www.ncbi.nlm.nih.gov/pubmed/21332915 (no pics)

I did a spot test for Salicylic acid as well as Glycolic acid on my skin, and surprisingly 25% SA hurt more than 40% GA.
As shown here (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921757/), when using the same %, SA works just a little bit  better than the GA after a couple of treatments every two weeks. 

I'm thinking of doing something like this:
TCA Cross 50% on my acne scars (cheeks), followed by 12% SA on chin, nose and forehead and 25% SA on my cheeks. Next day-light derminator.

This is interesting on preparation, post care and maintenance :
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921757/

Edited by WaterFountain

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10 hours ago, WaterFountain said:



I'm thinking of doing something like this:
TCA Cross 50% on my acne scars (cheeks), followed by 12% SA on chin, nose and forehead and 25% SA on my cheeks. Next day-light derminator.

This is interesting on preparation, post care and maintenance :
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921757/

What!? Tca 50% + 25% SA + derminator the next day? Wt*!?
U obviously ve never tried tca 50% lol 

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10 hours ago, Rdnhey said:
What!? Tca 50% + 25% SA + derminator the next day? Wt*!?
U obviously ve never tried tca 50% lol 
 Don't worry, maybe one day you'll find a way to solve your problems. 
 
1 hour ago, ELPUMA said:

Im curious if the TCA Cross worked for you. did it?


Well, I only did a patch test of different peels and so far I haven't had any bad reactions.
Less than 24 hours later, my skin is healing well.
The TCA Cross looks like I have small marks from past pimples and my skin is a bit pinkish from the patch peel.
 

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I am glad your finding a way to fix your scar issues.

That being said 100% in a doctors office Cross is different than doing it at home. That is why we must do less. First of all they have medical experience to treat you, they have the liability of the malpractice, they have done hundreds of peels, and they have emergency resources we don't to deal with emergencies (drugs, sprays, creams, devices).

I am just saying be safe, I have had many people, who slapped on the 50% to 100% and were destroyed. Like the first link you posted. Don't mix your acids, you can do Sali first, or Jessner to prep for TCA that's fine, this is the same thing as Acetone (aka 100% perfume free nail polish remover) which I recommend to prep for peels. If microneedling that just be done first before using any acid to avoid it going down the channels. It's when we do too many treatments mixed too soon, there can be issues. Were in experimental territory. Some doctors after a medium to deep deep peel make you wait 3-6 months for another. Too soon every 2 weeks can lead to sub par outcomes, as the skin has not healed, it all depends on your test spot and how your skin heals.

Be safe, and keep us updated on your progress. 

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The GA spot is still pink and the SA's one isn't, so I will stick to SA for the near future!
I've attached pics of the TCA Cross so you guys can see what it looks like a day later.

Peeling procedure

The standard procedure for chemical peeling with SA involves use of a 20% or 30% SA formulation in an ethanol base. The peels are repeated at an interval of 2–4 weeks. Peak results are visible after a series of 3–6 chemical peels depending on the severity of the condition being treated and skin type. It is wise to perform the initial peel with a 20% SA formulation in order to assess sensitivity and reactivity of the patient’s skin to the peeling agent. Before starting the peel, the face should be thoroughly cleansed with alcohol and/or acetone to remove oils from the skin. The peel is then applied. Various methods can be used to perform the peel. Usually, 2×2 wedge sponges, cotton-tipped applicators, and 2×2 gauze sponges are used for application. In clinical practice, 2–3 coats of SA are usually applied in one sitting. The manner in which the peel is applied on the face can vary. One good method is to apply the peel first to the medial cheeks and working laterally, followed by the perioral area, then chin, and lastly the forehead. The peel is then left on for 3–5 minutes. During the procedure, most patients complain of mild burning and a stinging sensation. After 1–3 minutes, some patients may experience anesthesia of the face due to the anesthetic properties of the SA peel. The sensation of burning and stinging can be reduced using a portable handheld fan or ice packs. Within 30 seconds to 1 minute of peeling, a white precipitate is formed, as a result of crystallization of the SA. It must be remembered that the frost seen in a SA peel represents precipitated SA, while the frost in a trichloroacetic acid peel is formed by precipitation of skin proteins.3 Once frosting has occurred, it means that the patient will observe some crusting and peeling after the procedure. This crusting and peeling may be quite acceptable for treating a patient with photodamage, but when treating melasma and other pigment dyschromias, minimal or no frosting is the preferred option. The SA peel has an advantage over the α-hydroxy acid peel in that the former does not need to be neutralized and the frost is visible once the peel is complete.10 Once the peel has had sufficient contact time, which varies in the range of 3–5 minutes, the face is rinsed thoroughly with tap water. A bland cleanser can be used to remove any residual SA precipitate. After rinsing, a bland moisturizer is applied to the skin.

Post-peeling care

For the first 48 hours post-peel, bland moisturizers and cleansers are continued or until all post-peel irritation has ceased. Patient can then resume their topical skin care formulations, which may include topical demelanizing agents, topical anti-acne medications, and/or retinoids. Excessive desquamation and irritation in the post-peel period can be treated with low to high potency topical steroids. It should be noted that topical steroids have been found to be effective in mitigating post-peel inflammation and reducing post-inflammatory hyperpigmentation. However, any hyperpigmentation remaining after the peeling procedure responds to topical hydroquinone and frequent use of sunscreens.

Side effects

Peeling with SA has been well documented in the literature, but certain adverse effects (Table 2) occur, which are usually mild and transient. Lee and Kim performed SA peeling in 35 Korean patients with acne vulgaris and found prolonged erythema that lasted more than 2 days in 8.8% of their patients.40 Dryness has been reported in 32.3% of cases. This can be managed with frequent application of topical moisturizers. Grimes reported intense exfoliation and crusting following SA peeling in 17.6% and 11.7%, respectively, in her patients. However, exfoliation cleared in 7–10 days. There were no cases of scarring or persistent post-inflammatory dyschromias.6 In a study that investigated the safety and efficacy of SA chemical peels in darker ethnic groups (20 African Americans and five Hispanics), 16% experienced mild side effects. Temporary crusting and hypopigmentation was seen in one patient, which cleared in 7 days. Transient dryness and hyperpigmentation was seen in three patients, but resolved in 7–14 days. The author concluded that a SA peel is safer in individuals of darker ethnicity.38

 

Edited by WaterFountain

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Day 2

AM
My 25% cheek looks like I have freckles, but my 50% cheek looks like I have some serious PIH.  Makeup was difficult to apply and I had to use my full coverage for the spots.

PM
All of my "freckles" peeled in the shower.
 

 

 

 

Edited by WaterFountain

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Day 3

AM
Moisturizer with my makeup

PM
Skin is peeling where I have lightly derminated and used adapalene. 50% TCA Cross spots peeled again. I used a light natural toner on a cotton ball to get rid of the flaky skin and then I moisturized with oil.

Honestly, the process is not that bad, but there are definitely some highs and lows in this joutney. One day your skin will look better and another so much worse. Things will be unpredictable. 

My experience with peels:

Pros:
- you have more control over the process and the results. You can always start low and build yourself up.
- If you're unhappy with the results, you haven't wasted $150 on a chemical peel (or more for some other treatment)

Cons:
- it's a bit painful 
- it requires a lot of preparation, knowledge and testing in advance. The actual peel is only a very small part in the middle of the process
- after the peel, you need some downtime and once you return to work/school you'll still have some temporary pigmentation
- you never know when your skin will crust, peel and recover
- superficial peels don't really help scars, they're more of an exfoliating treatment, so don't get your hopes up
- you must select an appropriate type of peel and a percentage to to correct your individual skin issues 
- repeated treatments are neccessary

Edited by WaterFountain

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REAL PEEL

Pm:
Did the 50% tca cross on my cheeks. I also covered some areas with enlarged pores and bad texture, so it wasn't only box scars and ice picks. First I took care of the deep bothersome scars and then I kind of filled the spaces in between, so I covered a much bigger area on my cheeks than anticipated. 
I used 25% SA on my forehead, nose, temples and chin.
I don't want to post pics, because I look pretty horrific and don't want to discourage anyone. 

I might experiment with Jessners peel next time:
http://www.jcasonline.com/article.asp?issn=0974-2077;year=2015;volume=8;issue=1;spage=42;epage=45;aulast=Puri
 

Edited by WaterFountain

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Am:
I moisturized my whole face with oil. My mild moisturizer was too irritating. 
Skin is nowhere near crusting- in fact, a spot on my right cheek looked frosted for a bit too long than the rest until 12 hours later.
The rest of my face is looking normal. I guess 25% SA are pretty safe :)

I think I've finally come to a good acne scar plan!

Every 2 weeks: 25% SA on forehead, nose, chin and temples

Every 4 weeks: alternate 50% TCA on cheeks or 1.5mm derminator.

Thank you BeautifulAmbition, the creators of this website (Dan?) and all the members for being there  <3

In the meantime, I'll apply the hyaluronic acid serum I recently ordered for speedy recovery after my treatments.

Edited by WaterFountain

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Day 2:

Lunchtime (less than 48 hours after the peel)

The discoloration has deepened more than ever. I hope I recover by day 5. The peel never looks too bad when you do it or on day 1, but as time progresses the color develops. My cheeks are rough to the touch when i apply moisturizer and the skin wrinkles up. However, I don't think it'll peel anytime soon, because I've been keeping it moist unlike the test spots. 

My 25%SA peeled a bit from my chin today, but considering I put it all over my face it'll be a long way to go to have it all fall off.

Edited by WaterFountain

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On 4/5/2017 at 9:12 PM, WaterFountain said:

Pm:
Did the 50% tca cross on my cheeks. I also covered some areas with enlarged pores and bad texture, so it wasn't only box scars and ice picks. First I took care of the deep bothersome scars and then I kind of filled the spaces in between, so I covered a much bigger area on my cheeks than anticipated. 
I used 25% SA on my forehead, nose, temples and chin.
I don't want to post pics, because I look pretty horrific and don't want to discourage anyone. 

I might experiment with Jessners peel next time:
http://www.jcasonline.com/article.asp?issn=0974-2077;year=2015;volume=8;issue=1;spage=42;epage=45;aulast=Puri
 

@WaterFountain When you say you "kind of filled in the spaces in between".... do you mean that you did individual scars with a toothpick?  

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1 minute ago, kat22 said:
@WaterFountain When you say you "kind of filled in the spaces in between".... do you mean that you did individual scars with a toothpick?  

Yes, I used a toothpick for all the deep scars that were the most obvious and then i just ran the TCA toothpick on other bad skin areas on my cheeks, essentially covering not only individual scars, but whole areas of my cheeks.

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