Please do NOT do a full face phenol peel. It is not appropriate for dark Asian skin. It is only used in the fairest skin because it runs a real risk of permanently destroying pigment cells. That is not as much as a problem for fair Caucasian skin, but in dark Asian skin it could be a disaster waiting to happen. Even in the best hands, phenol peels are unpredictable in ethnic skin tones. That's just a fact.

There is no method that will clear your skin "completely". The technology is not there yet. You can only get improvement (sometimes significant improvement). The reality is that it takes many, many procedures. There is no such thing as a one and done treatment. If you go into it with that mentality you'll end up making things worse.

2 hours ago, PlCode said:

Let me know what you all recommend!

Was the subcision done using the NOKOR? I would try one more subcison but with FILLER this time to elevate the pits as much as possible. Afterwards, you can smooth out the defined edges with fully ablative erbium laser.

9 hours ago, dazzed said:

Please do NOT do a full face phenol peel. It is not appropriate for dark Asian skin. It is only used in the fairest skin because it runs a real risk of permanently destroying pigment cells. That is not as much as a problem for fair Caucasian skin, but in dark Asian skin it could be a disaster waiting to happen. Even in the best hands, phenol peels are unpredictable in ethnic skin tones. That's just a fact.

I also have ethnic skin and had phenol cross done (88%) by Dr Rullan; the brown marks probably covered 15% of the total facial surface area - he used it on all scar types (rolling, box, ice pick). I'm 17 days out and do not see any issues yet. He likes phenol cross over TCA as a study came out demonstrating phenol was better than TCA.

Why don't people here recommend phenol peels for ethnic skin? Is there a resource I can read demonstrating phenol destroying pigment cells? I was considering it for superficial scars. I found several journal articles using phenol on ethnic skin; they mention phenol's possible severe side effects and report no negative side effects after the study.

1 hour ago, f93d said:

I also have ethnic skin and had phenol cross done (88%) by Dr Rullan; the brown marks probably covered 15% of the total facial surface area - he used it on all scar types (rolling, box, ice pick). I'm 17 days out and do not see any issues yet. He likes phenol cross over TCA as a study came out demonstrating phenol was better than TCA.

Why don't people here recommend phenol peels for ethnic skin? Is there a resource I can read demonstrating phenol destroying pigment cells? I was considering it for superficial scars. I found several journal articles using phenol on ethnic skin; they mention phenol's possible severe side effects and report no negative side effects after the study.

Do you think you can send/post before and after photos please?

Do you think the phenol peel was worth it?

Im debating if I should go for the phenol peel or go with phenol cross, subcision and micro needling again.

Everyone: To add about the phenol peel, Dr. Rullan did a case study on the phenol peel in 2004. (In case you didnt know) Since then hes added subcision to the Phenol Peel procedure.

1 hour ago, PlCode said:

Do you think the phenol peel was worth it? 

I didn't have a phenol peel, just cross. Here are my pictures, not sure what can be derived from it as I'm still bruised. I'm half asian, I have different scars than you.

I'm on day 17 and still look like day 15 from the pictures, just a little less pink. Used aspirin and suction to prolong the bruising. 

I'm leaning towards getting a phenol peel, understanding the risk of pigmentation issues, however I'd like to get another round of subcision and cross. Phenol cross brown spots peel faster than TCA and I didn't see the expanding of scars that occurred with TCA cross. Dr Rullan mentioned this also and is one of his reasons for pushing phenol over tca.

`

3 hours ago, f93d said:

I didn't have a phenol peel, just cross. Here are my pictures, not sure what can be derived from it as I'm still bruised. I'm half asian, I have different scars than you.

I'm on day 17 and still look like day 15 from the pictures, just a little less pink. Used aspirin and suction to prolong the bruising. 

I'm leaning towards getting a phenol peel, understanding the risk of pigmentation issues, however I'd like to get another round of subcision and cross. Phenol cross brown spots peel faster than TCA and I didn't see the expanding of scars that occurred with TCA cross. Dr Rullan mentioned this also and is one of his reasons for pushing phenol over tca.

 

Wow your scars improved a lot.. you can barely see your scars. I wish I had similar results. My scars are still apparent as if I had no treatment done. Was this after your first treatment? 

I think I just need to increase the phenol percentage. Since it was my first treatment I think Dr. Rullan was conservative. 

I™m probably going to pass on the phenol peel because it™s very invasive, expensive and most likely I™ll have to come back for another treatment after the peel...

[

Time to purchase phenol.

@f93dHoly cow dude these results are amazing! You should be postings these pics all over the forum for the scar treatment skeptics, such as myself lol. Im blown awayyy if your results really look this good! I wouldnt even bother with more treatments, why risk damaging results that look phenomenal ! Congrats!

Hate to be that guy, but the light is totallydifferent. I can't tell what's going on.

@quanhenry i agree the lighting is different, but it looks like directional lighting to me, if his scars were the same as before they should be very noticeable in that lighting imo. Mine would be painfully obvious in that after picture, and i think most of mine are actually a little more shallow than his before photo.

@PICode your scar type is quite common for ethic skin (general term), pores, enlarged physiological pores, pick scars (shallow), medium pick scars, and deeper ice pick scars, with mixed tethered, atrophic and box car scars. I am no expert compared to a real doctor, but studies have shown the following combinations may give a good result 1. TCA CROSS 80-90 % medium to deep ice pick and pick scars. 2. CO2 low density after to the area - once white, your protein is coagulated, so laser is safe 3. Subcision with saline for temple scars, 3. Layered multicoat TCA to box car scars . Treat deep to superficial. Once they are shallow, possibly fully ablative erbium. Each to their own. Phenol peels are old school BUT I do not dismiss them. In the correct hands they can be better than ablative lasers, and certainly beats 1/4 million dollar pico lasers, its the skill of the Specialist, and your specialist has a good reputation. A little hint to anyone contemplating scar revision- specialist know what they are capable of delivering, however they can also read you - especially if you are nervous, or a little on the conservative side. They will always under promise everything and not perform their duties to their full potential. I am not here to judge Rullan nor your outcomes, but standardised before and afters can help. These are just my thoughts on your pictures, with you telling the story. Once again, no disrespect to anyone, just my opinion as your scar pattern is quite standard for your Ethnicity and the treatments are very straight forward.

@f93dthe technique was a multi - coat paint technique you had, not CROSS, vvvv good technique for medium to deep box car scars, as well as shallow box cars. Very flexible method of applying TCA. The result is great. The harshest critic is the patient, so everyone going on about lighting etc... etc...take a step back, as if the patient is content, then, well, results speak for them selves. Unless one has a Visage system at home it is hard to do standardised lighting. Once scars are photographed at their worse to highlight, it about position BOTH light and patient, and to replicate XYZ position for two variables (patient and light), this would be extremely difficult. The point of angle lighting is to see what the patient sees and to rectify their concerns and NOT to revise scars that are seen on the photographs. That is certainly a scientific method and should be considered, but real world scar revision is to understand the patient's mind and concerns. Get into their head, revise what they see, and mission accomplished. Hope my comments don't offend the hard core 'find a way to get exact lighting situations in all cases'. This point I am happy to debate the complexities of vectors with two variables.

17 hours ago, f93d said:

I didn't have a phenol peel, just cross. Here are my pictures, not sure what can be derived from it as I'm still bruised. I'm half asian, I have different scars than you.

I'm on day 17 and still look like day 15 from the pictures, just a little less pink. Used aspirin and suction to prolong the bruising.

 

Hey, you did suction even though you had cross peel at the same time?
I have had tca cross + sub done a few days ago and I didn't plan to do cupping this time since the subcised and crossed areas overlay pretty much everywhere. I thought it was dangerous. But it didnt cause you problems?

14 hours ago, QuanHenry said:

Hate to be that guy, but the light is totallydifferent. I can't tell what's going on.

Me neither. I didn't bother with the same lighting b/c I'm still bruised - when bruised, results always look good regardless of lighting. I primarily wanted to share the 48 hour picture. When I get my before / after pictures in the same harsh lighting from the doc, I may post them on a separate thread. The after picture is VERY deceptive as Day 18 I can still see a bluish tint on both cheeks in the mirror; the sunlight wiped out the bruising from the pic.

@ObiWan thanks for the comment. Maybe it wasn't cross but I did ask it was 88% phenol. It felt like he used a toothpick to apply it, but it also felt like he used a lot of phenol so it bled outwards from each application point - didn't see, didn't ask.

@OP I should of mentioned this is my second procedure (subcision/phenol). The doc didn't do my first phenol treatment like this; it was super mild. The second procedure of this chemical treatment was exponentially harsher. I had negligible improvement from my first subcision/cross (no suction) - people I know said it looked the same.

@eva_li Couldn't suction until day 6 - day 8; aspirin appears to make the bruising blow up 3 fold. By then the phenol spots have peeled and I could suction. To give you an idea, I went back to work on day 9 and was asked if I got beat up.. twice - I looked terrible.

Your scars look amazing, but you are only 18 days out. But it looks promising.

For people considering phenol as a peeling agent, the danger lies in full face phenol not phenol cross. The op was considering a full face phenol peel, which is way too aggressive.

`

People are really falling for these pics? The befores apear to be in overhead fluorescent lighting (worst),and the after is directsunlight (best)It's not even close. I hope you post more accurate pictures because these are inconclusive.

I could do the same thing, and make it look like I got 100% improvement,but I'd hate to see this place go down that road. Not saying it doesn't work either, just that I would need to see better pictures before I decided to go for phenol.

3 hours ago, QuanHenry said:

People are really falling for these pics? The befores apear to be in overhead fluorescent lighting (worst),and the after is directsunlight (best)It's not even close. I hope you post more accurate pictures because these are inconclusive.

I could do the same thing, and make it look like I got 100% improvement,but I'd hate to see this place go down that road.

I myself am falling for the picture because a severe case of scarring would look severe in either of those photos (at least in my experience)

@F93D, what do you yourself grade your improvement?

17 hours ago, QuanHenry said:

People are really falling for these pics? The befores apear to be in overhead fluorescent lighting (worst), and the after is direct sunlight (best) It's not even close. I hope you post more accurate pictures because these are inconclusive.

I could do the same thing, and make it look like I got 100% improvement, but I'd hate to see this place go down that road. Not saying it doesn't work either, just that I would need to see better pictures before I decided to go for phenol.

QuanHenry, I'm glad you brought up this issue as it's important, however please emphasize that I'm still bruised and swollen. Maybe people don't understand how much better swelling makes the skin look. It looks like good improvement in the picture b/c it looks like there is good improvement - someone commented the other day in person my skin looked smoother. I'm not trying to trick you with the sunlight - again I'm bruised and swollen.

I attached a picture I posted on an old thread showing that I could take a picture showing lots of pits with sunlight. In the Day 15 picture, I couldn't make the scars cast a shadow b/c the blood acted as a temporary filler, so I took a picture for my own reference. Today is Day 19, same situation. OP asked for pictures, I posted what I had. If people want to base their decisions off a bruised Day 15 picture.. I hope they stay safe. Phenol is dangerous and stronger than TCA.

If anyone is interested, PM me in a few months for final before/after pictures in the same lighting. I won't be commenting more on this thread related to these pictures or my results - thread has gotten sidetracked.

@f93dWhy don't you start your own post ;-). We would happy to see your updates and progress. They are not attacking you. For some back story, there are some posters on this sub that doubt every outcome because the pictures do not match up and they doubt anything can provide results.

Quan graciously recently provided more pictures and tired to be as accurate as possible (click on his username to see post history). IF anything they are considering this treatment for their own situations. I applaud you for sharing here, that is most valuable. From the picture directly above you biggest improvement would come from subcision and filler. The Phenol could latter be used once everything is normalized more to work on surface texture and or any icepicks. TCA works in a similar way and is easier to find, ... Rullan is a expert at peels and as such favors Phenol often used for deep sedated peels. I fully agree with you. I believe the improvement so far is not conclusive as one swells from days to months after depending on their propensity for healing. Swelling is really a magical thing. It is like filler as it hides irregularity. For those reading do not start with peels before you subcicse and do filler or you could make the skin worse. I would do rf microneedling as well as it works well for all skin types to stimulate collagen. Then move onto cross / peels. Again thank you so much for sharing! Hope to see more.
Sincerely,
BA

Didn't mean to derail thispost, and maybe I could have been a little more tactful. Would love to see your progress.

Photos from May 2nd.

I do not have any current photos because I had my third session of subcision, Carbolic acid (CROSS) and microneedling done yesterday.

my bad for all the bad lighting in my photos..

I think once they get shallow enough, you can get something for the texture.

How do you feel about your treatments so far?