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Gimozzi

TCA Cross + Subcision + Low Dose Accutane (Photos)

There is not much TCA Cross forum in this website so I thought it would be great to start one.

I wish this treatment works out really well for me and hope it will be helpful for others considering TCA Cross or other scar revision treatments.

I am Asian, 27 years old and currently on low dose Accutane, 10mg/day (stopped taking it a week ago because of the treatment. Going to take it next week 20mg/week probably)

 

So after a very long purging period (almost 3 months) I finally did first session of TCA Cross + Subcision.

Treatment did not go well but I think it was okay. One of the scar has excess TCA around it and it became quite dark. 

My Doctor did not really do TCA paint but rather treated all the scars (ice pick and boxcars) the same way, TCA Cross.

He treated my right cheek with 50% TCA and left cheek with 70% for some reason. Maybe because my left cheek is more severe? It could be good comparison, I guess..

Anyways, I have attached the pictures, first 2 are before the treatments, last 2 are right after the treatments. 

I will post another pictures within few days after scars are formed. 

 

My treatment plan (3 months apart):

- TCA Cross + Subcision  x 3

- Intracel RF + Duet RF x 3

- Subcision + Scultra (maybe if needed depending on how I heal)

- Erbium peel or TCA Peel or Laser resurfacing (after when all the treatments above is done, if needed)

- Picosure for pigmentation 

 

Cheers,

 

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Edited by Gimozzi

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I think you will need to wait a few weeks before you can properly assess the treatment. It looks like you have swelling and you're giving yourself three months between treatments, so that's a good starting point.

You said you were going on Accutane again? How long are you planning on the 20mg dose. Remember, the skin may be a little sensitive doing treatments while on Accutane, but hopefully your doctor has said this is all okay. I personally wouldn't do any treatments while on Accutane or six months after it, but that is me. You and your doctor know best.

Keep us updated.

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On 12/21/2018 at 10:50 PM, ScarRight said:

I think you will need to wait a few weeks before you can properly assess the treatment. It looks like you have swelling and you're giving yourself three months between treatments, so that's a good starting point.

You said you were going on Accutane again? How long are you planning on the 20mg dose. Remember, the skin may be a little sensitive doing treatments while on Accutane, but hopefully your doctor has said this is all okay. I personally wouldn't do any treatments while on Accutane or six months after it, but that is me. You and your doctor know best.

Keep us updated.

Yes, I was on 10mg/day for 3 months and I waited until purging period end. I stopped taking Accutane 1 week before the treatment and planning to take 20mg/week instead 1 week after the treatment. My doctor said it is okay to take low dose Accutane and do Subcision + TCA Cross. 

I noticed that my face is a lot more sensitive and more prone to scarring (or maybe less healing ability) but I wanted to make sure all active acne under control before I start the treatment. I am planning to take 20mg/week for a very long time, probably until I finish all the treatment.. so probably more than a year at least. 

I have done test spots with TCA while I was on 10mg/day and the result was not satisfying but meh.. I will see how I heal after this treatment and try to adjust my future plan.

It will be long journey, but I will be keep updating :D

 

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* Day 3 *

- Seems like scabs are slowly forming 

- Most of the treated spots became so much darker

- Trying to keep spots moist all the time (3~5 times a day) with polysporin and Taro-Mupirocin 

- Swelling slowly going down but still there

- I had 4 subcision point and 3 of them are healing pretty well but one of them has a really big hole and does not seem to be healing well.

- Had small bruises around the subcision points and I felt a little pain and discomfort but I feel better on 3rd day

 

It is  frustrating and depressing to look at the mirror every day and see all these scabs and dark treated spots on my face.. it is very mental draining..

I will try to stay strong and focus on something else.. all I can do now is to wait and hope I heal well, I guess :smileys_n_people_38:

Have a great holiday everyone!

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Edited by Gimozzi

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* Day 7 *

- I have been moisturizing many times to make sure all the spots moist. This made all the scabs to be jellish? and while I very softly applying cream on my face one of the scab fell off. This spot was very deep pitted ice pick scar and it seems to be wider  (but the depth is hard to tell whether it is improved or not- no visual improvement) 

- 2 other scabs fell off for more swallow scars and they became wider (again, no visual improvement in depth wise, so far). It is certainly less red compared to the very deep pitted spot. I guess, redness after the treatment is proportional to the scar depth? and TCA concentration.

- Since yesterday, I am not moisturizing often as I am afraid I might scrub the scabs while applying creams. I am going to apply creams to the spots w/o the scabs now. 

- I felt very tingly itchiness on random part of my face.

- I tried all my best to keep all the scabs as long as possible but within a week, 2 fell of naturally and 1 fell off by my mistake (pretty much no improvement for this scar)

- Planning to start taking Accutane again, 20mg/week.

 

Its only been a week, so its hard to tell whether I am healing okay or not (I am very sensitive and my healing ability is not good at all) but so far, looking at the 3 spots with scabs fell off, there is pretty much no improvement. I see spots being wider for sure and no visual improvement in depth. Redness is there always.

Hopefully, they will heal well over time

My next treatment plan is ( Intracel RF + Duet RF  or maybe add TCA Cross for some deep scars)  - 3 months later.

 

Cheers,

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Edited by Gimozzi

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* Day 10 * ( Picture : Left (Before treatment), Right (Today) )

Almost all scabs fell off and honestly, I do not see any improvement at all. 3-4 months ago, my Dr have done test spot with TCA for 2 of my scars. This time, after the treatment, I have not moisturizing at all and the scab was hard and took longer to be fell off. After scab fell, these tested spots were very red and took about 10 weeks to be normal.

This time, I moisturized soooooo much, like at least 5 times/day. I found out that when I moisturize too much, the scabs did not become hard but rather, stay on the skin like another jellish skin layer on top of my skin. I noticed that after these jellish scabs fell, the treated scars are not even red or anything, it is just basically the same as before the treatment, literally.

The scar/scab condition after the treatment when I did not moisturize and when I moisturize a lot was totally different. 

I know it is little too early to tell whether I am improved or not, but its been 10 days and there should be at least a little bit of improvement. Most of the treated scars are not even red, it is seriously the same as before :smileys_n_people_24:

I am assuming that I moisturized too much that I did not allow the scabs to form completely (or to be hard), so the acid did not do much for the scars.. my skin reacting totally different than before when I did not moisturize much after the test-treatment. 

Looking at these scars which are not even red, it seems like the healing is already done (and I heal very poorly and slowly). 

I was told from many Drs from realself that for the dark and Asian skin like me, there will be redness for at least 1-2 months (and it actually did 3 months ago, when I got test treated and did not moisturize much) but this time there is literally no redness...

 

Would this be okay...? I am so worried that the treatment did not go well..

Anyone has any ideas?

 

Thank you so much

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Edited by Gimozzi

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I don't want to go into everything here ... but I have helped you for months through private message, the Dr you chose is not experienced with TCA Cross but you decided to still treat with him. You still have active acne your dealing with and heal poorly. As I said in private cross cant take months to heal from. I don't know if the Dr used dilute acid - need a higher %, did not clean your pits with acetone first so you were greasy, had bad technique. Cross take many sessions not one. If your a poor healer then it won't work well. You can try it without moisturizer next time if you wish. If it did not go well, then why go back to him, ... or find the part that went wrong and fix it. Your still in your healing phase. Your other option as I told you if this does not work, is punch excision and or excisions which would be all over your face- cutting out scars and making them linear and then laser would be needed. If you heal poorly as I said before this can be a nightmare and is VERY dependent on the Dr's experience which is not the guy your going to. 

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Not to mention he is taking Accutane, which can can make your skin more sensitive and thin, which can also add to the healing time. You're a lot braver than me, that's for sure. 

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17 hours ago, beautifulambition said:

I don't want to go into everything here ... but I have helped you for months through private message, the Dr you chose is not experienced with TCA Cross but you decided to still treat with him. You still have active acne your dealing with and heal poorly. As I said in private cross cant take months to heal from. I don't know if the Dr used dilute acid - need a higher %, did not clean your pits with acetone first so you were greasy, had bad technique. Cross take many sessions not one. If your a poor healer then it won't work well. You can try it without moisturizer next time if you wish. If it did not go well, then why go back to him, ... or find the part that went wrong and fix it. Your still in your healing phase. Your other option as I told you if this does not work, is punch excision and or excisions which would be all over your face- cutting out scars and making them linear and then laser would be needed. If you heal poorly as I said before this can be a nightmare and is VERY dependent on the Dr's experience which is not the guy your going to. 

Active acne is because I stopped taking Accutane one week before the treatment and started taking accutane 1 week after the treatment. During this 2 weeks of not taking Accutane, I have got 1-3 new active ones. Hopefully, they be gone soon :smileys_n_people_24:

My Dr completely cleaned my pits with acetone before the treatment and about the technique, I saw him doing the procedure with the mirror and I would say he did the treatment quite okay. 

I know cross take many sessions and I also know I am a poor healer but it is just too different that what I experienced 3 months after I got test-treated with TCA. That time, I did not moisturize at all and the HARD scab actually formed, and after the scab fell, treated spots were very very red and remained red for at least 1-2 months. I could actually see something was going on on my skin and it actually turned out to be the test-treated scar have improved at least 10~20% in depth (but definitely got wider) However, this time, when I moisturized so much, scabs were not HARD but it was rather very jellish and after scabs fell, and the treated spots are not even red after scabs were gone.Plus, during the test-treatment period (3 months ago), I was actually on Accutane, 10mg/day everyday. But this time, I stopped taking Accutane, 1 week before the treatment. 

It is definitely took early to tell the improvement as it is only 3 weeks passed, but I feel like there will not be any more healing. These treated spots are literally not even red.. it is just same as before the treatment. It is way too different than what I experienced before when I got test treated. 

I think the point of doing TCA Cross is inducing the HARD scabs.

I will probably look into some RF microneedling mixed with TCA Cross (only for very deeply pitted ice picks) for the next treatment and I will try no moisturizing until the scabs are fully formed. 

Hopefully, I will heal much better over time.

 

15 hours ago, ScarRight said:

Not to mention he is taking Accutane, which can can make your skin more sensitive and thin, which can also add to the healing time. You're a lot braver than me, that's for sure. 

My Dr said taking low dose Accutane (10mg/day) will be totally fine. Beautifulambition and Dr. Lim in realself also stated that taking low dose Accutane and doing cross was okay. I would have not done it otherwise :D

 

12 hours ago, Goddess420 said:

Wow your scars look so much better! Amazing! On your way to healed beautiful skin! 

Thank you so much! but if you take a look at the pictures carefully, it is really hard to see the improvements.. :smileys_n_people_24: hopefully I will heal better over time!

 

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I think there isn't much to update as all scabs fell and the treated spots literally look the same as before the treatment, no redness at all. Hopefully, they will improve over time.

If they heal well within few months, it means moisturizing prevented hard scabbing and redness but still improved.

If they do not get better within few months, I may conclude that there should not be moisturizing until the HARD scabs are formed and the HARD scabs are what makes the scars improve. However, by looking at my treated scars, there are not much to heal as they already look they are completely healed. 

I will update within few weeks or earlier if If see any difference. 

 

Happy New Years everyone!

Cheers,

 

 

 

 

Edited by Gimozzi

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