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witsend30

Just had Fraxel + CROSS for scars and pores in Korea. After care advice?

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Posted (edited)

Hi everyone, 

Last year around this time I made a thread about freaking about my already enlarged pores joining together to form mega pores

Well I am now in Korea, and have just received the first of a series of 3 treatments of Fraxel Re:pair (a fractional CO2 laser) + TCA CROSS.

In a nutshell: it was extremely painful as the doctor used a tiny TCA-infused needle to puncture my scars and pores. She was very aggressive and went everywhere. And this was all before the laser which by that time the Lidocaine numbing cream had mostly worn off. I was tearing and squirming, lol. By far the most painful experience I've gone through (and there's two more, yay!)

I also consulted at two other places (would have liked to consult at more, but I speak 0% Korean so my choices were limited), and the doctor at both places recommend "TCA Dot Peel," which I have since learned is different from CROSS as it simply drops the the TCA into the scar, as opposed to puncturing the bottom of the scar like CROSS. I don't recall ever seeing this distinction here in all the threads I've read.

Right now my face is extremely red, a little sore, and shiny as I applied Aquaphor all over. 

I'm a little confused about aftercare: they recommended washing tonight (with cleanser), until scabs form. But I'm a little unsure as my skin feels a bit too raw to use anything on it.

I've read through the threads here and there seems to be dividing opinions on whether one should keep the scabs dry or moist (with Aquaphor)?

I was also given an antibiotic liquid to put on my face twice a day.

There is also lot of talk about keeping your skin away from water/topicals to keep the scabs on for as long as possible. 

Can anyone with experience shed some light? How does one go about washing your face? Do you apply Aquaphor at all? 

And I do plan on posting pictures, but right now it's a pointless as I just had it done. I'll make updates here, but do you guys think it's a good idea to start a blog with pictures and more detailed updates, so that it's easier for people to find? I know TCA is covered a lot, but it was(and still is) extremely difficult to find pictures of after results online. Almost everything I find are scars and pores frosted over, and no response from the doctors when people ask for results. It's very frustrating.

 

Anyway sorry for the long post!

Edited by witsend30

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@witsend30 Good for you on getting treated. Many places Speak English in Korea, a favorite of mine is Renewme, but they charge prices for foreigners and have all the latest and greatest. 

You had laser, so yes you want to use some aquaphor over the laser area for a few days, do a 50/50 (dilution water to white vinegar), vinegar pats on the face to kill bacteria and then reapply aquaphor when dry. You can stop aquaphor and goto moisturizer when things heal up a bit. Wear a physical sunscreen (zinc), should be easy to find there. No scrubs, washes, exfoliates, or harsh treatments. You gentle washes and treatments if you must that are for sensitive skin with minimal ingredients. They should have things like oxygen facials, or healing facials for after laser, inquire with them. PRP injections or with laser helps you heal quicker, I would suggest this next time. 

Red is normal, will be that way for some weaks. Speak to the clinic about skincare for healing and facials to accelerate healing / sooth the skin.

You had laser so you need aquaphor or something to keep moist, Grease for peace.... there is debate with tca cross spots, ... you can avoid them if you wish to keep those areas dry.

You can wear concealer when the scabs have fallen off. Zinc from sunscreen is also healing.

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Posted (edited)
13 minutes ago, beautifulambition said:

@witsend30 Good for you on getting treated. Many places Speak English in Korea, a favorite of mine is Renewme, but they charge prices for foreigners and have all the latest and greatest. 

You had laser, so yes you want to use some aquaphor over the laser area for a few days, do a 50/50 (dilution water to white vinegar), vinegar pats on the face to kill bacteria and then reapply aquaphor when dry. You can stop Aquaphor and goto moisturizer when things heal up a bit. Wear a physical sunscreen (zinc), should be easy to find there. No scrubs, washes, exfoliates, or harsh treatments. You gentle washes and treatments if you must that are for sensitive skin with minimal ingredients. They should have things like oxygen facials, or healing facials for after laser, inquire with them. PRP injections or with laser helps you heal quicker, I would suggest this next time. 

Red is normal, will be that way for some weaks. Speak to the clinic about skincare for healing and facials to accelerate healing / sooth the skin.

You had laser so you need aquaphor or something to keep moist, ... there is debate with tca cross spots, ... you can avoid them if you wish to keep those areas dry.

You can wear concealer when the scabs have fallen off. Zinc from sunscreen is also healing.

Thanks for your response. Always so knowledgeable. :)

But this is why I'm confused.

Their aftercare instructions is only antibiotic liquid pat on face twice a day until the scabs fall off. Then, after the scabs have fallen off, regenerative cream.

Yet, everywhere I've read online is Aquaphor or Vaseline for laser, and then split opinion on dry/moist for TCA scabs.

How do I keep it moist and dry at the same time? And if I'm putting on Aquaphor, doesn't it mean I'll need to wash in the morning and at night, therefore risking the scabs from coming off early?

The place I went with didn't have the best pre/post-care, but the doctor was by far the most knowledgeable and confident. I also did email Renewme and their prices (via email) were outrageous compared to what I was being quoted at other places. 

 

Edited by witsend30

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@witsend30 Have about 100+ pm's to answer today, ... quickly

Water/vinegar pats can be done on the whole face. You would apply aquaphor everywhere except the cross areas if that is your choice for dry, ... wet put it all over. 

IF you want to use their stuff, use it all over, antibiotic... Regenerative cream (avoid the cross areas), if you choose to do dry, ... or follow their directions.

Scabs can take about a week for some to come off. Don't put shower water on them, splash instead - hands.

If your whole face has tca cross, ... then antibiotic, and wait as they said until scabs come off, then creams.

Washing isn't the dry part, ... it's the aquaphor or regenerative.

Yes Renewme has all the latest and greatest, and they all speak English, support staff, all that. But I understand. 

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1 hour ago, beautifulambition said:

@witsend30 Have about 100+ pm's to answer today, ... quickly

Water/vinegar pats can be done on the whole face. You would apply aquaphor everywhere except the cross areas if that is your choice for dry, ... wet put it all over. 

IF you want to use their stuff, use it all over, antibiotic... Regenerative cream (avoid the cross areas), if you choose to do dry, ... or follow their directions.

Scabs can take about a week for some to come off. Don't put shower water on them, splash instead - hands.

If your whole face has tca cross, ... then antibiotic, and wait as they said until scabs come off, then creams.

Washing isn't the dry part, ... it's the aquaphor or regenerative.

Yes Renewme has all the latest and greatest, and they all speak English, support staff, all that. But I understand. 

Thanks, I think I'm going to continue with Aquaphor until scabs form, because I can't imagine having a dry face right now with this redness and pain.

Funny thing is, there were some immediate scabs from the needles that drew blood, and some of them came off when I was applying the Aquaphor and the pores look bigger. Hopefully it's nothing.

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Thank you for docummenting this, its not usual nose pore treatments in this forum other than lasers and home/routine creams.

as i can see you already have before pictures to compare with the upcoming results, wish you the best luck

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7 hours ago, De Rerum Natura said:

Thank you for docummenting this, its not usual nose pore treatments in this forum other than lasers and home/routine creams.

as i can see you already have before pictures to compare with the upcoming results, wish you the best luck

Thanks for the well wishes! I completely get what you mean. There is really not much here or out there. And the nose pores/scars threads in the "Emotional and psychological effects" forum are absolutely devastating, and relatable. I'll do my best to be thorough.

It's Day 2, and no scabs yet. Aquaphor is sitting on top of my skin from last night, and I'm not sure if I should wash it off and apply a new layer or leave it be.

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@witsend30 Keep it moisturized with Aqua, take a antihistamine or pain pill as needed. In time normal moisturizer and sunscreen

If the redness continues see the Dr for a follow up.

Things will look bigger, remember healing takes place over 3 months, it's not instant, also you need several treatments, with cross we widen the scars and lift the floor so then you can resurface as they become shallow. Observe how they heal. Healing is slow.

 

 

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21 hours ago, beautifulambition said:

@witsend30 Keep it moisturized with Aqua, take a antihistamine or pain pill as needed. In time normal moisturizer and sunscreen

If the redness continues see the Dr for a follow up.

Things will look bigger, remember healing takes place over 3 months, it's not instant, also you need several treatments, with cross we widen the scars and lift the floor so then you can resurface as they become shallow. Observe how they heal. Healing is slow.

 

 

Still a bit red, but nowhere near as bad as Day 1. No pain.

The holes do look bigger, and I don't have much scabbing, just a little on my temples. It's slightly worrying, and I have a lot of thoughts running through my head, but it's the long-haul and I have to have faith in the process.

My next treatment is actually in a month. Every place I consulted at actually recommended laser + TCA monthly. I know they went with the deepest setting (1.6mm), but maybe not that high of density or energy level, because I'm not bloody at all and recovery isn't all that bad.

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@witsend30 This is normal great. Healing takes time, very slow process. 

Scabbing per say is variable, it's not a scab, this is scarring, ... it's a light skin cap (body's defense mechanism) protection over delicate new skin. As such if they come off keep the area moist and covered. Hence why you don't shower directly on them.  I did prepare you they will get wider, and they will be red for some time. If you go to see a Dr like Dr Lim, he would give you a concealer to put over them once they healed up a bit. All the good Dr's do this if you ask, guys or girls, can spot treat. Korea has some great concealers / tinted sunscreen. Also it's a slow process, we are trading a larger scar, for it being more shallow and then resurfacing, make since. It's the Dr's skill as well. If he is not good then that is a factor.

I would not treat monthly, this is nuts. For the benefit of the clinic $$$$$, ... this does not benefit your healing. You already have signs of sensitivity and prolonged healing, why blast a wound again. I just had a gentleman who had his whole face ruined (texture) by doing 10 monthly laser treatments. No time to heal, no time to observe changes, ... blast a wound again and again. Good for the Dr I suppose. constant state of swelling, see look at the swelling, looks better, ... they say, needs more laser and they continue. You do what you feel is right. I would never for myself or anyone else tell them to do monthly laser. Now if there are areas on your face that have not been treated, sure get those treated sooner. But why blast a wound again and again, ... I want you to observe your healing, redness, sensitivity and make a rational choice. Who cares what a Dr says. All the cosmetic companies tell me to use harsh exfoliants daily, great for them $$$$$, but if I did that I would wreck my skin, you see what I am saying here.  The deepest setting is even more of a reason not to do this monthly. 

Recovery is cumulative, ... if you cut yourself, ... you have a wound, then you continue to cut yourself over and over, ... wallah scars. 

I have just helped thousands tough, do what you feel is best. Perhaps it will work well for you. 

 

 

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I have to agree with BA, specially because ur doing TCA cross with high percentage and lasers which are super strong methods.

being not conservative i would give 3 months between each laser session, and if u want to be safe, 6 months. U can repeat the TCA cross each 6-8 weeks. 
 

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12 hours ago, beautifulambition said:

@witsend30 This is normal great. Healing takes time, very slow process. 

Scabbing per say is variable, it's not a scab, this is scarring, ... it's a light skin cap (body's defense mechanism) protection over delicate new skin. As such if they come off keep the area moist and covered. Hence why you don't shower directly on them.  I did prepare you they will get wider, and they will be red for some time. If you go to see a Dr like Dr Lim, he would give you a concealer to put over them once they healed up a bit. All the good Dr's do this if you ask, guys or girls, can spot treat. Korea has some great concealers / tinted sunscreen. Also it's a slow process, we are trading a larger scar, for it being more shallow and then resurfacing, make since. It's the Dr's skill as well. If he is not good then that is a factor.

I would not treat monthly, this is nuts. For the benefit of the clinic $$$$$, ... this does not benefit your healing. You already have signs of sensitivity and prolonged healing, why blast a wound again. I just had a gentleman who had his whole face ruined (texture) by doing 10 monthly laser treatments. No time to heal, no time to observe changes, ... blast a wound again and again. Good for the Dr I suppose. constant state of swelling, see look at the swelling, looks better, ... they say, needs more laser and they continue. You do what you feel is right. I would never for myself or anyone else tell them to do monthly laser. Now if there are areas on your face that have not been treated, sure get those treated sooner. But why blast a wound again and again, ... I want you to observe your healing, redness, sensitivity and make a rational choice. Who cares what a Dr says. All the cosmetic companies tell me to use harsh exfoliants daily, great for them $$$$$, but if I did that I would wreck my skin, you see what I am saying here.  The deepest setting is even more of a reason not to do this monthly. 

Recovery is cumulative, ... if you cut yourself, ... you have a wound, then you continue to cut yourself over and over, ... wallah scars. 

I have just helped thousands tough, do what you feel is best. Perhaps it will work well for you. 

 

 

These are really great points and I totally agree with you that I need to be more careful. 

I did research on Naver (Korean Google basically) and it seems monthly CO2 is the norm here. My theory is that they do it on the low density setting, with a strategy of repeat but frequent treatments. Here is Davin Lim talking about it on RealSelf and saying that low density CO2 heals up in 3 days. I'm going to talk to the doctor about the density and ask more about intervals.

I'm on Day 4, and I have almost no redness anymore. And I finally can see tiny scabs or plugs on some of my pores. Some are brown, and some are flesh coloured. I think those are whiteheads. I guess I'm going to start using the antiseptic face liquid today, and I'm going to start applying the Aquaphor only to areas where there are no scabs.

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@witsend30

Dr Lim recommends my advice ;-) , No skin through histological (white papers) - studies heals in 3 days (your ""visible"" aftercare possibly on low settings).  He meant the top layer of your skin can heal. Underneath you are regenerating after laser for up to 6 months, depending on the setting. I often get those who over treat. Had a Dr who did laser every 2 weeks, ... skin was ruined. It's again cumulative. You need to heal. But if you think that's best for you and your responding well then go ahead with the Dr's plan. I am here to give you another perspective and not sell you something. You ask the Dr, ... he will tell you treat daily (I joke), but it is $$$$ to him. You decide who has the best interest I suppose. Laser alone won't sole everything. I think what the Korean Dr's are doing is dragging out treatment at a low Wattage of laser (Setting) and doing it often to make money, instead of a harsher setting depending on what you can handle with lower down time. I am more inclined for cross, and subcision to be done than constant laser out of experience. 

 

Redness is not a issue, it's cumulative ongoing laser that is done close together. You can stop your Aquaphor soon, you don't want to break out, it was to be occlusive.

 

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16 hours ago, beautifulambition said:

@witsend30

Dr Lim recommends my advice ;-) , No skin through histological (white papers) - studies heals in 3 days (your ""visible"" aftercare possibly on low settings).  He meant the top layer of your skin can heal. Underneath you are regenerating after laser for up to 6 months, depending on the setting. I often get those who over treat. Had a Dr who did laser every 2 weeks, ... skin was ruined. It's again cumulative. You need to heal. But if you think that's best for you and your responding well then go ahead with the Dr's plan. I am here to give you another perspective and not sell you something. You ask the Dr, ... he will tell you treat daily (I joke), but it is $$$$ to him. You decide who has the best interest I suppose. Laser alone won't sole everything. I think what the Korean Dr's are doing is dragging out treatment at a low Wattage of laser (Setting) and doing it often to make money, instead of a harsher setting depending on what you can handle with lower down time. I am more inclined for cross, and subcision to be done than constant laser out of experience. 

 

Redness is not a issue, it's cumulative ongoing laser that is done close together. You can stop your Aquaphor soon, you don't want to break out, it was to be occlusive.

 

Well actually I pre-paid for the three treatments, so they're getting my money regardless. lol but I completely hear what you're saying. I'm going to discuss with the doctor and see what she has to say.

It's Day 5, and I'm troubled by all the specks of hardened sebum on my cheeks. Anyone with large pores can imagine what a nightmare it is to not exfoliate for five days. But at the same time, I can't clean them off because I don't want to disturb the scabs. Interestingly, all of the scabs are on my cheeks. They're tiny. None on my nose, which looks a mess because of the combination of sebum and Aquaphor, which is never totally cleaned off my face because I pat with water, pat with cleanser, and then pat with water again to rinse. It's really a mess.

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Day 6 - most of the scabs are gone. Pores look about the same. I can count maybe 3 post-scab red marks, 2 of them are on the sides of my nostrils. Definitely not the same TCA experience I read about on here... 

Face colour is back to normal, but parts of it still feels like sand paper. I rubbed some of the hardened sebum off, some remain. 

This week, I'm going to try to seek out a few more opinions. I'm not sold on this doctor's technique and I'm definitely not happy with the aftercare. I also want to prevent any potential damage... I've yet to come across anyone having so many pores CROSSed at once and the more I think about it, the less sense it makes.

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Posted (edited)

Update:

 

It's been a tough two weeks. After all the hardened sebum came out, some of the pores looked not only looked wider, but deeper. Really sent me on a tailspin , and I thought I had made the worst decision ever. Worst part is that the "bright red" mark left behind by the scab that everyone else has seen, I didn't see at all. Just wider, deeper pores. It was a dark time and I contemplated things I shouldn't have been contemplating.

Desperate, I consulted with a different doctor, a known TCA expert. He said that this is normal, and that my pores will continue to heal over the next few months, and that my doctor definitely didn't use 100%, which could explain the mild scabbing. He also said that sebum doesn't play well with TCA CROSS, so I'm not going to get the results I desire because I'm too oily. Obviously this was hard to hear. When I asked him what treatment he recommended, he replied he wanted to do non-ablative Fraxel five more times (spaced out one month each), before doing TCA again. And then another four rounds of Fraxel. Then TCA. Unfortunately, I don't have the luxury of being here for that long. This was on Monday, exactly two weeks after my treatment.

Over the next few days, however, I began to see the pores on the left side of my face growing shallower--like I can see the bottoms of some of them. The right side continues to look a mess. The right side is the side that had larger pores to begin with. The tip of my nose doesn't look better or worse, but the nostrils kind of look better.. I think? This is slightly promising.

I have a follow-up consultation next Tuesday with my doctor. I'm going to discuss the possibility of going on very, very low dose Accutane (10mg every three days) to get the sebum under control before proceeding with the next TCA treatment. It's a good sign that the left side is healing well.

And I know, I know, another wall of text. I'm documenting all of this and promise to not disappear and post pictures documenting all of this.

Edited by witsend30

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@witsend30 TCA Cross by design makes your scars wider, that is the purpose, ... You resurface after many. Perhaps your Dr's skill was not good I cannot say. Sometimes a change in practitioner's helps. Sometimes it's our healing ability does not work well with cross. Rubbing Sebum off to me sounds like piking, so that could have effected results. It is a slow process, your skin is not going to feel "normal" when treating. Deeper, a wound ... can get deeper while healing for 3 months which is the time it takes. 

Red marks are completely normal, ... what did you think nothing was going to happen from a treatment where we are stimulating your body to heal itself. Put some concealer over it if it's a issue. 

If you were too oily he could have done treatments prior to cross, like BBL, topical creams, and we clean the face with acetone to get rid of oils. Sound like a non-experienced Dr, find someone else.

No one needs fraxel to fix icepicks. He could do the very abrasive and surgical excision, but he does not sounds good. He wants your $$$$$ - Fraxel.

If the left looks good, those were done right, ... the other side most likely needs more tca cross (several sessions are needed), and he needs to get rid of the oiliness before doing it. Also why not use a higher % of acid, silly.

Glad your documenting, always good to see another Dr for a 2nd opinion. 

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