Jump to content
Acne.org
Search In
Find results that contain...
Find results in...
GroovyRam

HELP ME PLS, Boxcar Scars All Over Face! Already tried lasers and infini RF

Recommended Posts

Posted (edited)

I dealt with severely inflamed adult cystic acne that covered my entire face, including the area under my chin and behind my ears. That was 3 years ago. Now I am left with scars all over my face, mostly concentrated on both of my cheeks. I have a mix of scars, mostly boxcar, with some ice pick, and hypertrophic (although not very noticeable). I've tried non-ablative lasers in Los Angeles with very little results. I've also gotten Infini RF done 6 times by Dr. Evan Ransom in San Francisco. I did initially see an improvement in the softening of scars with the Infini RF, but the results were not worth it for the price I was paying for each of the additional sessions.

  @beautifulambition I've followed your posts, and have a lot of respect for you. I would be grateful for your advice. What do you recommend for reducing my scarring? I currently live in San Francisco, CA, and the only doctors I could find besides Evan Ransom, were Usha Rajagopal MD and Charles K Lee (Infini RF).  

These scars have really ruined my self-esteem, becoming a daily obsession and fear of mine. It's been a struggle having relationships both romantic and platonic because my self-worth is so deeply tied to my appearance (that's the way I was raised).

Thank you for your help.

1465188397_Right_Overhead-Lightcopy.jpg.246402ba04cbeb10a25ab5f04425398e.jpgIMG-6201.JPG

IMG-6202.JPG

IMG-6203.JPG

IMG-6204.JPG

IMG-6205.JPG

IMG-6188.JPG

IMG-6191.JPG

IMG-6192.JPG

IMG-6194.JPG

IMG-6196.JPG

IMG-6200.JPG

Edited by GroovyRam

Share this post


Link to post
Share on other sites

@GroovyRam Thank you for the kind words

That is a lot of treatments. Perhaps provided poorly as it does not make since you had no/ very little results. Non-ablative lasers would do noting for your case, you need ablative sciton resurfacing or a deep peel at the end for surface textural issues. I believe what happened with the rf needlin is it was to deep to work on your surface textural scars, so it did very little.

I would have you see Rullan in San Diego for Phenol Cross of your textural boxcars. The missing piece here was manual methods. I would have done either multi-coat pain on to the box cars, (3 layers of a lower % than tca cross). Some of your scars could use tca cross as they seem to be small enough as well.

In your case I would do low density co2 laser 3-7% density and the highest power multiple passes over the box cars.

I would have you buy a Derminator (Google) with a single needle attachment and needle the borders specifically of your boxcars monthly at home. Do this between Dr's sessions. You can alternate monthly with glycolic peels at home.Dr's sessions should be 3 months or more between sessions.

If you don't want to travel see if "Rajagopal" does tca cross and deep acid peels for someone with your ethnicity, how many times she has done it etc. Or if she does Sciton fully ablative laser resurfacing (do this last). You will have down time from procedures that work. 

If everything else fails, which I doubt it will if you have a more aggressive treatment with down time. There is always punch excision or punch float, this is done by a dermatologist who is familiar with this, you would have to call around. I am not sure if Ransom can do it. Obviously surgical methods we save for last as they can have side effects. 

Dr Swenel and Dr Morganroth are two other's in the bay, but I would not overly suggest them. Dr Pien is in Hollywood and great with lasers in ethnic skin, or Dr Lopez in Fresno also does Sciton Fully ablative erbium resurfacing for ethnic patients. 

Use nightly: Retin-a or tretinorin(prescription), or Differin (Target/Walmart), The Ordinary Granactive Retinoid (if you can't get the above). Cureology(USA) & Yoderm(USA) provides online prescriptions with customized skin care creams for your concerns, those in UK Dermatica provides the same thing. Apply a moisturizer when your face is dripping wet. Wait 5 minutes for it to dry, and then apply the tretinoin. This cuts down on irritation, you can also skip days of application (one or two days a week) if it's irritating and you need to build up %. This provides skin turnover - new collagen. To prevent (reds & browns from all Dr-treatments to ethnic skin or to work on current skin discoloration), try PCA hydroquione free gel for Hyperpigmentaion (Amazon) or Cureology/Dermatica includes this in their products if ordered. Using this prevents hyperpigmentation from treatments. Hydroquinone has side effects for some people, natural options  are better with ingredients like: kojic acid/Konjac, Alpha Arbutin, Niacinamide by The Ordinary is great for large pores, discoloration, and inflammation. The Ordinary, Cerave, Eucerin (QV Skincare in AUS), Dr Sam Bunting Flawless Cleanser, La Roche-Posay (sensitive), and Acne.org's products are all great options for moisturizers and cleaners without fragrance / dyes / allergens. The Three most important things one can use are: Vitamin A skin turnover (retinol, retinaldehyde, retinoid), Vitamin C Serum which makes collagen, and a sunscreen (zinc oxide physical for sensitive skin - DRMTLGY Active Sunscreen, Elta MD Physical).

Share this post


Link to post
Share on other sites

@beautifulambition Thank you so much for your thorough and thoughtful explanation! I truly appreciate your time and expertise. I took some time to digest all of this information before asking you clear follow-up questions.

You also suggested the following treatments for me:

  • Rullan in San Diego for Phenol Cross of my textural boxcars. (3 layers of a lower % than tca cross) TCA cross for smaller scars.
  • Low-density co2 laser (3-7% density and the highest power multiple passes over the box cars.)
    • Is this a fully ablative fractional laser?
  • Sciton fully ablative laser resurfacing

In what order should I receive these treatments?

 

You suggested Dr Pien in Hollywood for lasers in ethnic skin, or Dr Lopez in Fresno for Sciton Fully ablative erbium resurfacing for ethnic patients.

Are there any other that you would recommend for in Los Angeles or San Francisco area?

 

Thank you again. I am so grateful for the work you do. Thank you for giving acne and acne scar sufferers more hope and direction.

 

Share this post


Link to post
Share on other sites

@GroovyRam Welcome!

1) Ok great your going to Dr Rullan. 

2) I think you are confused what ablative means, ... fully ablative is resurfacing is done at the end or Dr Rullan does his deep peel which is similar. While fractional laser is "ablative," I am saying 3-7% density (yes fractional) out of 100% that is verrrrrry small. Multiple passes. on the scars Another option would be 1927nm fraxel 22 passes over the scars at full density on this one. Dr Pein can do all of this. She is in Hollywood that is LA. I would treat with Rullan several cross sessions, consult with pien. 

3) RF needling and or co2 or Fraxel first. We only do "fully" at the end.

4) SF bay area does not have good Dr's, there are a few laser Drs. If you need someone to treat locally checkout the FAQ pinned to the main scar treatments sub, bottom of that.

Thank You,

Ba

 

Share this post


Link to post
Share on other sites

Hi, I live in San Francisco also! I literally just finished my latest session with Dr Rullan this morning, and I highly recommend.

Share this post


Link to post
Share on other sites

@superburrito That's great to hear that! I have a lot of boxcar scarring which is my main scarring concern. A few questions which I hope you can help with ^_^:

  1. Was he able to improve or erase any of your boxcar scars with TCA or phenol cross?
  2. With TCA cross or phenol cross, how much have your boxcar scars improved on a scale of 1–10?
  3. How many sessions did it take?

In regards to Rullan, I'm worried about the costs of flying to San Diego, paying for a place to stay for a week (or more), and having to do that multiple times.

I'm weighing seeing Dr. Lopez in Fresno/Oakland instead because she is much closer and I would avoid multiple plane tickets and hotels/airbnb. Have you seen Dr. Lopez?

I'm also weighing just going straight for a Co2 laser, instead of using TCA cross. I mostly have wide boxcar scars with fewer icepick scars or shallow small boxcar scars. What do you think?

Thanks for your help! ;D

552201729_Right_Overhead-Lightcopy.jpg.329f00c62fdef1dc039f11a57fbb70ff.jpg
 

 

Share this post


Link to post
Share on other sites

@GroovyRam

 

  1. Was he able to improve or erase any of your boxcar scars with TCA or phenol cross?
    A definite improvement, but not complete erasure yes. This week was my third Phenol cross
     
  2. With TCA cross or phenol cross, how much have your boxcar scars improved on a scale of 1–10?
    I would say my boxcar and icepicks scars have improved 30-40%
     
  3. How many sessions did it take?
    I did my third session on Thursday

If you only do Cross with Dr Rullan, then you can fly down and fly up on the same day without having to stay overnight. Cross is his cheapest procedure, not sure how much it is on it's own, but I think it's ~200. Southwest Airlines is your best bet for cheap flights from SFO or OAK.

I have not gone to Dr Lopez in Oakland. The reason being is that Dr Rullan is the only doctor I know that uses Phenol acid for Cross instead of TCA. This has less risk of post-inflammatory hyperpigmentation for folks with non-caucasian skin stones. It also does not cause the scar to widen like TCA does.

Not sure if Co2 is the right way to go as a first-line of treatment. First, it's a lot more expensive, and a lot of downtime. With Cross, it's very localized, and a lot less expensive. Dr Rullan also uses a paintbrush instead of a toothpick to apply the acid. So he's able to cover wider boxcars as well.

 

 

 

Share this post


Link to post
Share on other sites
On 5/23/2019 at 2:20 PM, GroovyRam said:

@superburrito That's great to hear that! I have a lot of boxcar scarring which is my main scarring concern. A few questions which I hope you can help with ^_^:

  1. Was he able to improve or erase any of your boxcar scars with TCA or phenol cross?
  2. With TCA cross or phenol cross, how much have your boxcar scars improved on a scale of 1–10?
  3. How many sessions did it take?

In regards to Rullan, I'm worried about the costs of flying to San Diego, paying for a place to stay for a week (or more), and having to do that multiple times.

I'm weighing seeing Dr. Lopez in Fresno/Oakland instead because she is much closer and I would avoid multiple plane tickets and hotels/airbnb. Have you seen Dr. Lopez?

I'm also weighing just going straight for a Co2 laser, instead of using TCA cross. I mostly have wide boxcar scars with fewer icepick scars or shallow small boxcar scars. What do you think?

Thanks for your help! ;D

552201729_Right_Overhead-Lightcopy.jpg.329f00c62fdef1dc039f11a57fbb70ff.jpg
 

 

If you're worried about costs, at the very least find someone in the bay area that can do TCA CROSS. You'll probably get hyperpigmentation like I did (fair skin), but CROSS will help you more than just blasting your face with a laser. You want to raise those pits to the level of the rest of your face, and a laser won't do that. 

Share this post


Link to post
Share on other sites

how much you pay for the phenol cross or tca cross?

IMHO non ablative lasers are completely useless for your scars....you need multiple TCA (or phenol) CROSS and after that I'd do a couple of fully ablative lasers after your scars will raise from the CROSS

Share this post


Link to post
Share on other sites

@SimpleMutton  I gave a full plan above. Cross + laser will not fix her problems alone. Her scars may not raise from cross, she has widespread box cars which may not respond. Her scars will take a multiple of treatments, resurfacing techniques and collagen stimulating therapies. This is not a easy case to fix. This is why treatment is not standardized, it's customized, ... we cannot compare scarring. No scar case is the same, we are not clones, one person could do a million procedures and not be you, your all different ages, ethnic backgrounds, healing capabilities, plans for treatment, outcomes, different surgeons (they treat differently as well), etc, we could go on and on. The point being is never compare yourself to someone else. Sure you can learn from their experience but do we really know every single detail about what was done and why - no.  If someone heals poorly or had a poor Dr they typically hang around here. 

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


  • Personalized Advice Quiz - All of Acne.org in just a few minutes

×