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Gouzhenvi

I think the dermatologist have ruin my face with TCA, need a confirm pleasee

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I have a combi of treatment (subscision, TCA cross, laze co2) in vietnam, I have some very narrow box scar and the doctor use 50% TCA at first session. She used the toothpick and keep in the scar for 3 second. After 2 week the scabs falled off and it seemed a lot bigger and deeper. I read some review and learn that it normal, just give it time. And now it's 5 week and the red faded a little bit, but the scar is definitely alot bigger. It seems like it doesn's improve in dept compare to before the treatment (they said that it could get bigger but it have to be more shallow).

And note that the small box scars are now be connected (PIC below). my dermatologist said they connect them to make it become bigger and then they will treat them with [email protected]@. Can someone please confirm is it a right technique?

Now I'm so stressful and panic. i've pay alot but just make my scar look worse. I should have buy TCA 30% and did it myself

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Edited by Gouzhenvi

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@Gouzhenvi I am sorry your provider did not provide you proper aftercare and support. You paid them for this. That is their job.

Regarding TCA Cross this is supposed to happen, we widen the scar, and do a few other sessions then we resurface the scar texture. Redness in your ethnic type is common for some months. I cannot say the skill of the provider, ... excessive acid (drips), and not treating just the scar floor can sometimes lead to this. It does take skill. I know your a guy but how about some tinted sunscreen, or concealer like dermablend stick on the areas while you heal. Use a retinoid nightly, niacinamide, and the pca hydroinone free pigment gel to work on the area. It takes a full 3 months to see results from this. 

You can do peels with glycolic acid between Dr treatments monthly at home. 

See the big picture we widen the scar, then we treat the surface texture. 

See another provider who is more experienced if you wish for future treatment if you are not satisfied. 

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2 hours ago, beautifulambition said:

@Gouzhenvi I am sorry your provider did not provide you proper aftercare and support. You paid them for this. That is their job.

Regarding TCA Cross this is supposed to happen, we widen the scar, and do a few other sessions then we resurface the scar texture. Redness in your ethnic type is common for some months. I cannot say the skill of the provider, ... excessive acid (drips), and not treating just the scar floor can sometimes lead to this. It does take skill. I know your a guy but how about some tinted sunscreen, or concealer like dermablend stick on the areas while you heal. Use a retinoid nightly, niacinamide, and the pca hydroinone free pigment gel to work on the area. It takes a full 3 months to see results from this. 

You can do peels with glycolic acid between Dr treatments monthly at home. 

See the big picture we widen the scar, then we treat the surface texture. 

See another provider who is more experienced if you wish for future treatment if you are not satisfied. 

You say I have to wait 3 month to see the result. But my derm will take 2nd treatment after only 1 month. Is it too fast?. 

And look at the number 3 in my picture. They used TCA on it and It looks worse than before after 1 month, any chance it could be recover? And which treatment is most suitable for next session at that area?. I'm so affraid of TCA right now because I think my body don't react good to it. Should I tell my derm stop using TCA in my next session?

Edited by Gouzhenvi

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Some of them too big and shallow for TCA cross but too small for subscision. My derm did nothing to them excep Laze co2 which brought no improve even it's a new scar (about 6 months). I dont know what to do with them

 

Screenshot_2019-08-14-09-55-37-534_com.miui.gallery.png

Screenshot_2019-08-14-10-00-53-742_com.miui.gallery.png

Edited by Gouzhenvi

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@Gouzhenvi Your confusing me with the double post about the same issue I was helping you with. I added the topics together. 

The dermatologist DID NOT ruin your skin. This is a marathon not a race, this will take time and treatment to deal with. The biggest thing your seeing besides the widening is PIE or redness that draws attention. 

By design tca cross can widen scars and produce redness. Yes your Derms skill was questionable. You now would do some pulse dye laser and some rf needling/ co2 to work on the scars. Redness I gave you a tool also to use tinted sunscreen or a concealer as you heal (Some take a year to heal). The issue with tca cross is multiple treatments are needed. Now that they widened them more is needed but you do not trust your provider for this, so perhaps find another aesthetics Dr. 

To recap what you said above, ... your Derm only CO2, ... now we must use something like rf needling & CO2 as the scar type changed. I think they used excessive tca (drips), and did not meticulously just paint the scar floor of the boxcar/ icepick. This can be fixed. 

In some Asian Countries punch excision is used for box cars like this as they do not have the skills to tca cross. Look for a plastic surgeon or derm who may perform this and ask for pictures. This may be a option prior to energy devices, I seldom recommend it because of the side effects and down time, but it can be effective with experience. 

To recover again pulse dye laser, rf needling, and co2. Goto a skilled Dr, this provider is not good. Get a second opinion by some other Drs. 

I want you to at home do dermastamping on them and glycolic peels, monthly. No we do not treat monthly with ""Dr based treatments"", ... this will cause you healing issues, collagen is slow to build, ... your skin type can take 3-12 months to heal post procedure.

Again ... I would consult with another few Drs and pick the one you like best, ... your not stuck with the Derm you see now. 

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14 hours ago, beautifulambition said:

@Gouzhenvi Your confusing me with the double post about the same issue I was helping you with. I added the topics together. 

The dermatologist DID NOT ruin your skin. This is a marathon not a race, this will take time and treatment to deal with. The biggest thing your seeing besides the widening is PIE or redness that draws attention. 

By design tca cross can widen scars and produce redness. Yes your Derms skill was questionable. You now would do some pulse dye laser and some rf needling/ co2 to work on the scars. Redness I gave you a tool also to use tinted sunscreen or a concealer as you heal (Some take a year to heal). The issue with tca cross is multiple treatments are needed. Now that they widened them more is needed but you do not trust your provider for this, so perhaps find another aesthetics Dr. 

To recap what you said above, ... your Derm only CO2, ... now we must use something like rf needling & CO2 as the scar type changed. I think they used excessive tca (drips), and did not meticulously just paint the scar floor of the boxcar/ icepick. This can be fixed. 

In some Asian Countries punch excision is used for box cars like this as they do not have the skills to tca cross. Look for a plastic surgeon or derm who may perform this and ask for pictures. This may be a option prior to energy devices, I seldom recommend it because of the side effects and down time, but it can be effective with experience. 

To recover again pulse dye laser, rf needling, and co2. Goto a skilled Dr, this provider is not good. Get a second opinion by some other Drs. 

I want you to at home do dermastamping on them and glycolic peels, monthly. No we do not treat monthly with ""Dr based treatments"", ... this will cause you healing issues, collagen is slow to build, ... your skin type can take 3-12 months to heal post procedure.

Again ... I would consult with another few Drs and pick the one you like best, ... your not stuck with the Derm you see now. 

I'm affraid I cannot change the provider, I've bought a set of 3 sessions here so I have 2 left (this is also the most reputable Derm in my country), so I don't know who else I can trust :cry:. So you think I should tell them to delay the next session to let my skin to heal? 

And as there is no punch excision provided in my country. So you think the only way to treat my small box scars (1-3mm wide, less than 1mm in depth) is TCA? So next time I have to ask my derm to reduce the concentration?

Some of my icepick after be treated with TCA just get bigger and no change in depth. Next time should i continue with them in lower concentration or lower quantity?

And I'm always using sunscreen, thanks for your advide

 

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"So you think I should tell them to delay the next session to let my skin to heal?" - Yes you need time to heal, quicker succession will not help here. The above picture is not icepicks anymore, they are enlarged box cars, as such you need rf needling and co2. But I am not sure if your provider has the skill to do this. 

"And as there is no punch excision provided in my country. So you think the only way to treat my small box scars (1-3mm wide, less than 1mm in depth) is TCA? So next time I have to ask my derm to reduce the concentration?" - No I said punch excision is another method, but box cars can also be treated with fractional laser. You need to call around and research and ask about punch excision if your interested in it. You could try a lower TCA %, ... The scars are already widened, your provider does not have the skill to perform this sadly and you bought a package so your locked in. 

"Some of my icepick after be treated with TCA just get bigger and no change in depth. " Poor technique and excessive acid, ... we don't treat widened scars. This takes skill to do. What are you trying to accomplish with a lower % exactly? Your instructing the Dr and that is never a good thing, ... did you bring up to them that your scars are wose and wider than before - what exactly did they say. Your paying them thousands for your care and aftercare, they need to fix this not me, ... if you don't want to goto another provider.

The worst part of scars above is the PIE or redness, not the widening of the scars, this is normal with TCA Cross. 

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15 hours ago, beautifulambition said:

"So you think I should tell them to delay the next session to let my skin to heal?" - Yes you need time to heal, quicker succession will not help here. The above picture is not icepicks anymore, they are enlarged box cars, as such you need rf needling and co2. But I am not sure if your provider has the skill to do this. 

"And as there is no punch excision provided in my country. So you think the only way to treat my small box scars (1-3mm wide, less than 1mm in depth) is TCA? So next time I have to ask my derm to reduce the concentration?" - No I said punch excision is another method, but box cars can also be treated with fractional laser. You need to call around and research and ask about punch excision if your interested in it. You could try a lower TCA %, ... The scars are already widened, your provider does not have the skill to perform this sadly and you bought a package so your locked in. 

"Some of my icepick after be treated with TCA just get bigger and no change in depth. " Poor technique and excessive acid, ... we don't treat widened scars. This takes skill to do. What are you trying to accomplish with a lower % exactly? Your instructing the Dr and that is never a good thing, ... did you bring up to them that your scars are wose and wider than before - what exactly did they say. Your paying them thousands for your care and aftercare, they need to fix this not me, ... if you don't want to goto another provider.

The worst part of scars above is the PIE or redness, not the widening of the scars, this is normal with TCA Cross. 

Thanks you for answering me very careful.

I have some these more questions I have wonderred for long time. But its hard to find any artical or study about them. I don't know if it in your reach

I had seborrheic dermatitis during the time after treatment. It made my cheeks have layer of dead skin like pic below 3 week after last treatment, so it also kept the scabs from subscision and tca from falling off nomally (7days is normal, but mine is 3 weeks). Did it affect the healing of scars?. Next time what I need to do to prevent this? My derm tell me to apply Tacrolimus.

Another thing, I know this sound ridiculous. But in my country (vietnam) people believe that eating seafood (shrimps), beef when you have wound can cause hypertrophic scar (or keloid i'm not sure). Because it make your wound to build exceed of the collagen it need. So, can I eat them after treatment to help raise the scars? Help me please if you know about nutrition too. 

 

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Edited by Gouzhenvi

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@Gouzhenvi 

""seborrheic dermatitis during the time after treatment. It made my cheeks have layer of dead skin like pic below 3 week after last treatment, so it also kept the scabs from subscision and tca from falling off nomally (7days is normal, but mine is 3 weeks). Did it affect the healing of scars?. Next time what I need to do to prevent this? My derm tell me to apply Tacrolimus." - Seborrhea is actually oily skin. It's a health condition and must be managed with a dermatologist. Can be bad genetics, health concerns, and bacterial acne. USe a BHA cleaner twice a day (don't over do this). Over cleaning makes your skin make dryness= more oil.  Gentle cleanser like the oil free acne wash (leave on 10 mins and wash off). You need a light moisturizer. No toners or alcohol. A retinoid is a must. There are lasers which can target oil glands ask your provider about this. Diet - no dairy, sugar, refined foods, wheat, lots of fruit and veggies are fine - lean meats. Try Nizoral shampoo it's for fungal acne which can create some of this. 

Yes this can effect your results, your skin is dealing with fungus or excess sebum. 


 

 

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how did you treat the scars after the treatment?

 

i also have seb derm, its hard to know what to do as you dont want to rub the area after treatment but also you dont want to let the dead skin build up over the freshly treated area

 

did any of the scars improve with tca cross?

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