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Wilko44

TCA cross done by dermatologist.. doesn’t seem right?

Hi guys! 

I’ve been browsing the forums for a long time and have finally made an account to share my experience’s. 

After having two unsuccessful laser sessions (co2 and non albative Fraxel) plus subcision with a local dermatologist in Australia, the Derm suggested we try TCA cross as it is the flagship for the Ice pick scars I have. So finally I had a week off work and booked in to have the procedure, now it’s been 5 days since and I’m a little concerned with how it’s all looking. I had done a ton of research before having it done and looked at pretty much every before/after, log and image on the internet there is. Now that I’m 5 days in I can’t find anything online that looks similar to what I’m experiencing. I feel as if he may have gone overboard in some areas and now I have big wounds over my face where I had the deepest scars. I know it’s only early days but the doc said I would be right to go back to work in 5 days and it doesn’t look like I will be anytime all. I thought I’d share some images here and get your guys thoughts! Thanks :) 

 

sorry for the bad quality in advanced, ill try and get better photos tomorrow in the morning.

B7D9A7D8-A43F-46EF-890C-5784EE7E3A64.jpeg

37DC0F8B-E64B-470B-B167-4AEC3917FC28.jpeg

8BC559A6-0E30-4D94-AF2A-AA98ED5033EC.jpeg

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Hi, 

It's normal for the 5th day that most of your tca scabs still haven't fallen off, mine were similar color on the 5th day, too. What does stand out to me though is that your scabs are somewhat bigger than those I had after the CROSS. But that could be a desired effect, I suppose, as I've read that the cross method is also applied on box car scars.

If you have concerns why don't you go to your dermatologist for a follow up? Or look for a second opinion, at the Dermatology department of a nearby clinic.

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It looks good. Keep the scabs on as long as possible. Use moisturizer lightly on the scabs to keep them moist and try to stay out of sunlight.

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looks good, use aquafor/vaseline to keep scabs moisturized, you want scabbing. Scabbing is your body healing. Your scars look deep so It might scab for 10-15 days. I know mine did when I had my first treatment.

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5 hours ago, dodgerguy said:

It looks good. Keep the scabs on as long as possible. Use moisturizer lightly on the scabs to keep them moist and try to stay out of sunlight.

Yahh thats my main concern, where there are massive wounds i had one or two ice pick scars not rolling or box car scars so thats what makes me a little worried. 

 

1 hour ago, joeysk said:

looks good, use aquafor/vaseline to keep scabs moisturized, you want scabbing. Scabbing is your body healing. Your scars look deep so It might scab for 10-15 days. I know mine did when I had my first treatment.

Cool thanks man! ive been keeping them moist daily and washing them with salty as the derm prescribed. Did you have scabs that big also? 

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Why did he use it on such large scars?  I know some doctors use it on boxcars but some of these scars look way too wide to be treated with tca cross.   Personally, I would keep a very close eye on this and if it's not healing within a few days you need to get a second opinion. 

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8 hours ago, dazzed said:

Why did he use it on such large scars?  I know some doctors use it on boxcars but some of these scars look way too wide to be treated with tca cross.   Personally, I would keep a very close eye on this and if it's not healing within a few days you need to get a second opinion. 

Yep thats the thing, i didn't have large scars before hand.. they where all isolated ice pick scars (no box car or rolling scars) and not really large ones at that. Now they have turned into massive holes, After keeping them moist by putting vaseline on them as per the DR's post op care instructions i have woke to them looking like this.... my skin was not that bad before now its unbearable to look at 
IMG_7681.jpg.18a6ff85096b2ee81eaf194ec27701c1.jpg

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Not to be an alarmist, but I would personally want to be seen for this.  I get the sense that the doctor is not an expert on this and they watched a couple youtube videos and thought they could do this.  Number 1, it's obvious they used a really large tool like a q-tip or something to put the acid.  And second, the scars they treated are not appropriate for TCA Cross IMO.   

It goes without saying you need to be careful and not let the scabs get pulled off too early.  

 

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The doctor looks like he didn't space out the TCA enough if that wasn't a large boxcar. Like everyone else says about the scabs, you need to avoid having them fall off as long as possible. The holes you have after the scab theoretically will begin to gradually fill. The left side of my face didn't agree with TCA CROSS and I stopped after three treatments, but didn't leave a noticeable whole as deep as yours, and that was with 80%. Seeing how large that hole is in the picture I'd go see the doctor asap or a more experienced dermatologist. 

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I would stop seeing this dermatologist imo and look for someone who knows what they are doing. 

Since you're in Australia why not go see davin lim?

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On 11/24/2019 at 6:47 PM, incepticon said:

How does it look now, any improvement?

Hey, sorry for the delay!


I went and saw the dermatologist on monday and i was shocked when he told me it's going really well and this is what he expected... He put me on some antibiotics which has definitely helped, and relieved a little bit of the inflammation.

Contrary to literally everything i have read about TCA Cross here and everywhere else, he wanted to remove all the crusting and scabbing and keep the wounds moist, his reasoning was the crusting and scabbing will hinder the wounds ability to heal from the bottom up? confusing i know.... but anyway.. to abide by his healing instructions for future reference, in the case this would leave permanent disfiguration and i where to pursue legal rectification, i did exactly as he has instructed to cover my own ass.
It has improved thats for sure, some of the smaller spots have already raised which is astonishing.. only one of the larger spots is still healing though it should become a closed wound in a day or two, And the one larger hole on my cheek has closed and raised a tiny tiny bit though i'm still left with a pretty large hole and something that resembles nothing like what i had before. Where the hole is i had 3 ice pick scars and they seem to have merged into one large.... i don't even know what to call it.

I saw the dermatologist again today and had some yellow light therapy to speed up the healing and reduce redness, I'm really limited with time off work, and this has led me to 3 weeks off which has cost me a absolute fortune in lost pay. It was my understanding having a week off would have been suitable which it certainly was not, so his plans are to do some non ablative erbium glass laser in the new year. I'm going to see this out till after the laser and give it time to heal before i make any other decisions.. 

Without giving away too much information to identity, as this ordeal is not over..  the Dr is a professor and the director of dermatology at one of the biggest hospitals in the area:smileys_n_people_74: his list of credentials are quite substantial if i'm honest. One would hope he does have a clue.

Anyways, ill post a picture tomorrow to keep you all updated with the progress and i really appreciate everyone's concern and interest. ^_^

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@Wilko44 thanks for the update, and glad that your skin is healing! Your doctor is certainly taking an unusual approach to TCA CROSS, but glad you’re feeling more hopeful.

TCA can cause merging of scars because it does widen the scar while lifting it at the same time. My understanding is that expert practitioners apply TCA in a way that avoids merging.

Before starting laser, definitely get a second opinion. Perhaps from @beautifulambition, as many doctors try to upsell lasers because it’s a moneymaker. 

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I really really hope he knows what the hell he is doing because you are right.... I have never, ever seen anyone advise a patient to peel off the scabs.   Did you continuously keep the areas moist to prevent scabbing initially after the procedure?   

I don't want to be an alarmist, but a lot of these dermatologists are academics and not that great at real world practice.   That's good that the wounds are now healing.   Sorry to hear about the hit to your finances.  The doctor totally did not advise you correctly on the healing time and he should have talked to you about how aggressive he was going to be.  

Anyways, good luck with healing and please update us on your progress.

Edited by dazzed

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