How do you prevent PIE from TCA Cross 100% or lessen the duration?

[Jirachi 0]

It seems like every time it takes 3-6 months for the PIE to almost completely go away. This is not ideal as I am trying to lessen my acne scars. Last one was done in September and I still have PIE. I have been microneedling with the Derminator and I recover much better from that. I usually alternate them each month, but I've been stuck with PIE for so long that it's bothering me more than the scars themselves. It is so frustrating that the only reasonable treatment is lasers, and next to nothing can be done at home. How do I prevent or lessen the PIE that is caused from TCA Cross in the first place? Would diluting it to 50-80% help? Should I be applying anything special to help prevent it before it is done?

 

Thanks.

[Amanda Hall 42]

3 hours ago, Jirachi said:

It seems like every time it takes 3-6 months for the PIE to almost completely go away. This is not ideal as I am trying to lessen my acne scars. Last one was done in September and I still have PIE. I have been microneedling with the Derminator and I recover much better from that. I usually alternate them each month, but I've been stuck with PIE for so long that it's bothering me more than the scars themselves. It is so frustrating that the only reasonable treatment is lasers, and next to nothing can be done at home. How do I prevent or lessen the PIE that is caused from TCA Cross in the first place? Would diluting it to 50-80% help? Should I be applying anything special to help prevent it before it is done?

 

Thanks.

PIE sucks. It can make things look worse than they looked originally.

A few products you can try are vitamin C and Niacinamide which are not that expensive. I purchased these along with about three other products after treatments with prolonged erythema. I'm not sure if these helped or if the redness would have just gradually faded so keep that in mind. Doctors have told me to use Hydroquinone 4% but that really aggravated my skin. Maybe I needed to use it longer for my skin to become accustomed to it but I didn't have the patience. 

Please stay out of the sun as much as you can and avoid heat (spa, sauna, being outside in heat for a good amount of time, etc.). Use sunscreen!!! Sunscreen isn't just for PIE but it's to reduce wrinkles, keep your skin looking healthier, minimize brown spots, etc. 

[Sirius Lee 386]

9 hours ago, Jirachi said:

I usually alternate them each month, but I've been stuck with PIE for so long that it's bothering me more than the scars themselves.

Seriously, like TCA this month and derminator next month? No wonder, you have a prolonged PIE. If you don't want PIE, don't treat yourself so often.

Applying TCA more often doesn't give you a better outcome. It's likely more counter-productive because it will only disrupt the collagen production. It takes about 3 months for full collagen rejuvenation. So TCA 100% should not be repeated earlier than 3 months.

If you want to reduce PIE, apply a lower concentration (eg. 25% or less) after 4 weeks.

[Jirachi 0]

4 minutes ago, Sirius Lee said:

Seriously, like TCA this month and derminator next month? No wonder, you have a prolonged PIE. If you don't want PIE, don't treat yourself so often.

Applying TCA more often doesn't give you a better outcome. It's likely more counter-productive because it will only disrupt the collagen production. It takes about 3 months for full collagen rejuvenation. So TCA 100% should not be repeated earlier than 3 months.

If you want to reduce PIE, apply a lower concentration (eg. 25% or less) after 4 weeks.

I thought it could be repeated every 4-6 weeks. I guess that doesn't always mean it should. It just seems like either way the PIE persists, hence why I only did it in September and not since. I think that was the only time that I tried 100%. Previously I had just layered 15% for TCA cross on the scars until there was some frosting, but not sure if that would help much.

Is it okay to use the Derminator every month? It doesn't take as long to recover like TCA cross, and supposedly it can actually help with PIH/PIE? I've seen really good results that other users have shared.

Would alternating a TCA peel every other month be better? Or do you mean applying a lesser concentration for TCA cross to reduce PIE? I also considered just alternating a month with a glycolic acid peel, but I feel like that could just might prolong the PIE.

Agh, it's frustrating trying to treat the scars but getting PIE, but it's understandable considering how harsh TCA can be. Do you have any good production recommendations for reducing or preventing it? Thanks!

[Jack817 20]

You can try Vascular laser to reduce the redness.  I don't know if there's a way to prevent PIE. May be reduce the concentration of TCA that you're using. 

[Sirius Lee 386]

53 minutes ago, Jirachi said:

I thought it could be repeated every 4-6 weeks. I guess that doesn't always mean it should.

Who told you that it's okay to apply 100% TCA every 4-6 weeks?

53 minutes ago, Jirachi said:

Is it okay to use the Derminator every month? It doesn't take as long to recover like TCA cross, and supposedly it can actually help with PIH/PIE? I've seen really good results that other users have shared.

Derminator (eg. non-energy microneedling) can be done every 4 weeks. The rationale is that it takes 4 weeks (or 28 day cycle) for the skin to exfoliate.

56 minutes ago, Jirachi said:

Would alternating a TCA peel every other month be better? Or do you mean applying a lesser concentration for TCA cross to reduce PIE?

Here's a rough guideline for repeating TCA application:

20% or less: every 4 weeks

20% to 35%: every 6 weeks

35% to 50%: every 6-10 weeks (eg. 35% = 6 weeks; 50% = 10 weeks)

55% and up: 12 weeks (especially if it's over 70%)

[Jack817 20]

7 minutes ago, Sirius Lee said:

Who told you that it's okay to apply 100% TCA every 4-6 weeks?

I think lots of publications state that they apply TCA in high concentrations monthly or even bi-weekly:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2956965/ This is one example. 

[Jirachi 0]

56 minutes ago, Jack817 said:

I think lots of publications state that they apply TCA in high concentrations monthly or even bi-weekly:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2956965/ This is one example. 

Yes, most sources online seemed to have given this time frame. It does make more sense to wait 3 months. I don’t think every 2 weeks is a smart idea at all.

[Sirius Lee 386]

52 minutes ago, Jack817 said:

I think lots of publications state that they apply TCA in high concentrations monthly or even bi-weekly:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2956965/ This is one example. 

And I personally find it questionable. For instance, consider the following quotation taken from the link you provided.

Quote

RESULTS

Out of 12 patients, 10 patients completed the follow-up period of six months and were included in the study. Immediately on application, the patients experienced mild burning, which was well-tolerated. This was followed by frosting, erythema and oedema, that decreased in four to six hours. Crust formation was observed on the next day, which subsided by three to four days in most patients. [Figures 2 a, ,bb and andc].c]. In one patient crusting was observed for seven days. Eight patients (80%) showed excellent improvement [Figure 3], while two patients (20%) showed good results after four sessions [Table 1]. One patient had transient hypopigmentation that lasted for six days [Figure 4]. There were no major adverse effects observed such as post inflammatory hyperpigmentation

Usually, with 100%, crust/scab does not show up for 3 days. Moreover, to say that none of the patients incurred PIH (and they were all dark-skinned) sounds dubious.

With regards to bi-weekly application, to me it's an overkill and I highly doubt that it will lead to better outcome. Also note that TCA is highly toxic on our organs. Why would you want to put your liver and kidney at risk?