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Curiousobserver90

Best treatment for my scars? Background below

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I had cystic acne in 2017 which was treated with a year long treatment of isotretinoin (orally) and Glycolic Acid and Kojic Acid applications with Salicylic Acid cleanser. I was left with some bad scarring for which I used Retinol 0.5% and Dead Sea Mud Masks (went to Jordan to get these haha) for over 6 months at the end of whihc my scarring was almost all gone except couple of deep scars which seemed softened enough to not bother me.

Recently had a short bout of Acne in May 2020 (about 10-15 closed comedones on my face and mostly my right cheek). This time I used just zinc + beta carotene supplements orally and applied Glycolic Acid and Kojic Acid applications with gentle cleansing + azelaic acid spot treatements. I've got some scarring too but my derm looked at it and simply said there is only some scarring not a lot. To my eyes it looks like a LOT. She has started me on retinol 0.5% again and asked me to continue for minimum of 12 weeks before we meet again. However, I am seeing absolutely no improvement with the retinol as of now.

All pictures are below, at angled lighting as well we how it appears to my eyes. I have also put a picture of 2017 scars which can give an idea of some of the old scarring whihc suddenly looks prominent now :/

What are the best procedures for me? My right cheek seems to be way worse than my left cheek.

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Screenshot_20210126-173803_Photos - upload.jpg

Today 2.jpg

20210126_104054 - Upload.jpg

Edited by Curiousobserver90
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12 hours ago, Curiousobserver90 said:

1) The derm has started me on retinol 0.5% again and asked me to continue for minimum of 12 weeks before we meet again. However, I am seeing absolutely no improvement with the retinol as of now.

2) What are the best procedures for me? My right cheek seems to be way worse than my left cheek.

1) Unfortunately, 0.05% is frankly too low. If your skin can tolerate it, ask for 0.1% prescription. Also you need to be on it for at least 6 months to see any noticeable difference. However, tretinoin by itself is not enough to correct the scars.

2) Just get rid of any defined scar borders. That alone will give you 90% improvement. I would suggest TCA cross for this. Once the borders have been smoothed down, then I suggest dermal filler to lift up the pits. Initially, you would want to go with temporary filler like Juvederm, but eventually semi-permanent like Sculptra or Radiesse will be more preferable.

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1. Im not on Tret. 05% - its retinol 0.5%.

2. Thanks will speak to the derm. About TCA CROSS. She did speak about it once but also mentioned microneedling. Has asked me to see her in a few months to decide. I see from the efficacy mentioned on this website that both work. Any risks in TCA cross (for Indian skin) that I could discuss with her? 

6 hours ago, Sirius Lee said:

1) Unfortunately, 0.05% is frankly too low. If your skin can tolerate it, ask for 0.1% prescription. Also you need to be on it for at least 6 months to see any noticeable difference. However, tretinoin by itself is not enough to correct the scars.

2) Just get rid of any defined scar borders. That alone will give you 90% improvement. I would suggest TCA cross for this. Once the borders have been smoothed down, then I suggest dermal filler to lift up the pits. Initially, you would want to go with temporary filler like Juvederm, but eventually semi-permanent like Sculptra or Radiesse will be more preferable.

both work for smaller sc risks in TCA cros

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4 hours ago, Curiousobserver90 said:

2. Thanks will speak to the derm. About TCA CROSS. She did speak about it once but also mentioned microneedling. Has asked me to see her in a few months to decide. I see from the efficacy mentioned on this website that both work.

Are we talking about the RF microneedling or the manual needling? If RF, you might see some improvement from collagen induction, but with the manual, likely not. It's worth noting RF microneedling will not help with the scar borders though. It really would be pointless to get RF micro without first smoothing down the scar borders. 

 

4 hours ago, Curiousobserver90 said:

Any risks in TCA cross (for Indian skin) that I could discuss with her? 

More or less the same side-effects as with any other treatments: swelling, redness, oozing, and possible infection.

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On 1/28/2021 at 3:18 PM, Sirius Lee said:

1) Unfortunately, 0.05% is frankly too low. If your skin can tolerate it, ask for 0.1% prescription. Also you need to be on it for at least 6 months to see any noticeable difference. However, tretinoin by itself is not enough to correct the scars.

2) Just get rid of any defined scar borders. That alone will give you 90% improvement. I would suggest TCA cross for this. Once the borders have been smoothed down, then I suggest dermal filler to lift up the pits. Initially, you would want to go with temporary filler like Juvederm, but eventually semi-permanent like Sculptra or Radiesse will be more preferable.

Does .1 tretinoin over .05 really make a huge difference?  For rough texture/very shallow scarring?

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2 minutes ago, Cubsfan24 said:

Does .1 tretinoin over .05 really make a huge difference?  For rough texture/very shallow scarring?

You'll definitely be shedding more skin at a faster clip, which will help with the texture. Combining tretinoin with light TCA peel on a routine basis seems to give even more added boost to collagen production, according to a few research papers I‘ve read.

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