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Phenol Peel Update

 
MemberMember
181
(@wombatstaywoke)

Posted : 12/31/2021 10:48 am

Hello all!

I wanted to use this section to document my progress phenol peel. I wanted to do this in one go so I don't have to keep checking this website as much.  I'll try to post pictures en masse at the 30 day mark. 

Update 02/08/2022: Imgur Album Days 1-50 (I'll be adding photos in real time)

2014:  Acne Scar Journey Begins on a Bad Start: 

F™ed up big time and went to a plastic surgeon™s office where I was oversold on the care package below. I did get significant improvement but not to the extent that I would™ve liked in relation to the money I spent. I still get mad thinking about the price so I™m not gonna drop it.

  • 3x Infini RF - This is literally the only thing that worked (-_-)
  • 3x PRP facial aka œ vampire facial (aka aka œwaste of money)
    • Not really sure if this actually contributed to anything but science said so?
  • 3x. Glycolic acid peel - to control oiliness during above
    • I most likely got ripped off by having this added to my care package. Felt like a glorified Neutragena byproduct rubbed on my face.

Total Improvement from Baseline: ~20%

2015 - 2018: œFinancial Recovery Period and DIY Days

Poor as hell and underemployed, I paid off the debt for the first round. I discovered here and on blogs that scars and specifically acne scar revision is a subset within dermatology that requires specific modalities besides œjust a laser to wipe a face clean. I discovered the impact of at home microneedling using OwnDoc™s device as well as DIY TCA Cross. 

I received a good amount of improvement using at home methods, almost just as much as the œprofessional scar treatment I got from the surgeon™s office. I would go into the office with redness and scabs on my face topped with brown and blotchy clown makeup (œiM a GuY) to cover it up. 

I did treatments on and off every 7 weeks, microneedling with Derminator 2.0mm and 2.5mm first on boxcar scars and then suctioning each section everyday for two weeks. On day 4 I would do TCA Cross on small boxcars, pores, and icepicks.

  • ~12x Derminator Microneedling sessions at 2.00mm/2.5mm 
    • Smacking the cheeks every 7 weeks!
    • Speed: Medium
    • Arsenal: 9 needle cartridge; f*ck that single needle sh*t.
    • Did you get the temples? Lol Like that worked
    • Suction: Until the area turns into a grape.
  • ~20x TCA 100% Cross
    • Ice picks, little boxcar scars, and faux pores.
    • Used at my discretion whenever I saw them. 
    • Literally the real MVP when it comes to DIY acne scar treatment.

Total Improvement from 2014: ~20%

2019-2020: More Money = Time to Treat

With a solid understanding of how to treat acne scars now, it™s time to research real dermatologists who have the skill to do it. After watching Dr. Davin Lim, Board Certified Dermatologist in Brisbane, Australia™s numerous educational videos on œmodalities and treatments I felt informed on what I needed to do next: manual methods then the best energy device. 

At this point I realized once I have the relevant patient/consumer info, I can tackle the issue in the most cost efficient way possible. I get the following treatments from a series of doctors over the course of this year:

  • #1 Infini RF x Nokor subcision (December 2019)
    • Subcision acne scars using a single point of entry per scar (that popping sound tho¦)
    • Infini: Literally, what™s the point of numbing cream when I can feel the heat and all 49 needles?
  • #2 Infini RF x Cannula subcision (July 2020)
    • œYou can just not give me numbing cream. Acne scars hurt more than these needles
    • Subcision: Single point entry for the entire face.
  • #3 Infini RF (October 2020)
    • œNo, I don™t want your exclusive acne scar package. Only thing vampire facial is gonna fix is your wallet

Total Improvement from 2018: ~30%

2021: Time to top it off; getting too old for this level of worry.

All the treatments I™ve done at the point have converged to this moment. My scars are at a level where I™m content albeit not happy with them. Under the worst lighting, under the sun, even under the sea, they™re almost faint and I need to actually need to try to get myself worked up about my scars. Nothing™s perfect - no treatment plan nor no face. Trust me, I™ve seen a lot celebrities in person with a past job I worked and while they may not eat cake, they sure as hell have cake-like faces with makeup covering their skin imperfections. At least your acne scars are deeper than their personalities, most likely!

So I drive to meet what some here might call¦. œThe Guy to get œThe Procedure.

Everything from puberty, to sports, to eating like sh*t, to even the skin treatments have f™ed my skin pretty good and it™s not the best texture. I go in and sign the dotted line and hope for the best:

  • Phenol Peel (feat. cannula subcision, Phenol Cross here and there, Tongue Depressor chemabrasion to cure your Skin Depression)
    • This is literally the boss battle for your entire face - but you want the boss to win.

Total Improvement from 2020: ~60% (See Final Review Down Below)

12/20: Day 1 - Not feeling excited about this procedure since it™s the week of Christmas but I figured this is the best gift I can hope to give myself for the future and to kill appearance anxiety once and for all. I™m sure the cold weather, holiday break, and remote work will be on my side during healing. From what @f93d has said, this downtime is no joke and I™m trying to mentally prepare for that. 

Dr. Rullan has an ER nurse drug me up with narcotics and hooks me up to an IV. My heart rate is pretty fast and blood pressure is moderately high indicating that I™m clearly nervous despite me saying I™m calm.

The procedure on Day 1 of 2 is the worst. Although the procedure is a conscious sedation, I could still feel the cannula through my cheeks and each swab of the first layer of phenol. The stinging sensation lasts for almost 140 or so LONG seconds. Even with fentanyl you can still feel a good amount of pain. After about two hours of subcision and the first phenol pass on all quadrants, they tape up my face and net me up. I look like a bank robber who got his ass beat because he didn™t know the tellers would all be UFC fighters. 

My face doesn™t look too bad leaving the clinic but when I get to the hotel my face has swelled up immensely. I could barely read the subject lines of emails on my laptop and had to force my eyes open using two fingers. I™m given pain medication and insomnia pills but they barely ward off the itching and burning pain caused by the phenol. I sleep and wake up about four times throughout the night. I™m crying harder and louder in my own head than the baby up on the floor above.

___

12/21: Day 2 - I go into the office to see Rullan and his team and the first one to greet me is the ER nurse who™s ready to drug me up yet again. She asks how I tolerated last night and I inform her that I could barely sleep. My face felt as if it was on fire, like a thousand ants were digging their way through to my skull. œThis day is usually a little bit worse but at least you™re here for a shorter amount of time. Our conversation doesn™t last long before Rullan comes in with the œgoodies. 

I™m consciously sedated again. The nurses carefully remove the net stocking off my fluid-filled and swollen head like releasing an over-pump Costco grapefruit from its packaging. They then carefully remove the tape so as to not rip off any scarred skin. Dr. Rullan instructs his nurses to scrape my face with tongue depressors of what damage the first coat of phenol had done. Holy sh*t! I can feel this with a lot of itchiness and pain. Rullan comes over to me, eyes opposite mine upside down and says, œready for round 2?. Without giving a response because of the painkillers™ effect, he begins to scrape my face with what feels like sandpaper. He does this for roughly three or so minutes on each cheek. I™m not sure if he got my temples despite me asking him to specifically target those areas. I get a 30 second rest and the nurses press on my cheeks with gauze and¦ sssSSZZZZzzz¦. goes the second coat of phenol on the abraded skin. They hold it for a solid 20 seconds in each area - It burns like no other. 

The team is done doing their damage - the face is a wreck and they refuse to show me with a mirror because of how much of a mess it is. They top it all off with bismuth powder over the entire face minus the orbital regions. Wheeling my closet crybaby self down to the first floor, the nurse says I handled it well compared to other patients. I look at the full body mirror in the lobby and think two things: œwas this a mistake to do this? and œwow, I look like a man who just wanted to dip his face into some cumin, huh?

___

12/23 - 12/25: Day 4-6: It takes three days for my swollen eyes to open back up and my mouth is held nearly shut by the stiffness of the mask. I can barely open my mouth to accept a stick of chewing gum. My face is in pain and it is itching like crazy. The prescribed prednisone can only do so much to ward off the urge to rip off the œcumin mask and scratch away. 

It™s getting crustier by the hour and the mask really cuts into the lines where Rullan drew the borders. I™m yearning for the Day 8 mark as I type this, reading the Dermatology Institute™s 2-Day Phenol Post-Op care doc. I want to know if Rullan can see me so he can remove this Hades-forsaken mask off my face and tell me the next steps to heal. 

Thank goodness I can text him and send him all my concerns. And to think, I™m missing out on a juicy turkey dinner and vanilla bean ice cream with apple pie because all I can have are liquid foods. Everyone in my home is singing and saying œHO HO HO around me and all I can think about are the œHA HA HAs I got throughout life because of my sh*t skin. I reframe those memories into thinking they were just telling me to get something with œhyaluronic acid this entire time. œThank you, friends! (@ssholes!).

__

12/28 - Day 8: I drove to Chula Vista to get the mask removed from Dr. Rullan himself as I had some additional followup questions to ask. Normally you could do this at home but I wanted to be sure I was clear on next steps. Even with pandemic shortages and inflation, gas money is no object to me to make sure my skin concerns are squared away. Others who have gotten this ( @f93d and @shei514)  are not kidding about the redness. My face is a combination of red as a tomato to a cosplayer trying too hard to look like Kirby from Mario Kart or worse.

I look at his magnification mirror and it looks like all the skin imperfections that I™ve been scrutinizing for the past 15 years are nearly gone: Boxcars seem elevated and flattened; ice picks feel as though they need a microscope to be seen; rolling scars seem they™ve blended with the curvature of my cheeks. I™m trying not to get too excited as this could very well be swelling from the peel but Rullan says this is a good sign and with the entire healing process being a year the expectations should be higher. Also, shout out to the prior procedures I™ve done in the past. I wouldn't have gotten here without you! (Except you vampire facial)

The most significant thing to worry about right now is the hard red complexion that I have. I™m just concerned as to how I™m going to plan my social life as I write this since the contrast between my face, neck, and chest is absurd. One of the reasons I got this procedure was so my facial complexion could match my neck more but I don™t know if I™d feel more elated or worried if it ended up matching my chest! I™d better suck it up and make a trip down to Sephora so I can get color matched. Rullan informs me to get an oxygen facial next week and end of month to help reduce sensitivity and redness. This and a special serum in my procedure goody bag are aimed at tackling just that. Thank goodness they™re included in the price I paid for the peel!

__

12/29 - Day 9: The skin is so much cleaner today than it was yesterday. The use of the cleanser provided to me removes much of the mask remaining on my face as well as any excess oil. I leave much of the mask that™s within the border of my hairline intact and try not to pick it as it will just irritate my skin. Shampooing and adding conditioner in hair has never felt so refreshing! I use the serum provided to me as directed and while I was told to use Aquaphor for the first three days switch to using an HA moisturizer as the texture is better and is already refreshing. 

The skin is tender but not as tender as you would think for an operation of this magnitude. What I think is renewed skin is probably post procedure swelling. As I said before, I won™t get too excited about it so we™ll see how it fares in about a week after my first oxygen facial and and a month after my second one. 

The elephant in the room at this stage of the phenol peel is the redness. It™s insane and I can™t stop looking at my face with equal parts worry and awe and how much constructive damage the peel has done. Depending on the lighting my face looks like a faint salmon-like pink outdoors to a bright hot red when indoors next to my monitor. I™m not looking forward to putting on makeup. I already know it™s going to look like shit because I can barely spread mayo on bread. I™m trying not to worry about it as I know others have healed just as well and I™m hoping I™m no exception to the studies done on those with skin types IV and V. Skin gods, please be on my side! I™ll send you a sacrifice of my leftover Proactive from 2008! 

 

February 2022 (2/10) : ~30 Day Phenol Update:

Hello all!

2022 Phenol Peel Progression (album)

I wanted to follow up where I last left off on embarking on the notorious phenol peel journey by informing you all where I'm at right now as I close in on the 50th day of post-op with Dr. Rullan. I count this as the 50th day when the bismuth sulfate mask (aka "The Thing from Fantastic 4 Mask") came off. If you want to count it from the first day of the procedure, I've numbered the photos as so in previous post's imgur album. Please don't be mad at me for doing it this way. I only want to post this way as to ensure my privacy. 

Basically, here's where I'm at right now: My skin has gotten a lot sensitive to the point where 2 minutes in the sun feel like hell unless I have SPF 50 with zinc oxide and my handy, dandy Asian Mom Face Shield Visor. My skin is slowly reverting back to my untanned form and much of the hyperpigmentation and textural scarring left by years of cystic acne have improved by miles but I still have a marathon to go for healing. I don't really bat an eye when seeing most of my acne scars anymore as they look a lot better surface wise. I already knew volume/collagen loss wouldn't be resolved with phenol peel so I wasn't too surprised there. (Filler recommendations anyone? Getting kinda tired of this acne scar skinsecurity if you ask me)

I still have burn marks or PIH (Rullan used the terms interchangeably) around the demarcation line around the neck and the eyes. In addition, around days 40-48 I started to receive irritation, redness, and some minor acne around the cheeks; something along the lines of tiny whiteheads. They're annoying but I don't dare scratch at them. We all know what happens when you f*ck with acne by scratching.

I am still quite worried as some may have felt around this mark. My skin is very beat up, uncomfortable, and I get weird stares from coworkers, gym mates, and strangers. Up close, the skin doesn't look normal. It's like a cross between having your face dragged across sandpaper, the Sahara in July, and having no sleep for two weeks only to be hydrated later on; the skin looks weathered but it looks better than where it was before, ironically. I know it's a part of the healing process but I just need to stick through with it. 

As for daily routines, I've been using a pH-neutral face wash (CosRX Good Morning FaceWash) along with Alastin Skin Serum ($$$) day and night. If my face does get a little dry during the day, which it often does, I apply a dime-sized amount of Hada-Lobo HA facial moisturizer. Thank you, Covid for making remote work a thing! I would be dying of anxiety every day in the office if I had to go to work like this! I stopped using green primer + foundation during weeks 1-3 because it was pointless as the redness was so damn RED it bled through the make-up. It looked less harsh on Google Meet but 1000x harsh on Zoom calls. I would lie and say I was having technical difficulties for my camera being off. By week 5, much of the redness traded in for PIH so I was able to somewhat get away with using just a tinted moisturizer. The skin still looks weird and irritated but a lot better than it was before. I live like a vampire: Waking up at 0400 to go workout and jog, only to race home before sunrise. And then when the sun dips below the horizon I go out to do grocery shopping or go for a nice walk to de-stress from a long day. 

I only hope my skin is looking solid at the 90 day mark. I spent a pretty penny on this procedure and it would kill me if I got subpar results. I'll hopefully post again at the 80 or 90 day mark. 

Yes, I did sacrifice my leftover ProActive from 2008 to the Skin Gods. They're probably mad at me that I sent them some expired shit and gave me some irritation. Oh, well. :)

 

March 2022 (3/28) : ~90 Day Phenol Peel Update:

*I'll be sure to edit and post this on my original post so people don't have to go to other pages to see/read updates collectively. 

** I just woke up the day I took the photos of me wearing a black shirt. Excuse the messy hair!

Scar wise, so far so good. Complexion/hyperpigmentation wise, so far so good (I think).

I've noticed that during my mornings and afternoons when my skin isn't super oily from a stressful day, my scars look rather faint and the texture is still rather very smooth. It should be no surprise that the scars are still there but I'd say they've improved a fairly good amount in terms of collagen production, texture, and appearance at least in my opinion. For reference, places that I frequent often like my bathroom mirror (lol fml), the gym mirrors (bathroom and weight room), and outdoor shops, I barely take notice or at least as much notice to my scars. There's a scar spot in particular on my left cheek that's rather devoid of collagen. I'm sure you'll see it below. But that area won't be plump until I get some filler.

 

My skin is a little dry and patchy at times but I'm applying a HA moisturizer three times daily. It's crazy to think that the signs of phenol peel would last this long after three months! I'm hopeful that I'll continue to see improvement in particular my skin tone being more uniform with my untanned skin. You'll notice that there has been some PIH left behind around the eyes. Yes, I have been told by people if I'm trying to stay up for an entire week or if I got initiated by the raccoon tribe outside my backyard. It looks bad at times but I always say I'm just tired )-_-(*. 

 

I'll post another update in late April to mid-May on this when I'll be at around the 4 month mark. Again, I'm not skin type I-III so I have a lot more healing to do. The results of doing this on a person with a little more (a lot more) melanin can cause some issues and I think healing from it properly with the right amount of time and care are needed. Scar wise, I think after 5 to 6 months I'll revisit and see if I want to do anything else. Maybe another at home microneedling session for filling in and then filler. Complexion wise, I'll have to wait and see what over the counter skin lightening methods i.e. kojic acid, vitamin c, arbutin, and lord forbid hydroquinone, can do to help even out the complexion. I'm hoping Father Time is kind to me and heals quick cause I'd really like some self-confidence back. I know f93d  said it took around 7 months for the demarcation lines alone to disappear so I'm hoping any hyper/hypopigmentation left evens out by then.

 

I think my skin has come a long way from my first treatment from 2014 and now this treatment in 2021/2022. It still bothers me but it doesn't bother me as much. I don't bat an eye! Except of course I look at my temples... sigh. Dr. Emer for Belafill, anyone? Nah, better find someone better, more economically priced, and doesn't come off as money hungry on social media.Do I think it's worth what I paid? I think it could've been a little more cheaper but this is an intense procedure that requires more than one medically trained person in the room so there's that. 

 

 

 

May 2022 - 6 Month Post Op Final Review:

Total improvement from previous treatments in 2020 and 2021: ~60%

Let me first start off by saying it's crazy to think that it's been a whole six months since I decided to get the phenol peel with Dr. Rullan, not only to improve only acne scars but also my overall skin appearance. I hate to be clich© but time really does fly when you're having fun! ... staying indoors all day, away from friends, contemplating thoughts you shouldn't be thinking, looking at all the beautiful people and their photo shopped or not skin on social media ... ah, yes the final word!

Per Dr. Rullan's office, the perceived final result is usually around the 6 month mark after the procedure. I got this procedure done towards the tail end of December 2021. We'll take it from here since I haven't seen any drastic changes in  improvement and healing. I will say overall that I'm happy with what the phenol peel has done for my scarring but there are some things I wish could be better. 

 

The Good: 

The peel has done some amazing improvement in improving texture (+35-40%), creating collagen growth for scars of all types (+55-60% from previous treatment), reducing fine lines and some wrinkles (~+15% more on this later), and removing stubborn hyperpigmentation from superficial scars (+80%). I've noticed the hyperpigmentation around my eyes has improved a lot but the fine lines in the same area didn't improve as drastically as the research papers had suggested.

While I'm no dermatologist, I do firmly believe at least in the context of acne scars that this procedure should be the final weapon after the scars have been deteathered, max volume of collagen induced from both economical and professional procedures, and have had active acne in all forms controlled.

The Bad:

The healing time was a little very brutal. Thank goodness I got this done during the nascent period of lockdown in the US and at a time when remote work has finally been deemed acceptable. Healing on weeks 0-3 was very painful and from weeks 4-16 is fully of itchiness, pain, embarrassing comments, odd stares at your RED tomato face, and a lot of white lies to tell your coworkers. I've never applied SPF 50 or used a face shield so much in my life but it's what you must do to protect your skin as it heals from possibly the strongest acid to be placed on the face (second to stomach acid). 

For those of you who are on your final step in the acne scar journey, after all the trials of (takes deep breath) ...

...at home microneedling,

...RF microneedling - Infini, Genius, Fractora Firm, anything with heat and needles and sh*t

...TCA Cross with all the percentages

...subcision with cannula here and Nokor there

...watching all the Dr. Lim videos 5x

...reading endless dermatology and device reviews and going on this forum and getting half depressed and half motivated, and thinking about which credit card to fund this procedure for ... 

I'd say be prepared. Dermatologists know the skin well but only you know when you will be comfortable in your own skin and what cost. Be mindful of everything I say here - from the price (~USD $6,000 excluding lodging, driver, and meal prep), the down time (3.5 months for redness to die down; 5-6 for complete improvement), and the side effects. The price (imo) could've been cheaper but this office is in $outhern California and requires stringent medical staff in the room in addition to Dr. Rullan. Even my primary doctor was a little shocked that I would be shelling out this much money for an out-patient, cosmetic procedure. She doesn't get my my/our struggle.

The Ugly:

No procedure comes with out risk or side effect. And I still see that even after 6 months of vigilantly watching my skin in all kinds of lighting. Aside from a long downtime, the risks they outline are very apparent (at least for me) when I see my face. I have some hyperpigmentation around mouth and eye lids and some hypopigmentation around my mouth. I was well aware of this since I am skin type IV/V and Rullan made sure I was aware of it. He did highlight the improvements more than the side effects but what smart doctor/businessman wouldn't?

It's a little shocking but I'd say I take the good more than the bad (ugly?) in this case. Even in the best lighting, you can see these marks. Do I get down about it? A little. But it's barely recognizable at this point unless the flash is really strong. I'm currently using kojic acid as well as 4% HQ to help reduce it over time. 

 

Final thoughts:
I'm happy to say I'm over the hardest days of my acne scar/ skin journey.

I no longer get as much anxiety when looking in the mirror although I still do get uncomfortable when I hear the words "ugly" or "your face" uttered in a conversation that does or doesn't include me. I still see the look of half not-to-be-rude expressions on those who speak to me (family included). I guess that's a form of trauma/abuse/mental distress that only I can try to figure out how to get comfortable with.

Is my skin baby smooth of magazine/Instagram glossy perfect? About three light years away, yes. I'll be taking a break from getting any kind of scar treatment done for at least this year since this has been an expensive, time consuming, and emotional journey. I forgot that I have a life to live and better things to worry about! 

For next steps, I'm thinking about getting Pico laser to help correct any long lasting pigmentation issues - aka my second big concern. I'm also considering seeing if it would be worth doing at home microneedling here and there to help level out the remaining acne scars. Filler? I'm thinking about it. I do have two areas on my left cheek and temples that could use some plumping up but it's not too pressing for me at the moment. In overhead lighting I can still see my scars well but they've improved a lot. Like, A LOT.  I don't even bat an eye as much in seeing them there.

Getting a second or partial phenol peel is in question, but it probably won't be for at least a very long time. I just hate that I'm Asian and people actually think I look older because of the fine lines around my eyes. It should be the opposite!  Perhaps 5 or 10 years from now when I'll really need it. Sun cream anyone?

But to be honest, I'm kind of just okay and happy with where I'm at right now on this penultimate day in May 2022, enjoying a coffee, watching sports, and finding an airline ticket at an inflated ass price. 

I'm just grateful for the research, improvements from trial & error, and the vast amount of support on this forum. From the bottom of my heart and my then deepest acne scars, thank you all for sticking with me on this journey and hearing about it! 

Another special thanks to @shei514and @f93dfor leading the way in documenting this procedure. Your input had made me more assured!

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(@candy-says)

Posted : 12/31/2021 11:00 am

great attitude man. Hope you'll heal well

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(@kay24)

Posted : 12/31/2021 1:37 pm

This gave me some good laughs and I'm so happy to hear about the improvements you've had over the years. I wish you a speedy recovery and many months of healing results. I think we underestimate how long our skin adjusts, you could get 9 months or so before it really is the end result.

I really want this procedure but my topwonder is about the strategy after? Did someone drive you home? For people who travel, did you stay at a airbnb? I guess a niceairbnb and a driver to get you there would be the best option.

I also wonder how much longer this treatment is even going to be available. How far from retirement is Rullan? Nobody else is taking over this method that I know. Was total price charged from the office around 6 or 7k?

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(@wombatstaywoke)

Posted : 12/31/2021 2:39 pm

1 hour ago, Kay24 said:

This gave me some good laughs and I'm so happy to hear about the improvements you've had over the years. I wish you a speedy recovery and many months of healing results. I think we underestimate how long our skin adjusts, you could get 9 months or so before it really is the end result.

I really want this procedure but my topwonder is about the strategy after? Did someone drive you home? For people who travel, did you stay at a airbnb? I guess a niceairbnb and a driver to get you there would be the best option.

I also wonder how much longer this treatment is even going to be available. How far from retirement is Rullan? Nobody else is taking over this method that I know. Was total price charged from the office around 6 or 7k?

Hi!

I'd say you need about 3 days in San Diego/Chula Vista to get it done. Try to just get a reliable friend/family member to help you. Professional care givers areveryexpensive and you really don't need that level of care for that time frame. I didn't use Airbnb but rather the cheapest motel I could find and it was a steal at $45 a night which is way cheaper than the former. Plus it was clean!

 

There was another provider actually much closer to me providing this peel andhe is in the same age bracket as Rullan. I didn't select him cause he didn't have a lot of experience with people of color (mainly just old white ladies) and especially those with acne scars. From what he (the other guy) told me is that phenol peels are a dying art in that lasers have taken over as the standard for total facial rejuvenation to which he and others could agree. While phenol has a longer downtime the chemical on rejuvenating the skin is almost tried and true. I spoke to Rullan and he has no plans on retiring anytime soon. If he does, his daughter Jennifer would be more than competent to conducting the procedure.

 

I paid $6k for the total treatment at Rullan. I'll judge its worth at the end of my recovery period which I have set to March 2022. So far, so good!

Kay24 liked
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(@gynoscar)

Posted : 12/31/2021 4:34 pm

Wishing you the best! Do you have a customer facing job?

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(@wombatstaywoke)

Posted : 12/31/2021 6:32 pm

1 hour ago, gynoscar said:

Wishing you the best! Do you have a customer facing job?

Sort of. My job is remote but I do need to be on camera sometimes. My face doesn't look too bad on camera but it also depends on lighting/filters.

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(@shei514)

Posted : 01/02/2022 6:11 am

Definitely consider a light tinted moisturiser or something similar. It will help with the redness as the redness lasts for months after (it gets better over time, like two weeks post-op you look like a tomato). And if you go for the oxygen peel that might help.

Your post brought me back to what it was like having the phenol done. Its really hard to describe the procedure to someone who has never had it done before. The first 3 days are so challenging and the pain is definitely up there. But you got this!

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(@trueromance093)

Posted : 01/02/2022 11:14 am

I knew that phenol peeling is not effective on deep acne scars.

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(@wombatstaywoke)

Posted : 01/02/2022 5:46 pm

11 hours ago, shei514 said:

Definitely consider a light tinted moisturiser or something similar. It will help with the redness as the redness lasts for months after (it gets better over time, like two weeks post-op you look like a tomato). And if you go for the oxygen peel that might help.

Your post brought me back to what it was like having the phenol done. Its really hard to describe the procedure to someone who has never had it done before. The first 3 days are so challenging and the pain is definitely up there. But you got this!

@shei514You are a queen for going through with this! I appreciate you so much for your thread and answering my questions!

I know it's been a while since you last posted but howlong did it fully take to get back to your normal skin color? Like three months at most? Do you have any tinted moisturizer brands that you recommend? The patient coordinator provided me with a concealer specifically meant for post-op skin patients but the redness bleeds through. I guess I'llhave to wait it out for it to look more normal.

Also, did you have really bad panda/raccoon eyes first weeks post op? While my under eye circles/wrinkles have improved a lot, the rest of my eyes are all dark and did not get phenol application as much. I'm worried the pigmentation might be off as I move closer to being fully healed.

God speed on your skin journey!

 

 

6 hours ago, catchingFeelings said:

I knew that phenol peeling is not effective on deep acne scars.

You're right, it's not. You're supposed to get other treatments (subcision, microneedling with or without RF, TCA, etc) to raise the scar as much as possiblebeforeyou get this peel done. Phenol specifically for acne scars is meant to level everything out from a texture standpoint. It does however induce collagen reproduction but not to the degree of other treatments I would say.

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(@gynoscar)

Posted : 01/29/2022 12:15 am

1 month has pass. i'm wondering where you stand with the phenol peel procedure?

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(@dirigo39)

Posted : 01/29/2022 10:52 am

Call we see photos?

 

I asked rullan to do my fore head and he ignored that.

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(@wombatstaywoke)

Posted : 02/08/2022 10:54 pm

On 1/28/2022 at 9:15 PM, gynoscar said:

1 month has pass. i'm wondering where you stand with the phenol peel procedure?

 

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(@wombatstaywoke)

Posted : 02/09/2022 9:38 am

Apparently I don't know how forums/online message boards work so I'm repasting my update here. It's a separate post as well!

___

 

Hello all!

2022 Phenol Peel Progression (album)

I wanted to follow up where I last left off on embarking on the notorious phenol peel journey by informing you all where I'm at right now as I close in on the 50th day of post-op with Dr. Rullan. I count this as the 50th day when the bismuth sulfate mask (aka "The Thing from Fantastic 4 Mask") came off. If you want to count it from the first day of the procedure, I've numbered the photos as so in previous post's imgur album. Please don't be mad at me for doing it this way. I only want to post this way as to ensure my privacy. 

Basically, here's where I'm at right now: My skin has gotten a lot sensitive to the point where 2 minutes in the sun feel like hell unless I have SPF 50 with zinc oxide and my handy, dandy Asian Mom Face Shield Visor. My skin is slowly reverting back to my untanned form and much of the hyperpigmentation and textural scarring left by years of cystic acne have improved by miles but I still have a marathon to go for healing. I don't really bat an eye when seeing most of my acne scars anymore as they look a lot better surface wise. I already knew volume/collagen loss wouldn't be resolved with phenol peel so I wasn't too surprised there. (Filler recommendations anyone? Getting kinda tired of this acne scar skinsecurity if you ask me)

I still have burn marks or PIH (Rullan used the terms interchangeably) around the demarcation line around the neck and the eyes. In addition, around days 40-48 I started to receive irritation, redness, and some minor acne around the cheeks; something along the lines of tiny whiteheads. They're annoying but I don't dare scratch at them. We all know what happens when you f*ck with acne by scratching.

I am still quite worried as some may have felt around this mark. My skin is very beat up, uncomfortable, and I get weird stares from coworkers, gym mates, and strangers. Up close, the skin doesn't look normal. It's like a cross between having your face dragged across sandpaper, the Sahara in July, and having no sleep for two weeks only to be hydrated later on; the skin looks weathered but it looks better than where it was before, ironically. I know it's a part of the healing process but I just need to stick through with it. 

As for daily routines, I've been using a pH-neutral face wash (CosRX Good Morning FaceWash) along with Alastin Skin Serum ($$$) day and night. If my face does get a little dry during the day, which it often does, I apply a dime-sized amount of Hada-Lobo HA facial moisturizer. Thank you, Covid for making remote work a thing! I would be dying of anxiety every day in the office if I had to go to work like this! I stopped using green primer + foundation during weeks 1-3 because it was pointless as the redness was so damn RED it bled through the make-up. It looked less harsh on Google Meet but 1000x harsh on Zoom calls. I would lie and say I was having technical difficulties for my camera being off. By week 5, much of the redness traded in for PIH so I was able to somewhat get away with using just a tinted moisturizer. The skin still looks weird and irritated but a lot better than it was before. I live like a vampire: Waking up at 0400 to go workout and jog, only to race home before sunrise. And then when the sun dips below the horizon I go out to do grocery shopping or go for a nice walk to de-stress from a long day. 

I only hope my skin is looking solid at the 90 day mark. I spent a pretty penny on this procedure and it would kill me if I got subpar results. I'll hopefully post again at the 80 or 90 day mark. 

Yes, I did sacrifice my leftover ProActive from 2008 to the Skin Gods. They're probably mad at me that I sent them some expired shit and gave me some irritation. Oh, well. :)

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(@sarathegerman)

Posted : 02/16/2022 4:28 pm

Looks god so far!

When do you think you can use things like tretinoin to help with the PIH?

Could you also add photos from before the peel ?

 

Thanks and I hope everything is going well!!!

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(@catharsis2018)

Posted : 02/20/2022 5:40 pm

On 12/31/2021 at 10:48 AM, wombatstaywoke said:

Hello all!

I wanted to use this section to document my progress phenol peel. I wanted to do this in one go so I don't have to keep checking this website as much. I'll try to post pictures en masse at the 30 day mark.

Update 02/08/2022: Imgur AlbumDays 1-50 (I'll be adding photos in real time)

2014: Acne Scar Journey Begins on a Bad Start:

Fed up big time and went to a plastic surgeons office where I was oversold on the care package below. I did get significant improvement but not to the extent that I wouldve liked in relation to the money I spent. I still get mad thinking about the price so Im not gonna drop it.

  • 3x Infini RF - This is literally the only thing that worked (-_-)
  • 3x PRP facial aka vampire facial (aka aka waste of money)
    • Not really sure if this actually contributed to anything but science said so?
  • 3x. Glycolic acid peel - to control oiliness during above
    • I most likely got ripped off by having this added to my care package. Felt like a glorified Neutragena byproduct rubbed on my face.

Total Improvement from Baseline: ~20%

2015 - 2018: Financial Recovery Period and DIY Days

Poor as hell and underemployed, I paid off the debt for the first round. I discovered here and on blogs that scars and specifically acne scar revision is a subset within dermatology that requires specific modalities besides just a laser to wipe a face clean. I discovered the impact of at home microneedling using OwnDocs device as well as DIY TCA Cross.

I received a good amount of improvement using at home methods, almost just as much as the professional scar treatment I got from the surgeons office. I would go into the office with redness and scabs on my face topped with brown and blotchy clown makeup (iM a GuY) to cover it up.

I did treatments on and off every 7 weeks, microneedling with Derminator 2.0mm and 2.5mm first on boxcar scars and then suctioning each section everyday for two weeks. On day 4 I would do TCA Cross on small boxcars, pores, and icepicks.

  • ~12x Derminator Microneedling sessions at 2.00mm/2.5mm
    • Smacking the cheeks every 7 weeks!
    • Speed: Medium
    • Arsenal: 9 needle cartridge; f*ck that single needle sh*t.
    • Did you get the temples? Lol Like that worked
    • Suction: Until the area turns into a grape.
  • ~20x TCA 100% Cross
    • Ice picks, little boxcar scars, and faux pores.
    • Used at my discretion whenever I saw them.
    • Literally the real MVP when it comes to DIY acne scar treatment.

Total Improvement from 2014: ~20%

2019-2020: More Money = Time to Treat

With a solid understanding of how to treat acne scars now, its time to research real dermatologists who have the skill to do it. After watching Dr. Davin Lim, Board Certified Dermatologist in Brisbane, Australias numerous educational videos on modalities and treatments I felt informed on what I needed to do next: manual methods then the best energy device.

At this point I realized once I have the relevant patient/consumer info, I can tackle the issue in the most cost efficient way possible. I get the following treatments from a series of doctors over the course of this year:

  • #1 Infini RF x Nokor subcision (December 2019)
    • Subcision acne scars using a single point of entry per scar (that popping sound tho)
    • Infini: Literally, whats the point of numbing cream when I can feel the heat and all 49 needles?
  • #2 Infini RF x Cannula subcision (July 2020)
    • You can just not give me numbing cream. Acne scars hurt more than these needles
    • Subcision: Single point entry for the entire face.
  • #3 Infini RF (October 2020)
    • No, I dont want your exclusive acne scar package. Only thing vampire facial is gonna fix is your wallet

Total Improvement from 2018: ~30%

2021: Time to top it off; getting too old for this level of worry.

All the treatments Ive done at the point have converged to this moment. My scars are at a level where Im content albeit not happy with them. Under the worst lighting, under the sun, even under the sea, theyre almost faint and I need to actually need to try to get myself worked up about my scars. Nothings perfect - no treatment plan nor no face. Trust me, Ive seen a lot celebrities in person with a past job I worked and while they may not eat cake, they sure as hell have cake-like faces with makeup covering their skin imperfections. At least your acne scars are deeper than their personalities, most likely!

So I drive to meet what some here might call. The Guy to get The Procedure.

Everything from puberty, to sports, to eating like sh*t, to even the skin treatments have fed my skin pretty good and its not the best texture. I go in and sign the dotted line and hope for the best:

  • Phenol Peel (feat. cannula subcision, Phenol Cross here and there, Tongue Depressor chemabrasion to cure your Skin Depression)
    • This is literally the boss battle for your entire face - but you want the boss to win.

Total Improvement from 2020: TBD

12/20: Day 1 - Not feeling excited about this procedure since its the week of Christmas but I figured this is the best gift I can hope to give myself for the future and to kill appearance anxiety once and for all. Im sure the cold weather, holiday break, and remote work will be on my side during healing. From what @f93d has said, this downtime is no joke and Im trying to mentally prepare for that.

Dr. Rullan has an ER nurse drug me up with narcotics and hooks me up to an IV. My heart rate is pretty fast and blood pressure is moderately high indicating that Im clearly nervous despite me saying Im calm.

The procedure on Day 1 of 2 is the worst. Although the procedure is a conscious sedation, I could still feel the cannula through my cheeks and each swab of the first layer of phenol. The stinging sensation lasts for almost 140 or so LONG seconds. Even with fentanyl you can still feel a good amount of pain. After about two hours of subcision and the first phenol pass on all quadrants, they tape up my face and net me up. I look like a bank robber who got his ass beat because he didnt know the tellers would all be UFC fighters.

My face doesnt look too bad leaving the clinic but when I get to the hotel my face has swelled up immensely. I could barely read the subject lines of emails on my laptop and had to force my eyes open using two fingers. Im given pain medication and insomnia pills but they barely ward off the itching and burning pain caused by the phenol. I sleep and wake up about four times throughout the night. Im crying harder and louder in my own head than the baby up on the floor above.

___

12/21: Day 2 - I go into the office to see Rullan and his team and the first one to greet me is the ER nurse whos ready to drug me up yet again. She asks how I tolerated last night and I inform her that I could barely sleep. My face felt as if it was on fire, like a thousand ants were digging their way through to my skull. This day is usually a little bit worse but at least youre here for a shorter amount of time. Our conversation doesnt last long before Rullan comes in with the goodies.

Im consciously sedated again. The nurses carefully remove the net stocking off my fluid-filled and swollen head like releasing an over-pump Costco grapefruit from its packaging. They then carefully remove the tape so as to not rip off any scarred skin. Dr. Rullan instructs his nurses to scrape my face with tongue depressors of what damage the first coat of phenol had done. Holy sh*t! I can feel this with a lot of itchiness and pain. Rullan comes over to me, eyes opposite mine upside down and says, ready for round 2?. Without giving a response because of the painkillers effect, he begins to scrape my face with what feels like sandpaper. He does this for roughly three or so minutes on each cheek. Im not sure if he got my temples despite me asking him to specifically target those areas. I get a 30 second rest and the nurses press on my cheeks with gauze and sssSSZZZZzzz. goes the second coat of phenol on the abraded skin. They hold it for a solid 20 seconds in each area - It burns like no other.

The team is done doing their damage - the face is a wreck and they refuse to show me with a mirror because of how much of a mess it is. They top it all off with bismuth powder over the entire face minus the orbital regions. Wheeling my closet crybaby self down to the first floor, the nurse says I handled it well compared to other patients. I look at the full body mirror in the lobby and think two things: was this a mistake to do this? and wow, I look like a man who just wanted to dip his face into some cumin, huh?

___

12/23 - 12/25: Day 4-6: It takes three days for my swollen eyes to open back up and my mouth is held nearly shut by the stiffness of the mask. I can barely open my mouth to accept a stick of chewing gum. My face is in pain and it is itching like crazy. The prescribed prednisone can only do so much to ward off the urge to rip off the cumin mask and scratch away.

Its getting crustier by the hour and the mask really cuts into the lines where Rullan drew the borders. Im yearning for the Day 8 mark as I type this, reading the Dermatology Institutes 2-Day Phenol Post-Op care doc. I want to know if Rullan can see me so he can remove this Hades-forsaken mask off my face and tell me the next steps to heal.

Thank goodness I can text him and send him all my concerns. And to think, Im missing out on a juicy turkey dinner and vanilla bean ice cream with apple pie because all I can have are liquid foods. Everyone in my home is singing and saying HO HO HO around me and all I can think about are the HA HA HAs I got throughout life because of my sh*t skin. I reframe those memories into thinking they were just telling me to get something with hyaluronic acid this entire time. Thank you, friends! (@ssholes!).

__

12/28 - Day 8: I drove to Chula Vista to get the mask removed from Dr. Rullan himself as I had some additional followup questions to ask. Normally you could do this at home but I wanted to be sure I was clear on next steps. Even with pandemic shortages and inflation, gas money is no object to me to make sure my skin concerns are squared away. Others who have gotten this (@f93dand @shei514) are not kidding about the redness. My face is a combination of red as a tomato to a cosplayer trying too hard to look like Kirby from Mario Kart or worse.

I look at his magnification mirror and it looks like all the skin imperfections that Ive been scrutinizing for the past 15 years are nearly gone: Boxcars seem elevated and flattened; ice picks feel as though they need a microscope to be seen; rolling scars seem theyve blended with the curvature of my cheeks. Im trying not to get too excited as this could very well be swelling from the peel but Rullan says this is a good sign and with the entire healing process being a year the expectations should be higher. Also, shout out to the prior procedures Ive done in the past. I wouldn't have gotten here without you! (Except you vampire facial)

The most significant thing to worry about right now is the hard red complexion that I have. Im just concerned as to how Im going to plan my social life as I write this since the contrast between my face, neck, and chest is absurd. One of the reasons I got this procedure was so my facial complexion could match my neck more but I dont know if Id feel more elated or worried if it ended up matching my chest! Id better suck it up and make a trip down to Sephora so I can get color matched. Rullan informs me to get an oxygen facial next week and end of month to help reduce sensitivity and redness. This and a special serum in my procedure goody bag are aimed at tackling just that. Thank goodness theyre included in the price I paid for the peel!

__

12/29 - Day 9: The skin is so much cleaner today than it was yesterday. The use of the cleanser provided to me removes much of the mask remaining on my face as well as any excess oil. I leave much of the mask thats within the border of my hairline intact and try not to pick it as it will just irritate my skin. Shampooing and adding conditioner in hair has never felt so refreshing! I use the serum provided to me as directed and while I was told to use Aquaphor for the first three days switch to using an HA moisturizer as the texture is better and is already refreshing.

The skin is tender but not as tender as you would think for an operation of this magnitude. What I think is renewed skin is probably post procedure swelling. As I said before, I wont get too excited about it so well see how it fares in about a week after my first oxygen facial and and a month after my second one.

The elephant in the room at this stage of the phenol peel is the redness. Its insane and I cant stop looking at my face with equal parts worry and awe and how much constructive damage the peel has done. Depending on the lighting my face looks like a faint salmon-like pink outdoors to a bright hot red when indoors next to my monitor. Im not looking forward to putting on makeup. I already know its going to look likeshitbecause I can barely spread mayo on bread. Im trying not to worry about it as I know others have healed just as well and Im hoping Im no exception to the studies done on those with skin types IV and V. Skin gods, please be on my side! Ill send you a sacrifice of my leftover Proactive from 2008!

By the way do you have pictures right before the phenol? So we can see a comparison of the scarring

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Posted : 02/21/2022 2:42 pm

@SaraTheGerman @Catharsis2018

Hello! Please see below I've attached photos from late 2015 of my left side (the worst side and my most concerning) and where I'm currently at with phenol healing process. So far, I'm satisfied with the healing results. I'm just very concerned about the PIH that has developed around my eyes. I tried using azelaic acid on my eyes but it caused quite a bit or irritation and stopped. I don't think I'll even try to add this on that area until after 3 months have passed. The skin is still raw and red and depending on how the lighting is;  it can show up as brown, pink,  or red-brown. I try to stay indoors as much as possible because my skin is very sensitive.

I'd say phenol peel has provided a decent but not amazing amount of collagen stimulation on my acne scars (namely boxcars). The texture right now is still very beat up but I'm still healing. 

 

 

2015 (2).jpg

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IMG_20220220_172021077.jpg

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Posted : 02/21/2022 6:20 pm

3 hours ago, wombatstaywoke said:

@SaraTheGerman @Catharsis2018

Hello! Please see below I've attached photos from late 2015 of my left side (the worst side and my most concerning) and where I'm currently at with phenol healing process. So far, I'm satisfied with the healing results. I'm just very concerned about the PIH that has developed around my eyes. I tried using azelaic acid on my eyes but it caused quite a bit or irritation and stopped. I don't think I'll even try to add this on that area until after 3 months have passed. The skin is still raw and red and depending on how the lighting is;  it can show up as brown, pink,  or red-brown. I try to stay indoors as much as possible because my skin is very sensitive.

I'd say phenol peel has provided a decent but not amazing amount of collagen stimulation on my acne scars (namely boxcars). The texture right now is still very beat up but I'm still healing. 

 

 

2015 (2).jpg

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2015.jpg

2022 (1).jpg

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IMG_20220220_172021077.jpg

Thank you for posting these. And wow does your texture look so much better! Amazing. It seems the boxcars on the cheek responded better than the forehead (filled up more), is that right? 

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(@harmlessboy1441)

Posted : 02/21/2022 6:49 pm

Considering the before photos, I think it's much better and mostly level from what I can see, the only lingering issue is coloration and some rolling texture.I still have rolling mess texture in light. I hope the coloration and around your eye fades, any suggestions from the doc on the coloration? Just a curiosity but is phenol more risky for ethnic skin?

 

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(@wombatstaywoke)

Posted : 02/22/2022 8:37 am

14 hours ago, Catharsis2018 said:

Thank you for posting these. And wow does your texture look so much better! Amazing. It seems the boxcars on the cheek responded better than the forehead (filled up more), is that right? 

I'd say the boxcars on my cheek have responded quite well to not just phenol peel but also the treatments that I've had beforehand including microneedling and RF microneedling (i.e. Infini and Fractora Firm). I don't really have forehead acne scars, thankfully. I had one scar in between my eyebrows caused by a large whitehead in college (~2011) however it has since been diminished because of phenol. Rullan does phenol cross on Day 2 of PCA light peel since your acne scars are clear, open, and easy to target after the mask from Day 1 comes off.

Also, I tried to take these photos in natural lighting against my window on a semi-cloudy day however it seems the lighting hit the sweet spot where the acne scars are. I'll take more detailed photos as the weeks progress. Hope that helps! :D

 

13 hours ago, harmlessboy1441 said:

Considering the before photos, I think it's much better and mostly level from what I can see, the only lingering issue is coloration and some rolling texture. I still have rolling mess texture in light. I hope the coloration and around your eye fades, any suggestions from the doc on the coloration? Just a curiosity but is phenol more risky for ethnic skin?

 

Yes, the discoloration was a concern before and after I had phenol. I was well aware of this issue but discoloration/pigmentation was an issue I wanted phenol peel to target in addition to acne scarring of all types. I don't know if you read the beginning of my thread, but my face is significantly darker than my body due to years of sports and that has ruined my mental health over the years. Rullan has suggested using 2% HQ however I haven't decided to use it since any cream that's not hydrocortisone (i.e. anti-itching cream) irritates my face a lot. I think I'll just wait until end of March 2022 to address PIH. Not sure if I'm just being kind to myself but it looks better by the week however the "raccoon" look is still there.

I think scarred texture or more specifically that "rolling scar texture" will persist even after you've hit the max improvement for your scars. It's a stubborn look but as long as that wavy appearance can look normal as much as possible under normal lighting conditions, I'm okay with it. I think it can be further improved by microneedling + RF or just microneedling + suction if you're on a budget. To be honest, we'll be stuck with imperfect skin for the long haul but it's better than what we had before, right? haha 

And yes, phenol peel is normally a procedure marketed to, and to be blunt, "old white ladies with severe photo damage". Rullan has been seen as the de facto practitioner of phenol for ethnic skin or skin types IV-VI for this peel. This is a major reason why I chose him because he has dozens of photos of people that look like me treated for acne scarring/pigmentation.  I did see another phenol peel provider in the area that has treated ethnic skin before for over 30+ years (LA/OC/SD) however this person did not use a specific phenol formula for ethnic skin (i.e. Croton Oil concentration - that matters a lot, look it up), subcision, cross, double phenol on day 2 et al. It was standard phenol on the entire face. The price difference between Rullan and this other practitioner was USD $1,000 in case you were wondering. On the matter of  long standing PIH, I think the notion of overall/majority "permanent pigmentary changes" is a little rare from when I spoke to Rullan. His studies do show ethnic patients with PIH still present after 3 months post-op however it's very minor and is usually resolved after an additional month or two.

I spoke to another dermatologist in Asia and she said that if I do persist with PIH that has lasted longer than 5+ months from phenol, she would suggest using Q-Switch or Pico lasers to fix the issue. Hopefully I won't have to do that but I have the funds ready should I need to execute the procedure. Hope that helps :)

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Posted : 03/22/2022 6:21 pm

On 2/22/2022 at 8:37 AM, wombatstaywoke said:

I'd say the boxcars on my cheek have responded quite well to not just phenol peel but also the treatments that I've had beforehand including microneedling and RF microneedling (i.e. Infini and Fractora Firm). I don't really have forehead acne scars, thankfully. I had one scar in between my eyebrows caused by a large whitehead in college (~2011) however it has since been diminished because of phenol. Rullan does phenol cross on Day 2 of PCA light peel since your acne scars are clear, open, and easy to target after the mask from Day 1 comes off.

Also, I tried to take these photos in natural lighting against my window on a semi-cloudy day however it seems the lighting hit the sweet spot where the acne scars are. I'll take more detailed photos as the weeks progress. Hope that helps! :D

 

Yes, the discoloration was a concern before and after I had phenol. I was well aware of this issue but discoloration/pigmentation was an issue I wanted phenol peel to target in addition to acne scarring of all types. I don't know if you read the beginning of my thread, but my face is significantly darker than my body due to years of sports and that has ruined my mental health over the years. Rullan has suggested using 2% HQ however I haven't decided to use it since any cream that's not hydrocortisone (i.e. anti-itching cream) irritates my face a lot. I think I'll just wait until end of March 2022 to address PIH. Not sure if I'm just being kind to myself but it looks better by the week however the "raccoon" look is still there.

I think scarred texture or more specifically that "rolling scar texture" will persist even after you've hit the max improvement for your scars. It's a stubborn look but as long as that wavy appearance can look normal as much as possible under normal lighting conditions, I'm okay with it. I think it can be further improved by microneedling + RF or just microneedling + suction if you're on a budget. To be honest, we'll be stuck with imperfect skin for the long haul but it's better than what we had before, right? haha 

And yes, phenol peel is normally a procedure marketed to, and to be blunt, "old white ladies with severe photo damage". Rullan has been seen as the de facto practitioner of phenol for ethnic skin or skin types IV-VI for this peel. This is a major reason why I chose him because he has dozens of photos of people that look like me treated for acne scarring/pigmentation.  I did see another phenol peel provider in the area that has treated ethnic skin before for over 30+ years (LA/OC/SD) however this person did not use a specific phenol formula for ethnic skin (i.e. Croton Oil concentration - that matters a lot, look it up), subcision, cross, double phenol on day 2 et al. It was standard phenol on the entire face. The price difference between Rullan and this other practitioner was USD $1,000 in case you were wondering. On the matter of  long standing PIH, I think the notion of overall/majority "permanent pigmentary changes" is a little rare from when I spoke to Rullan. His studies do show ethnic patients with PIH still present after 3 months post-op however it's very minor and is usually resolved after an additional month or two.

I spoke to another dermatologist in Asia and she said that if I do persist with PIH that has lasted longer than 5+ months from phenol, she would suggest using Q-Switch or Pico lasers to fix the issue. Hopefully I won't have to do that but I have the funds ready should I need to execute the procedure. Hope that helps :)

Hey Wombat, any updates on your healing? Any more results?

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Posted : 03/22/2022 7:24 pm

47 minutes ago, Catharsis2018 said:

Hey Wombat, any updates on your healing? Any more results?

Howdy!

I'd say scar wise the surface of my skin has improved to the point where I don't notice my scars in natural light anymore but alas they seem they haven't healed at all under harsh, overhead lighting. I think that's just the way lighting is when it's positioned above any shaped, object with a curve, no? Temple scars are still there. I really do think filler in that area is the only option.

Pigmentation wise, it's slightly better more or less. My face looks like it's slowly matching my untanned skin (i.e. neck and chest) as the phenol peel promises to provide, however it really depends on the time of day, what lighting I'm in, if I'm tired, and if I'm wearing sunscreen or not. At times it looks like I'm seeing pseudo-hypopigmentation or severe hyperpigmentation. I know that makes it sound like I'm crazy but it's true. I can tell you for a fact I have hyperpigmentation lines a la marionette mouth and raccoon eyes. Those seem to get better as the days go on. I've also noticed I have random little whiteheads all over my face, in particular the nose area. I'm told they'll go away with time. My facial complexion looks a little lighter than before with texture looking and feeling a lot better. 

I'll provide a more thorough update sometime next week with photos so you can see where I'm at. I don't want to judge this procedure until after a complete 4-5 months post operation because I am a person of color and that's clearly a factor affecting complete healing. I'd say as of now I'm satisfied but not 100% amazed by the results. Again, phenol works slowly to correct the skin's issues so please keep that mind. 

Stay tuned and thanks for checking with me! :D 

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(@catharsis2018)

Posted : 03/24/2022 5:51 am

On 3/22/2022 at 8:24 PM, wombatstaywoke said:

Howdy!

I'd say scar wise the surface of my skin has improved to the point where I don't notice my scars in natural light anymore but alas they seem they haven't healed at all under harsh, overhead lighting. I think that's just the way lighting is when it's positioned above any shaped, object with a curve, no? Temple scars are still there. I really do think filler in that area is the only option.

Pigmentation wise, it's slightly better more or less. My face looks like it's slowly matching my untanned skin (i.e. neck and chest) as the phenol peel promises to provide, however it really depends on the time of day, what lighting I'm in, if I'm tired, and if I'm wearing sunscreen or not. At times it looks like I'm seeing pseudo-hypopigmentation or severe hyperpigmentation. I know that makes it sound like I'm crazy but it's true. I can tell you for a fact I have hyperpigmentation lines a la marionette mouth and raccoon eyes. Those seem to get better as the days go on. I've also noticed I have random little whiteheads all over my face, in particular the nose area. I'm told they'll go away with time. My facial complexion looks a little lighter than before with texture looking and feeling a lot better. 

I'll provide a more thorough update sometime next week with photos so you can see where I'm at. I don't want to judge this procedure until after a complete 4-5 months post operation because I am a person of color and that's clearly a factor affecting complete healing. I'd say as of now I'm satisfied but not 100% amazed by the results. Again, phenol works slowly to correct the skin's issues so please keep that mind. 

Stay tuned and thanks for checking with me! :D 

Thank YOU for all of your updates. did you ever have whiteheads before the procedure? I™m glad to hear your skin is healing and that texture is feeling better. Would you say your temple scars have improved the least? Would you ever consider another phenol? (Finances aside?)

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(@wombatstaywoke)

Posted : 03/24/2022 10:32 am

4 hours ago, Catharsis2018 said:

Thank YOU for all of your updates. did you ever have whiteheads before the procedure? I™m glad to hear your skin is healing and that texture is feeling better. Would you say your temple scars have improved the least? Would you ever consider another phenol? (Finances aside?)

I get minor inflammation here and there but no I've never had whiteheads before the procedure. I think shei514 had a similar experience. But these are whiteheads that aren't subsiding after days of using facial wash and azelaic acid, so it's a bit concerning. I would most definitely say that my temples responded the least to phenol peel. Again, the texture has improved under angled lighting but it terms of collagen formation, I haven't really seen that much of a difference. Maybe like ~10% if even. 

 

I would consider phenol maybe three or four years from now. I don't see finances as that big of an issue since I'm generally a smart spender even though I don't make much money. I'm a simple man. The reason for the time frame is that because we as acne scar sufferers look at our skin so much, we let it hold us back from actually enjoying life. When my skin get really battered from age, weather, and the occasional junk food I'll be eating here and there I'll consider it. I think I'd like to try anterior chemabrasion as I think it could do a good job in surfacing the remaining boxcar and rolling scars. I think that looks more promising than 2 day phenol since it uses old school sandpaper to resurface the skin.

Are you planning to get the procedure. Hope your day is going well! :D 

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(@orangelaser162gmail-com)

Posted : 03/24/2022 10:56 am

Do you know any doctor who does anterior chemabrasion?

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(@wombatstaywoke)

Posted : 03/24/2022 6:29 pm

7 hours ago, laserorange said:

Do you know any doctor who does anterior chemabrasion?

I'm actually trying to find a doctor myself who does that. It looks like it's a procedure that's been phased out in favor lasers, subcision, TCA, etc. Let me know if you find him/her!

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