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Phenol Peel Update: Day 50 Mark

MemberMember
181
(@wombatstaywoke)

Posted : 02/08/2022 4:46 pm

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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MemberMember
397
(@dirigo39)

Posted : 02/08/2022 6:39 pm

Has it helps your scars so far?

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MemberMember
181
(@wombatstaywoke)

Posted : 02/08/2022 10:56 pm

4 hours ago, dirigo39 said:

Has it helps your scars so far?

So far so good, I'd say. Did you ever get the procedure done with Rullan? I think you were trying to get subcision with him last I checked.

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MemberMember
397
(@dirigo39)

Posted : 02/09/2022 11:31 am

I got one trio with him. How many subs did he do for you?

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MemberMember
181
(@wombatstaywoke)

Posted : 02/09/2022 12:28 pm

56 minutes ago, dirigo39 said:

I got one trio with him. How many subs did he do for you?

The full face phenol peel comes with a subcision. I never had the trio done but may consider it at some point. Most likely not as I'm basically broke from this procedure haha

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MemberMember
397
(@dirigo39)

Posted : 02/09/2022 12:41 pm

Do you have a photo of your baseline.

I'm guessing rullan felt your scars were level enough for phenol. Normally he does the be trio first.

Should I do a second sub with rullan or do taylor?

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MemberMember
181
(@wombatstaywoke)

Posted : 02/09/2022 5:36 pm

@dirigo39These are photos from 2016. My left side is the ugliest and in worst shape. Everyone from friends to the doctors themselves have said so. The camera that I was using was on the Samsung Galaxy S3 so how the scars look is actually very forgiving. The lighting was still harsh. These are very deep scars that had only the three RF treatments. 

Rullan approved me for phenol peel because my skin had been abused by so many acne scar treatments he was certain I was ready for phenol. The trio recommendation is given to prospective patients as a measure to see how the skin will react to phenol, namely to see how bad PIH will be. 

Also, I think you need to just go ahead and see what treatments will work for you. If you've tried a procedure and it didn't work, maybe it's time to try something else.

20150608_161226.jpg

20151211_143130.jpg

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MemberMember
945
(@harmlessboy1441)

Posted : 02/09/2022 5:48 pm

In the new photos the scarring looks almost gone. I see some texture and obviously it does look like color/marks but looks significantly better to me, that's all I can say. I don't know much about phenol effects but the marks/coloration should fade because phenol probably "damages" the top layer and pigmentation goes weird. Anyway that's the hope that in 6-18 months I hope a lot of the texture/color normalizes.

But the scarring/levelness looks good for what it's worth, really good.

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MemberMember
181
(@wombatstaywoke)

Posted : 02/09/2022 6:19 pm

@harmlessboy1441Thanks but I think the photos don't do a lot of the improvement justice. The camera and lighting is forgiving I think it that it doesn't capture the acne scarring and texture at their worst. Yes, there is definitely an improvement but it's not "almost gone" as you've said. Whether there's bad lighting or not, if you saw my face in broad daylight, you'd def see some scars all over my face. I'm also hoping that phenol will remove decades (yes, decades) long stand hyperpigmentation that I've had on my face so that my facial skin tone matches my neck!

I'd say so far phenol has improved acne scarring by about 20% from the previous treatment. But then again, I am still only about 6 weeks out of treatment at the time of this writing.

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MemberMember
945
(@harmlessboy1441)

Posted : 02/09/2022 7:33 pm

1 hour ago, wombatstaywoke said:

@harmlessboy1441Thanks but I think the photos don't do a lot of the improvement justice. The camera and lighting is forgiving I think it that it doesn't capture the acne scarring and texture at their worst. Yes, there is definitely an improvement but it's not "almost gone" as you've said. Whether there's bad lighting or not, if you saw my face in broad daylight, you'd def see some scars all over my face. I'm also hoping that phenol will remove decades (yes, decades) long stand hyperpigmentation that I've had on my face so that my facial skin tone matches my neck!

I'd say so far phenol has improved acne scarring by about 20% from the previous treatment. But then again, I am still only about 6 weeks out of treatment at the time of this writing.

Hm. Well I'm glad you got some progress. Yeah in sunlight or shadows that's just the worst I know all about it. Why do you think I grow a beard but sunlight goes straight through it and it's bad. Anyway, hope you continue to get progress. Were you happy/impressed by Rullan by the way? Just out of curiosity did any other procedures outside phenol help over the years?

Does Rullan not do or not believe in Dermabrasion? I hate that I'm the only person that got such good results from it. I know the other guy on here did too though he's on the "linear scar thread" and he too said it was life changing like me. Maybe it's all a doctor's talent or something.

 

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MemberMember
181
(@wombatstaywoke)

Posted : 02/09/2022 8:15 pm

37 minutes ago, harmlessboy1441 said:

Hm. Well I'm glad you got some progress. Yeah in sunlight or shadows that's just the worst I know all about it. Why do you think I grow a beard but sunlight goes straight through it and it's bad. Anyway, hope you continue to get progress. Were you happy/impressed by Rullan by the way? Just out of curiosity did any other procedures outside phenol help over the years?

Does Rullan not do or not believe in Dermabrasion? I hate that I'm the only person that got such good results from it. I know the other guy on here did too though he's on the "linear scar thread" and he too said it was life changing like me. Maybe it's all a doctor's talent or something.

 

When you say "happy/impressed" I'm assuming by his method in treating acne scars, specifically with full face phenol "chemabrasion"? I'd say so far at this point I'm happy but not utterly fully satisfied or impressed. I think he, this forum, and other doctors (i.e. Dr. Lim) have boasted his method as being greater than it may be. Again, I'm still "early" from my total healing period. As a doctor, I think he's very informative but again the recommendations of Rullan will differ from Lim, Weiner, Novic et al. His recommendations for acne scars are very much the same for every patient that walks through his doors for a consultation; same price, modalities, etc.

I don't know anyone who does dermabrasion. I actually would like to find a doctor here in the US or anywhere that can do "anterior chemabrasion". I think that may be a good alternative to phenol. The surfacing results look promising.

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MemberMember
410
(@catharsis2018)

Posted : 02/13/2022 9:05 pm

On 2/9/2022 at 8:15 PM, wombatstaywoke said:

When you say "happy/impressed" I'm assuming by his method in treating acne scars, specifically with full face phenol "chemabrasion"? I'd say so far at this point I'm happy but not utterly fully satisfied or impressed. I think he, this forum, and other doctors (i.e. Dr. Lim) have boasted his method as being greater than it may be. Again, I'm still "early" from my total healing period. As a doctor, I think he's very informative but again the recommendations of Rullan will differ from Lim, Weiner, Novic et al. His recommendations for acne scars are very much the same for every patient that walks through his doors for a consultation; same price, modalities, etc.

I don't know anyone who does dermabrasion. I actually would like to find a doctor here in the US or anywhere that can do "anterior chemabrasion". I think that may be a good alternative to phenol. The surfacing results look promising.

Wow. Thank you so much foryour radical honesty, it is so needed. It is honestly very refreshing on this forum. Also, kudos to you for finally having the phenol done! My envy is an understatement. I have a few more questions

1. where has the 20% improvement been with your acne scarring?

2. what has had the least improvement?

3. how much more comfortable are you in your skin after the phenol (in terms of %)

4. If you could go back, would you still have had the phenol done?

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MemberMember
181
(@wombatstaywoke)

Posted : 02/14/2022 6:10 pm

20 hours ago, Catharsis2018 said:

Wow. Thank you so much foryour radical honesty, it is so needed. It is honestly very refreshing on this forum. Also, kudos to you for finally having the phenol done! My envy is an understatement. I have a few more questions

1. where has the 20% improvement been with your acne scarring?

2. what has had the least improvement?

3. how much more comfortable are you in your skin after the phenol (in terms of %)

4. If you could go back, would you still have had the phenol done?

Hello there! I'm sure the time will come when you can get it done, but please do your due diligence in making sure that time is right. I wanted to get this done at the beginning of 2021 but chickened out due to fears of having to go back into the office. Covid really blue-balled, didn't they?

Some good points and I'll do my best to address them:

1. I'd say 20% improvement has been in the overall surface texture of the scars. Overall, my cheeks (the left side photo you saw) have improved in appearance in almost any lighting with the exception of harsh overhead. I noticed that three or four scars on my right cheek, two scars between my eyebrows,as well as my enlarged pore scars have almost been eliminated entirely.I will inform you that I treated these areas myself with 100% TCA over two or so years. I would assume Rullan doing phenol cross on those areas were the final nail in the coffin.

 

2. I know I might get a lot of hate for saying this, but I think almost every treatment I've had has given some significant improvement on my skin and acne scars. When I saysomeI mean, at least 5-10% improvement. Regardless of what anyone has said here, RF microneedling, dermastamping/rolling, TCA cross, and subcision + suction have all provided good results for my scarring. I would say the biggest offender has to be the vampire facial or PRP facial. If any dermatologist/esthetcian sells that to you... RUN! Utter waste of money and even some derms say so as well.

 

3. As of this writing, I am currently 7 weeks out of operation after having the bismuth mask removed. I would say since I'm working remote and limiting how much time I see friends, I'm about 50-60% more comfortable with how my face looks. Why not the full 100%? Well, the photos can't show it cause even cameras are designed to make every pixel look nice, but my skin is really red, brown n' bruised, beat up, with burn demarcation lines. I'm going to use both @f93dand @shei514benchmark of 3 months to measure full improvement and see where it goes from there.If I need to take further action to fix those mess-ups phenol mayhave left behind, I'll be sure to plan accordingly. I'm optimistic that's not the case!My biggest issues are the persistentredness andthe raccoon eyes. It looks like I haven't slept in days with how much PIH there is but I'm sure they'll subside because I've had worse PIH from Infini RF on high settings, mind you.

 

4.Of course. 100%. For me, my skin journey has always been about my complexion and texture just as much as my scars and after reading not only Rullan's but also other doctors who have done phenol on ethnic skin (types III-VI), I was convinced this was indeed the final nail I had to drive to get on with my life. Looking back, I would definitely go about to get my treatments done in a different manner and order (i.e. economical methods first before expensive, professional treatments) but as long as my skin progress is moving forward, no amount of debt will keep me from taking action. While some irregularities still exist on my face, I've noticed my overall appearance, even while healing, have improved a lot. The fine lines around my eyes and pigmentationcaused by years of sports have been minimized a ton and I pray that it gets better with time. They say phenol continues to deliver results up to a year and that given a good skin routine et al result have been seen to last up to 10 years. It's a little good to be true but I guess we'll just have to wait (and pray) to see!

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MemberMember
100
(@isaac-j-deargmail-com)

Posted : 02/14/2022 7:32 pm

I would recommend co2 fractional on the eyes and jaw as it will blend the demarcation lines but it will cost you probably 600 dollars

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MemberMember
181
(@wombatstaywoke)

Posted : 05/30/2022 3:25 pm

Link to Main Update Post

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 full 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 here and there

...watching all the Dr. Lim videos 10x and Dr. Emer videos never cause he's the biggest ripoff

...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!

shei514 and liked
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MemberMember
0
(@demosthene-kgmail-com)

Posted : 07/06/2022 7:32 am

On 2/9/2022 at 6:33 PM, harmlessboy1441 said:

Hm. Well I'm glad you got some progress. Yeah in sunlight or shadows that's just the worst I know all about it. Why do you think I grow a beard but sunlight goes straight through it and it's bad. Anyway, hope you continue to get progress. Were you happy/impressed by Rullan by the way?  Just out of curiosity did any other procedures outside phenol help over the years?

Does Rullan not do or not believe in Dermabrasion? I hate that I'm the only person that got such good results from it. I know the other guy on here did too though he's on the "linear scar thread" and he too said it was life changing like me. Maybe it's all a doctor's talent or something.

 

Can I ask who your Dermabrasion dermatologist was? I™m looking into Dermabrasion for myself :)

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