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  1. Hey, I’m 14 years old supposedly struggling with hormonal acne. I’ve got spots and blackheads on my forehead, acne scars on my cheeks, whiteheads and blackheads on my nose and clogged pores pretty much everywhere. I’ve considered using AHA and BHA peels by The Ordinary as I’ve heard chemical peels really benefit your skin. I was wondering if they really work or if they make things worse. Has anyone tried chemical peels or are there alternatives?
  2. I’ve just done something stupid and used 60% glycolic acid on face... it was stinging as soon as I applied it but left it on for 2 minutes. I feel like my face is sunburnt. I used this once before but never experienced anything like this - it didn’t even peel nor burnt my face. But now, my face looks a bit red (though others are not noticing the difference) and it stings when I use a toner. Please help! How long do you reckon I will experience this? Also, when can I start applying makeup? Since it never peeled before nor did it leave wounds or scabs, does this mean I’m at no risk of infection? I’d appreciate any advice you can give!!!
  3. I want fast results to remove hyperpigmentation. I have brown marks that are acne hyperpigmentation. I still have active acne but wanted to sort as much hyperpigmentation out as I can before roaccutane as I know you can’t use peels for a long time after roaccutane. Should I get a glycolic or salicylic peel? Or some sort of lasering? Where is the best place in the London area to get a chemical peel/laser done. Does it have to be done by my actual dermatologist or can I just visit a clinic? My dermatologist said they just want me to start roaccutane and didn’t really listen to me when I said I wanted a peel.

  4. Take vitamin D and K to begin with, that will help rebalance your retinoids. Anxiety is probably one of the main causes, as Accutane completely messes up your stress and sex hormones, so right now your body probably feels a tonne of stress. People who take such a limited dose recover much better, and one of my friends took 80mg for 15 months and he is good now, though it knocked him around for a fair bit.

    One of the ironic things about accutane is it makes your body react poorly to stress, then creates a fuckton of it.

    My full recovery advise is:
    "Buy creatine, fish oil, coq10, zinc, multivitamins and a decent protein powder, take the recommended dosages for all of these, and try to meditate for 20 minutes a day"(if its early days take some k2 and vitD as well, that will get your retinoids in check post tane)

    Anyway, even if you are a random healthy male the things I've recommended would only improve your health, all would probs be available if you went to your local discount chemist 
  5. My derma just had me do YAG acne laser last week. She knows i'm on roaccutane 20mg everyday. I'm supposed to comeback tomorrow for chemical peel. But I've been reading and doctor has been saying it is bad. I dont know what to believe anymore. I'm doong everything i can to get this acne out because it is literally making me invalide. I cannot work with my acne. My line of job does not permit not perfect skin. I'm so sad. Acne laser cost a lot of money. If this will only damage me, I will be so broken. But at the same time, I really really need to get my skin healed because like i said, it is hindering my from job. Why did this happen to me . I thought i was finally over from this nightmare. I'm 23 now and I have cystic acne. It's horrible
  6. I posted this 2- years ago when I was asked for proof of successful treatments "pics", or has anyone had success. This is now included in my DIY Guide to Acid peels (Linked off the FAQ - top of the acne scar sub - first post - Under Peels). This post was made so you can see the treatments we offer do successfully work even if people do not post "pics". Acid peels are very successful as a alternative to laser at resurfacing the skin (without the side effects). If your doing DIY it takes many treatments over time ) 3 months it takes collagen to develop, or your Dr can do a "deep" sedated TCA or Penol peel to get under the scars. Microneedling without TCA is not effective they work synergistically together over time. This may be subsituated with RF Microneedling (Infini) if you have the proper scars and $$$$. Also be aware the above study exact method might not work for you or your individual case, this is why the FAQ was made (many studies like this hide secrets Dr's do for treatment or do things unsafe for home DIY. Do not attempt this without reading the FAQ and Acid Peel Guide. AS always a doctor can treat with much better results and quicker outcomes for your personalized scar types. Point anyone who wants proof to this post ("Pics" below). ______________________________ TCA, Microneedling, Subcision w/ Filler give the best results for Acne Scars! Combination Therapy in the Management of Atrophic Acne Scars Shilpa Garg and Sukriti Baveja J Cutan Aesthet Surg. 2014 Jan-Mar; 7(1): 18–23. doi: 10.4103/0974-2077.129964 INTRODUCTION Acne is prevalent in over 90% adolescents and it persists into adulthood in approximately 12%-14% of cases with psychological and social implications.[1,2,3] In some patients with acne, the inflammatory response results in permanent, disfiguring scars from either increased tissue formation or due to loss or damage of tissue. Hypertrophic scars and keloids are examples of scars that result from increased tissue formation. Scars with loss or damage of tissue can be classified into icepick, rolling and boxcar scars.[4] There is no standard treatment option for the treatment of acne scars. Medical management of atrophic scars can be done by using topical retinoids. Surgical management can be done using punch excision, elliptical excision, punch elevation, skin grafting and subcision depending on the type of scar. Procedural management includes microdermabrasion, chemical peels, percutaneous collagen induction by microneedling and dermabrasion. Tissue augmentation can be done using xenografts, autografts and homografts. Various ablative and non-ablative lasers and light energies are also available for treatment of atrophic acne scars.[5] Out of these multiple treatment options, treatment has to be tailored to patient's needs, tolerance, and goals along with the physician's assessment, skills and expectation. Patient should be counselled that the ultimate goal of any intervention is to improve the scars and no currently available treatment will attain total cure or perfection. In 1995, Orentreich and Orentreich described subcision as a method of subcuticular undermining of scars using a tri-beveled hypodermic needle. This results in lifting the scar by releasing the papillary dermis from the binding connections of the deeper tissues and by the formation of connective tissue that results from the course of normal wound healing.[6] It is mainly used for the treatment of rolling type of atrophic scars.[4] The mechanism hypothesised for action of percutaneous collagen induction using dermaroller is that it creates thousands of microclefts through the epidermis into the papillary dermis. These wounds create a confluent zone of superficial injury which initiates the normal process of wound healing[7] with release of several growth factors. This stimulates the migration and proliferation of fibroblasts resulting in collagen deposition[8] which continues for months after the injury.[9] Another hypotheses states that on penetration of skin with the microneedles, the cells react with a demarcation current which in addition to the needles own electrical potential results in release of various growth factors. This cuts short the healing process and stimulates the healing phase.[10] Dermaroller also opens pores in upper layers of epidermis and allows creams to be absorbed more effectively by the skin. Fifteen percent tricholoroacetic acid (TCA) peel is superficial peeling agent. It causes exfoliation, improves the skin texture and induces collagen synthesis.[11] The aim of our study was assessment of combination therapy using subcision, dermaroller and 15% TCA peel for the management of atrophic acne scars. The rationale for combining these three minimally invasive procedures was their additive action on acne scars. Subcision releases the scars from the underlying adhesions which should be the first step for any treatment for acne scars. Microneedling with dermaroller causes collagen induction along with enhancing absorption of tretinoin cream. Fifteen percent TCA peel causes improvement in skin texture as well as collagen induction. Hence by combining these three minimally invasive modalities one can release the scars, enhance collagen induction, increased penetration of topical agents and resurface the skin. MATERIALS AND METHODS Fifty patients with atrophic acne scars were enrolled in this study. Exclusion criteria were patients with active acne, active herpes labialis, patients on systemic retinoids, evidence or history of keloid scars, pregnancy or lactation, history of any facial surgery or procedure for scars and patients with unrealistic expectations. All the patients were counselled for surgical intervention and written informed consent was taken. The atrophic acne scars were graded by a single non-treating physician using Goodman and Baron Qualitative scar grading system [Table 1].[12] Table 1 Goodman and Baron Qualitative scar grading system Patient's skin was primed using topical tretinoin cream 0.05% at night along with sunscreen with a minimum SPF of 30 during the day for 2 weeks prior to starting the treatment. At the start of treatment, subcision was performed only once using a 24G needle. One day after the subcision, patient was called for the first sitting of microneedling with dermaroller containing 192 needles of needle size 1.5 mm. Eutectic mixture of lignocaine 2% and prilocaine 2% cream was applied under occlusion for 1 hour to the affected areas which was removed using gauze. Thereafter topical tretinoin cream 0.05% was applied to the affected area. Treatment was performed by rolling the dermaroller in vertical, horizontal and diagonal directions in the affected area until appearance of uniform fine pinpoint bleeding. Then the area was wiped with saline soaked gauze and tretinoin cream 0.05% was applied and washed off after 30 minutes. Two weeks after dermaroller, patient was called for 15% TCA peel. Whole face was cleansed using spirit and degreased using acetone. Fifteen percent TCA peel was applied with cotton tipped applicator on full face. Appearance of speckled white frosting was the end point of treatment with peel. After using dermaroller and 15% TCA peel, patient was instructed to apply sunscreen in the morning and mometasone furoate cream 0.1% twice daily for 5 days after which sunscreen was continued in the morning with tretinoin cream 0.05% applied at night time. Patient was asked to discontinue topical tretinoin cream application 2 days prior to TCA peel. Thereafter, dermaroller and 15% TCA peel were repeated alternately after every 2 weeks for six sessions of each and this was taken as the end point of our study. In some patients who developed inflammatory lesions of acne during treatment, capsule doxycycline or topical clindamycin cream 1% was given as and when required. Any adverse effects and interference in daily activities post-treatment were noted. Patients were evaluated for results 1 month after the last procedure was performed. Post-treatment scars were graded again by the same physician using Goodman and Baron Scale. Patient graded their response to treatment as poor, good, very good or excellent with 0-24%, 25-49%, 50-74% and 75-100% improvement, respectively, in their acne scars. The patients were followed up for 1 year at two monthly intervals to observe the sustenance of improvement in scars. Digital colour facial photographs were taken before treatment, during each visit of treatment, at 1 month after the last procedure and at 2 monthly intervals for 1 year after the last procedure. Patients were instructed to continue application of topical tretinoin cream 0.05% for 1 year after the last procedure. Statistical analysis Descriptive statistics such as mean and standard deviation are calculated. Data is presented in frequencies and their respective percentages. Data was entered and analysed using SPSS version 18. RESULTS Out of 50 patients, 49 patients completed the treatment. Out of 49 patients 2 patients were treated with capsule doxycycline during the treatment protocol due to active acne eruptions. Out of 49 patients there were 30 females and 19 males with age group between 18-39 years with mean age of 25.6 ± 5.2 yrs. 9 patients (18.4%) had Type III Fitzpatrick skin type, 32 (65.3%) type IV and 8 (16.3%) patients had type V Fitzpatrick skin type. Pre treatment melasma was present in 3 (6%) patients. Out of 49 patients who completed the treatment, 16 patients had Grade 4, 22 patients had Grade 3 and 11 patients had Grade 2 scars before treatment. The physician's assessment of response to treatment based on Goodman and Baron Qualitative scar grading system is summarised in Table 2. In patients with Grade 4 scars, 10 patients (62.5%) showed improvement by 2 grades i.e., their scars improved from Grade 4 to Grade 2 of Goodman Baron Scale [Figure [Figure1a1a and andb].b]. Six patients (37.5%) with Grade 4 scars showed improvement by 1 grade [Figure [Figure2a2a and andb]b] with scars being obvious at social distances of 50 cm or greater. In 22 patients with Grade 3 scars, 5 patients (22.7%) showed improvement by 3 grades i.e., they were left with no scars at all [Figure [Figure3a3a and andb],b], Two patients (9.1%) improved by 2 grades and as per Grade 1 they were left with only hyper-pigmented flat marks [Figure [Figure4a4a and andb]b] and 15 patients (68.2%) showed improvement by 1 grade by moving to Grade 2 [Figure [Figure5a5a and andb]b] as per Grade 2 their scars were not obvious at social distances of 50cm or greater. All 11 patients (100%) who had Grade 2 scars before treatment showed improvement by 2 grades in their scars and were left with no scars [Figures [Figures6a6a–b and and7a7a–b]. Hence all 49 patients (100%) had improvement in their scars by some grade with no failure rate. In patients with Grade 4 scars [Table 3], 12 patients (75%) graded their response to treatment as very good with 50-74% improvement in their acne scars after treatment and 4 patients (25%) had good improvement in their scars with 25-29% improvement. In patients with Grade 3 scars, 8 patients (36.4%) graded their response to treatment as excellent with 75-100% improvement in their scars and 14 patients (63.6%) reported the response as very good with improvement between 50 and 74%. All 11 patients (100%) with Grade 2 scars graded their response after treatment as excellent with improvement between 75 and 100%. Poor response with 0-24% improvement in scars was reported by none of the patients. Improvement in scars was first noted in majority of the patients after completing two sitting of dermaroller and peel. At the end of 1-year of follow-up, it was observed that all the 49 patients sustained the level of improvement in their grade of scars which was attained at the end of the last procedure [Figure [Figure8a8a–c]. Although improvement in the scars as noticed by the patient and the physician continued in the follow up period of 1 year, there was no further shift in the grade of scars. Table 2 Physician's assessment of response to treatment based on Goodman and Baron Qualitative scar grading system Figure 1 (a) Grade 4 acne scars; (b) Improvement in acne scars from Grade 4 to Grade 2 after treatment Figure 2 (a) Grade 4 acne scars; (b): Improvement in acne scars from Grade 4 to Grade 3 after treatment Figure 3 (a) Grade 3 acne scars; (b) Post-treatment patient had no scars Figure 4 (a) Grade 3 acne scars; (b) Improvement in acne scars from Grade 3 to Grade 1 after treatment Figure 5 (a) Grade 3 acne scars; (b) Improvement in acne scars from Grade 3 to Grade 2 after treatment Figure 6 (a) Grade 2 acne scars; (b) Post-treatment patient had no scars Figure 7 (a) Grade 2 acne scars; (b) Post-treatment patient had no scars Table 3 Patient's assessment of response to treatment Figure 8 (a) Grade 4 acne scars; (b) Improvement in acne scars from Grade 4 to Grade 2 after treatment; (c): Sustenance of improvement in acne scars from Grade 4 to Grade 2 at 1 year of follow-up There was improvement in rolling, boxcar and linear tunnel type of scars with little or no improvement in ice pick scars. All patients tolerated the procedure well. Side effects were mild and transient. Post-dermaroller transient erythema and oedema lasted for 1-4 days with a mean of 2.4 ± 0.7 days. Post-peel exfoliation of skin was present from 2 to 7 days with a mean of 4.4 ± 1 day. Only three patients (6%) developed post-inflammatory hyper-pigmentation (PIH) which was treated with sunscreen in the morning and triple combination of tretinoin, hydroquinone and mometasone at night time. The PIH subsided after 5 months of topical treatment. One patient (2%) developed mildly tender cervical lymphadenopathy each time after dermaroller which lasted for around 3 weeks and subsided on its own. There was no interference in daily activity with no loss of days at work. DISCUSSION This study has shown good results in patients with severe Grade 4 and 3 acne scars with 10 (62.5%) patients with Grade 4 scars moving to Grade 2 and 5 (22.7%) patients with Grade 3 scars improving to have no scars at the end of treatment. In Grade 2 scars all the 11 patients (100%) showed improvement by 2 grades and were left with no scars. Hence, all 49 (100%) patients showed improvement in their scars by some grade with no failure rate. The physician's analysis also correlated with the patient's assessment of improvement in scars with 12 (75%) patients with Grade 4 scars reporting improvement as very good, 8 (36.4%) patients with Grade 3 scars as excellent and 11 (100%) patients with Grade 2 scars as excellent with poor response reported by none of the patients. The procedure was well tolerated by all the patients. Post-procedure there was no loss of work days and side effects were mild and transient. In spite of patients being of Type III, IV and V Fitzpatrick skin type, only three patients (6%) developed PIH during the treatment, which subsided within 5 months of topical therapy. It has the advantage of being an office procedure and in being cost-effective. Topical tretinoin 0.05% favours the development of a regenerative lattice-patterned collagen network rather than the parallel deposition of scar collagen found with cicatrisation. Since dermaroller opens pores in the upper layer of epidermis and allows creams to be absorbed more effectively, it is for this reason that topical tretinoin was applied during dermaroller and kept for 30 minutes post-procedure to maximise its absorption in skin. Also the improvement in the grade of scars was sustained in the follow-up period of 1 year. Although ablative laser resurfacing is generally considered to be the most effective option for scar resurfacing, it is associated with significant damage to the epidermis and basal membrane with associated inflammation which causes erythema, scarring and pigmentation problems.[13,14,15] It also has a long downtime. In comparison, percutaneous collagen induction does not induce post-operative dyspigmentation as the epidermis and basal membrane are left intact.[16] CONCLUSIONS As the demand for less invasive, highly effective cosmetic procedures is growing, this combination of treatment for acne scars has shown good results not only in Grade 2 but also in severe Grade 4 and 3 acne scars. The treatment is well tolerated in Fitzpatrick skin types III, IV and V with no failure rates or loss of days at work. There is a high level of patient satisfaction, minimal downtime and the treatment is cost-effective to the patient. To our knowledge, this is the first study using this combination of therapy in the management of atrophic acne scars and the first in which topical tretinoin cream was applied both during and immediately after doing dermaroller. __________________________________________________________________________________________________________________ Indian Dermatol Online J. 2014 Jan-Mar; 5(1): 95–97. doi: 10.4103/2229-5178.126053 PMCID: PMC3937506 Subcision plus 50% trichloroacetic acid chemical reconstruction of skin scars in the management of atrophic acne scars: A cost-effective therapy Jasleen Kaur and Jyotika Kalsy1 Treatment of acne scars is a dilemma both for the treating physician and the patient as no oral or topical medicine works and it is associated with emotional and psychological stress. Acne scars are classified into three different types: Atrophic, hypertrophic, or keloidal. Atrophic scars are the most common type of acne scars. They have been further classified into three types as described by Jacob et al.[1] into ice-pick scars, rolling scars, and boxcar scars. Most of the patients with atrophic acne scars have more than one type of scars. Various treatment modalities like punch excision and elevation, subcision, chemical peeling using various strengths of TCA, micro-needling, ablative, non-ablative lasers and fillers either singly or in combinations have been described in literature with varying results. Most of these procedures require costly equipment and materials and not affordable by many people. Subcision or subcutaneous incision-less surgery is a term coined by Orentreich and Orentreich[2] in 1995 as the treatment option for atrophic acne scars. Here hypodermic 18 no. needle is used to break the fibrotic strands that tethered the scars to the underlying tissues leading to uplifting of scars. Combining subcision with other scar revision techniques or repeated subcisions may be beneficial to the patients.[3] TCA chemical reconstruction of skin scars (CROSS)[4] is another useful method for treatment of atrophic acne scars. It involves focal application of 50-100% of TCA with a wooden applicator on the base of an atrophic scar, which causes precipitation of proteins and coagulative necrosis of cells in the epidermis. There is necrosis of collagen in the papillary and upper reticular dermis. Healing is rapid because of sparing of adjacent normal tissues and adnexal structures. So there is reorganization of dermal structural elements and increase in collagen content that leads to filling of the atrophic scar. While going through the literature, we found that different studies have used subcision and CROSS TCA alone or in combination with other techniques as well as their comparative studies but we did not find any study combining these two techniques together to the best of our knowledge. Encouraged by that, we combined subcision and TCA cross in all types of scars as subsicion breaks the dermal tethering of the scar tissue and TCA will remodel the collagen underneath the scar which treats the basic pathology of the scar to some extent. In our study, 10 female patients between the age group of 20-35 years of skin type 4 and 5 with atrophic acne scars on the face were randomly selected. Most of the patients had more than one type of atrophic scars of grade 4 severity as described by Goodman.[5] In all the patients, there were no active acne lesions and none of them were on oral isotretinoin 3 months prior to inclusion in our study. Patients with keloidal tendencies, bleeding diathesis, and history of recurrent herpes simplex were excluded. Complete hemogram, random blood sugar levels, and viral markers were done in all the patients. Written consent after explaining the risks and benefits of treatment was taken from all the patients along with pre-/post-procedure photographs. Subcision followed by 50% TCA CROSS was done at 4 weeks interval for three sessions. Patients were followed-up monthly for improvement in scars up to 6 months. Priming was done 2 weeks prior to the treatment with 2% hydroquinone and tretinoin 0.025% cream at night and sunscreen more than 30 sun protection factor (SPF) was given in the morning. Procedure was carried out after application of topical anesthetic cream for 45 min followed by infiltration of 2% Xylocaine with normal saline under aseptic conditions. A no. 18 hypodermic needle attached to a syringe was introduced horizontally underneath each scar and was moved back and forth till the snapping sound was heard. We used no. 18 hypodermic needle because it is cheap and easily available. Homeostasis was maintained by pressure. We cleaned the entire area with normal saline which was followed immediately by 50% TCA with the tip of a toothpick by pressing hard on the entire area of depressed atrophic acne scars irrespective of the type of scar and frosting was taken as the end point, antibiotic cream was applied, and patient was sent home. Patient was advised to apply antibiotic cream twice daily followed by sunscreen in the morning. Erythema, edema, and crusting lasted for 7-10 days in all the patients to varying severity. After 10 days, the patient was advised to apply azelaic acid 20% cream at night. Results were evaluated on the basis of global scar grading system, visual improvement by photographs and patient satisfaction. The global acne scarring classification is a four-category qualitative system by Goodman[5] based on scar morphology and ease of masking by makeup or normal hair patterns. Grade 1 means macular scarring only, Grade 2 is mild atrophy, which is not visible beyond 50 cm and can be easily masked by makeup, Grade 3 is moderate atrophy obvious at social distance not easily masked by makeup while Grade 4 is severe atrophy. Percentages in improvement were calculated as a combination of the three parameters, i.e. global scar grading system by Goodman, visual improvement by photographs showing the change in the grade and patient satisfaction, which was assessed by giving a questionnaire to the patient where they had to rate their improvement on 0-10 point scale. Excellent >70% Good 50-70% Fair 30-50% Poor <30% We labeled results as excellent when there was a two-grade change in the scars observed by the dermatologist both by grading system, photographs, and patient rated his improvement as more than 7 [Figures [Figures11 and and33]. Figure 1 Sites involved right cheek. (a) Post-acne scars mostly ice pick, boxcars and few roller scars. (b) Decrease in number and depth of scars Figure 3 Site involved is left cheek and left temple. (a) Many ice pick scars and a few boxcars and very few rolling scars. (b) Decrease in depth and size of scars Results were taken as good when there was one-grade improvement in acne scars observed by the dermatologist both by grading system, photographs, and patient rated his improvement as 5, 6, or 7 [Figure 2]. Figure 2 Sited involved right cheek. (a) Multiple post-acne ice pick and roller scars. (b) Decrease in size and depth of all the scars Results were taken as fair when there was improvement in acne scars observed by the dermatologist by photographs only and patient rated his improvement as 3, 4, or 5. Results were taken as poor when there was no improvement in acne scars observed by the dermatologist either by photographs or by grading system but it was only subjective improvement as told by the patient when they rated it between 1 and 3. In all the patients, scar grading improved from grade 4 to grade 2 and results were graded excellent, good, and fair in 6, 3, and 1 patients respectively [Table 1]. Although in various studies best results with CROSS TCA are seen in ice-pick scars but since in our study we combined it with subcision, results were equally good even in rolling scars and boxcars scars. Post-inflammatory hyperpigmentation was transient in three patients, which persisted for 15-20 days post-procedure, which further decreased over the time period with 20% azelaic acid and in one case, the mild hyperpigmentation persisted even at the end of 6 months in spite of the best efforts for reasons not known. The patients were also happy with the results except for the one where hyperpigmentation persisted. Although the procedure has a downtime in the form of erythema, edema, and crusting, it is comparable to all other resurfacing procedures and the problem of post-inflammatory hyperpigmentation can be judiciously tackled with the proper and repeated use of sunscreens and lightening agents. Each procedure when done individually has downtime of few days. So, we tried to reduce it by combining the two procedures. Hence, it can be concluded that subcision combined with TCA CROSS is a simple, safe, and cost-effective procedure, which does not require any specialized or costly equipments or materials or any special training and can be performed as an out-patient-department procedure by any budding dermatologist.
  7. Hi everyone. I recently received a light glycolic from my dermatologist. I was wondering if Rosewater is a suitable moisturizer, or if I need something a bit more powerful? Last time I received a chemical peel I broke out. I blame it mostly on leaving my old oily cetephil moisturiser on for 3 days before washing my face. So is moisturiser bad in this case? I also noticed rose water contains rose oil. Is this had to leave on the skin for days at a time? (Lead to breakouts?) thanks for the help!
  8. Glycolic Acid 10% to 30%

    Forums Scar treatments 23 replies

    Ok, for all that are here, I wanted to take your time to talk about my transition from glycolic acid 10% to glycolic acid 30% and my future progress to 50%. I started using 10% recommended by my dermatologist. I used it until i could tolerate it at him and i decided to move to 30% im a couple days ive been shedding skin a lot w some stinging but its bearable. Im not sure if its my optimism trying to persuade me but i feel like bumps of skin coming from my scars and i was wondering if its new skin coming up from the dead skin, most of my scars are rolling scars, at what percent did you guys use and for how long did it take for you to see results? Thanks, you guys are awesome!
  9. Hi there! I've been trawling this site for a good many years as I've had recurring acne throughout the years. This is gonna be a fairly lengthy post as I go through my history so please bear with me! I'm now 22, and started getting acne when I was around 15. It was always mild, I'd get a few pimples but nothing terrible. Only thing was that as soon as one went down another would crop up. as I got older my skin steadily got worse and worse, I started getting cystic acne (around 18 I think). I tried numerous birth control pills, OTC products, prescribed products such as duac and antibiotics, many others that I can't remember the names of, eating really clean, going vegan, exercising etc etc. Nothing helped at all. When I was 19 I started dianette, and that helped a little bit I still kept getting cystic acne (just a little less of it). I decided to go with a private derm and was prescribed roaccutane. I stayed on this for about 4 months and saw no change for the better, only that I was dried up from the inside out, extremely lethargic, and since I am diagnosed with moderate depression I felt it definitely didn't help in that department. Then, curiously, the acne cleared up. I know stress had a major part to play here, but I went from hiding away indoors because I had such terrible skin to having absolutely flawless skin. Could eat what I want, sleep in make up, party all night and wake up with like ONE spot. It was magic. that lasted for about a year, and then my dad died. Moved back home a few months after to support my mum and slowly but surely it crept back... and worse than ever. Then, moved to London and it cleared right back up again!!! Was living with a new boyfriend, had started a great job (I work as a model) and was peachy. cut to another year later, I break up with this abusive boyfriend and spend two months in between houses. so thats obviously when I start breaking out again. And it's worse, AGAIN. I will add that I had the copper iud inserted in February this year, and had been off BC for a good three months before that (as I felt I didn't need the dianette) and I have been speculating whether or not that has had an effect on my skin. i went for a mandelic peel about two months ago after being recommended it by a friend for the sudden cystic spots that flared up on my forehead. Now I'm not sure if it was a reaction to the actual peel or incorrect after care by me but I now have these little white bumps all over my face!!! And I NEVER broke out there, I only broke out on my forehead. My thoughts/advice I've gotten from friends is that I either reacted badly to the peel, or my skin didn't need it, or that the products I used afterwards gave me this rough bumpy skin. (I used anessa sunscreen, and very stupidly the perfect whip cleanser that I found drying but kept using because I was so lazy and couldn't be bothered to find a new, more gentle one and I put Estée Lauder foundation on the next day!) They are impossible to get rid of, I've tried multiple exfoliators, moisturisers, washing less, colder water, nothing! My forehead has cleared up somewhat, it's definitely better and curiously with less of these little bumps but I'm still getting terrible cystic acne (now more so around my temples and eyebrows, really painful and flaring up within a day, coming to head within two). So now I'm here, and at a total loss. I'm not really sure what to do as it seems that at every turn there's something to make my skin worse. With my job there's flying involved, which definitely breaks me out, people touching my face constantly, hair products and possible comedogenic makeup, unclean brushes. So I can't help that, I don't wear makeup in my own time. I eat quite healthily but smoke, and eat pretty much what I want. I do eat junk food but that never affected my skin the two times it was clear so I don't think that's the culprit. I'm not on any prescribed drugs, for acne or otherwise, no BC apart from the coil, do not exercise. I am basically wondering if anyone's had the same reaction to a peel as I have, how to combat these new spots (both cystic and strange little bumps) and also how to deal with stress induced acne. I am going for an allergy test as soon as I get back and am considering taking out the coil as I've read sooooo many (anecdotal) posts on here from women who reacted the same way! Currently I double cleanse with cetaphil in the morning, tone with watered down tea tree oil, and moisturise with simple moisturiser. Then the same again in the evening except after my first cleanse with cetaphil I use clean and clear deep pore cleanser (which I do think has helped somewhat with the forehead acne... maybe.) Anyway, rant over! Felt good to write it down. Thanks for reading if you've gotten this far. I'm sure I've forgotten a lot to add in but please ask questions so I can put together a more comprehensive story line! Xx
  10. Can anyone who's done chemical peels offer me guide? I'm currently on Epiduo Forte and minocycline. I have so many red marks, hyperpigmentation all over my cheeks and really want to get a chemical peel to fade the spots. For anyone who have done chemical peel while on retin a, epiduo or other topicals, what steps did you go through?
  11. Hi guys, I have quite bad acne scars, deep pitting on my cheeks and it's effecting my relationships and self esteem. I am looking at Pixel ErbiumYAG Laser treatment to try to improve the appearance but if I am going to get treatment I want the most effective treatment possible. Does anyone know if chemical peels would be more effective? Are there any other treatments that are very effective? Here is a photo of the scaring;
  12. Hi! I've been using the regimen for ~8 months and it completely cleared my face up. It made my facial skin very smooth, no texture whatsoever. However, red marks are left behind by old acne. How to get rid of hyped pigmentation spots? Has anyone tried chemical peels or microdermabrasion or LED treatments?
  13. Hi! I am 14 yeas old. I've had acne since I was 12. I've tried many things except for a facial. I've been to a dermatologist but nothing helped. I don't want temporary acne pills, nor I don't want to be on accutane. Should I get a facial? Also, I have these colorless bumps almost all over ym face now. What are these? I also have "whiteheads" that don't go away. I feel hopeless.
  14. Can just one chemical peel make that much of a difference in hyperpigmentation? I have PIH and I am mixed race but half white. I have had 15% TCA peels before and undergo light peeling but didn't notice much difference from those. If I go higher what type of peel should I try? Also for a 25%+ of TCA, glycolic, mandelic or lactic acid peel did you have much experience with lightening of PIH?
  15. was suffering from bumpy skin several weeks ago from visiting a country with pollution. My skin had closed comedones and felt a little bumpy. I was recommended a light chemical peel from an esthetician (probably a BHA or salicylic acid) and this is my second time having the peel so it's been 3 weeks since I started having chemical peels. I've noticed way more bumps than usual and my skin looks worse than before. Is this purging or is my skin just reacting badly? My skin was just great a few months ago and this is really heartbreaking, please help!!!
  16. Hey everyone! I've been doing research on AHAs and BHAs and decided to try out a new BHA (salicylic acid) since I have very oily skin and unforgiving clogged pores. Dan recommends that you either apply his AHA 2-3 times a week or mix it 1/2 & 1/2 with your nighttime moisturizer. I was thinking of buying a salicylic acid (SA) product and mixing it with my moisturizer to bring it down to ~2% SA, but I have only really found SA gel peels. Does anyone have any experience mixing the SA gel with a moisturizer and using it every night as an exfoliating moisturizer? Also, has anyone tried a SA peel (I'm scared to tried this)? Any recommendations? Here is the gel I was thinking of buying:
  17. Yesterday I did an at home 25% Mandelic Acid Peel from I did it to treat hyperpigmentation, red marks from shaving, breakouts on the sides of my face and some ingrown hairs. Today, my forehead is covered in small red marks. It looked much better before the peel even happened. The sides of my face have very minor peeling but are mostly covered in red blotches. I discontinued using tretinoin roughly 36 hours before the peel, did not leave the acid on for more than 3 minutes or so, and washed it off thoroughly. I am wondering if this is a normal reaction and will go away in the next few days or if I did more damage. This was supposed to be a mild peel. I've attached pictures. my aunt, who has had peels done before, said it looks like a normal day after result, but a second opinion would be much appreciated
  18. This is going to be a long post. A little background info, I have had acne since I was 10 years old, and I am turning 20 this year, finally with clear skin. I call the past 10 years the "decade of hell". I think we all encounter some kind of moment where we go, damn, I've had enough of this crap. And thus began my last ditch efforts to salvage my skin, which I am happy to say has finally become beautiful. Having lurked on this forum for years, I feel like its time for me to give back. 1. Diagnosis First I narrowed down and diagnosed what conditions I had. Cystic acne on forehead, painful boils on my butt and pityrosporum folliculitis on my back (recurrent, would flare up from time to time). Now this was tricky, because I had both bacterial AND fungal infection. Am I supposed to care for my face and butt and aggravate the situation on my back, or the other way round? Damn this body of mine. 2. Prevention Having determined all the skin conditions to be treated, the most important thing now was to PREVENT FURTHER SCARRING AND PIGMENTATION. I cannot stress how important this is, because deep scarring is so much more difficult to cure, and being fair skinned, my hyperpigmentation takes a hell lot of time to clear. I'm talking about dark spots that remain even after a year. For my bacterial infections (acne on butt and face), I immediately went on doxycyline. Cheap, effective, doesn't cure the root problem but it did the job for now. The doctor would only prescribe me 3 months of doxycyline, 2x100mg pills per day. What I did was take a 100mg pill a day with breakfast, which lasted me for 6 months and worked fine. For my fungal infection on my back, I began orally taking oil of oregano by Swanson. The dosage is 150mg per softgel, and you are recommended to take 1-4 pills per day. Now this varies by manufacturing brand, so follow guidelines accordingly. I started off with taking 2 a day in the afternoon and evening (not clashing with my doxycyline). In addition, I would also apply topical oil of oregano to my back (either buy the liquid in bottle kind or cut open a softgel). Be sure to do it sparingly, and dilute it with an oil/cream of your preference if its not diluted beforehand because the strong stuff can burn your skin. Last of all, I used Head and shoulders shampoo to wash my back as it had 1% zinc pyrithione. All this is gonna make your back dry as hell, but do not moisturize because the fungus thrives in wet environments. Along with all these, I was applying 5% benzoyl peroxide on my forehead and 2.5% on the rest of my face as a precaution. I use the brand Benzac, but probably any kind of BP will do. All of these worked to curb the acne from ever rising to the surface for the time being. 3. Dealing with scars/pigmentation Now the acne was gone, but there were A LOT of scars and pigmentation, which looked especially terrible because I'm a fair skinned Asian. This is the part where it all gets expensive. For my face, I caved and did a full ablative Fraxel on it, which removes pigmentation, scars, and returns pores to original size. This is very costly in most countries, but I was in Seoul, South Korea for a month, and I managed to find a clinic that offered Fraxel for 280 usd. Fraxel was significantly painful and I had red peeling monster skin for about 7 days, but the end result was flawless. For my back, I did a 35% TCA peel for about 130 usd. Once again, skin blisters, angry red skin, the whole works. This was truly painful as hell after the numbing cream they used wore off. However, I had clear skin after it all peeled off and the one week mark. For my butt, I had been using arbutin and hydroquinone creams, but the results were too slow for my liking. I did a ng yag laser for brown spots at about 130 usd. I believe that alexandrite lasers could do the job as well. One session was all it took for the brown spots to dry up and flake off, but if I had not been using creams beforehand I might have required more sessions. 4. To cure the root cause Now this was the hardest thing of all, because I suspect my acne has hormonal causes (it got drastically better when I was on hormonal birth control for 6 months). However, I am not willing to be on hormonal bc full time (I use a copper iud), so that made things difficult. In addition, as a female who is open to having kids in the future, what the hell am I going to do when I get off bc? Suffer the same skin conditions once more? So I did it. I WENT ON ACCUTANE. Now there are smart ways to do this, and stupid ways. One stupid way is to go on low dosage accutane (about 10mg-40mg) and then complain that the results don't last. I am horrified at the number of derms and docs that actually allow this. Of course it doesn't work, accutane is not meant to be used this way. One good way to calculate dosage is by body weight: 1.0mg x ___ kg = your dosage I weigh about 45 kg, and this was my dosage for 6 months Month 1: 40 mg (To adjust to the dryness etc.) Month 2, 3, 4: 60 mg Month 5: 80 mg Month 6: 120 mg to knock the acne senseless forever Depending on whether your weigh more or less, your dosage will vary. Monitor yourself, don't push the limits of your body and take care of yourself. Note the side effects you suffer from accutane and DO NOT STOP taking it halfway just because your skin has cleared and you think you're set. You are not using accutane as an antibiotic to keep acne at bay, you want to knock out this pesky acne once and for all. Be smart about this, take a fatty meal with accutane so your body can absorb it better. For dry skin, any rich moisturizer will do, for painful cracked peeling lips, go to the pharmacy/get a prescription for certain brands of lip ointments that not only moisturize but promote healing of lips. (there are several, they cost about 10 bucks a tub, ask your doc/derm about it) Most people do not experience the feelings of depression that may come as a side effect, but if you do get a family member/friend to monitor you. Remind yourself that this lasts 6 months, but the results will be for a lifetime. Now I know some of you are firmly against accutane and prefer changing your diet/using whatever topical creams and solutions. I'm happy it works for you, but you have to understand that for a lot of people acne is not necessarily caused by diet, and topical treatments only keep the acne at bay, not cure the root cause. Do you really want a lifelong battle to keep the acne from erupting to the surface? 5. Aftercare All the problem skin areas on my body are finally clear after approximately one and a half years since I started this entire war against acne/pityrosporum folliculitis. For maintenance, I use very simple and gentle products on my face, just a face wash, toner and moisturizer. Sometimes I apply some 2.5 % bp on my nose, to keep it from getting too oily. For my back, I bought a znp bar to wash my body with, and I am starting with a new treatment-ELECTROLYSIS. Yes, without the hair follicles, there is no way for the fungus to survive. Ha! This is because although I no longer have even a single red spot on my back, 10 years of suffering have made me paranoid as hell and I will never go back to that ultimate emotional and physical low I was at before. Summary: Acne: Doxycycline, Accutane, 2.5% and 5% BP Pityrosporum folliculitis: Head and shoulders, oil of oregano (oral and topical), znp bar, electrolysis Scars and pigmentation: Fraxel, Ng YAG, 35% TCA chemical peel, arbutin cream, 4% hydroquinone cream Long story short, a battle with skin conditions can be long and tedious, but in the end when you look in the mirror and have clear beautiful skin after a decade of hideousness, it will all be worth it. Honestly, now I have friends who only knew me after I solved my skin problems, and they complain over a single small pimple and tell me "Omg you're so lucky, your skin is so good and you don't understand how stressed out I am over my pimple". This makes me think about just how much effort, money and time I put into researching and healing my skin, and just how far I have come. I hope this post can help some of you readers out there, if only in the slightest way. I love you guys and may we all achieve clear, beautiful skin. Work hard! Lots of love, Pursuitofperfection
  19. Hi everyone! I just got back from my 3rd session of CIT + growth factor and my face is redder than an angry tomato! :-) I can say that I have seen some improvement over the past 2 months in terms of what seems like newer collagen growth (and thus shallower scarring), especially on the right cheek area. The overall color tone of the scarred area may have some slight improvement as well, but that it tougher to tell. I am not in a hurry to get too many things done too soon and will not be going in for my followup appt. until 3 months from now. The aesthetician said that they really want to see how well my skin has responded by then. At that time, several options will be discussed to addressed leveling off my cheek areas - especially the huge atrophic scarred area on my left cheek. I am looking into temporary hyaluronic acid (HA) fillers and may get them put in at that time. The aesthetician also suggested that a chemical peel (medium strength SA or TCA) could be done before getting the fillers put in. I am unsure if I should get both of those procedures done on the same day. Do you think it would be too much done in one day if I got a chemical peel and fillers injected? I am likely going to lean toward just getting the atrophic areas filled since that makes the scarring look a lot worse.... The overall color tone isn't as important to me. Also, is my Dr. right to suggest temporary fillers such as Restalyne versus "permanent" ones like silicone beads or PMMA? She said that permanent fillers can cause some issues and if they do, they are a hassle to remove.... As always, I appreciate the knowledge, research, and advice that is available here!
  20. I am currently using tretinoin 0.1%. I have been using it for more than a month now and have used tazorac for two months prior before I switched to tretinoin (it was too harsh and I used it once or twice a week). I did a 15% salicylic acid peel last night and wake up with whiteheads on the underside of my lower lip. Is this normal or should I just stop using the peel? My face is not irritated or dry afterwards though I don't intend to use tretinoin tonight. Please help!
  21. I just had my 2nd Jessner peel last week and this time I didn't peel or really flake. I did notice that I shed a very fine layer (i was dry and "scaley" day 4). My esthetician told me that if I'd ever like something slightly more aggresive she could do a Vitalize peel or perform microderm immediately before a Jessner peel. I'm considering the microderm before the Jessner, but I'm not sure if that would be too much for my skin. I had microderm once about 2 years ago and my skin tolerated it fine, but my skin had very tiny bumps that came up for about a week after, nothing bad and it went away without leaving a trace. Do you guys think it might be better to try microderm maybe a week before the peel or same day? I don't mind spending the money if it's going to give me results. My skin is fairly clear, breakouts here and there. Mostly congested skin, minor red marks, large scarred pores and very shallow scarring and uneven texture (orange peel).
  22. I've had acne for years and years now. I tried all the usual stuff - BP, duac, lymecycline, adapalene, probably some other stuff that I can't even remember. I finally got started on roaccutane of which I'm now on my third month. I am getting less severe breakouts but I'm starting to see these little scars. I'm not sure if they are ice picks or enlarged pores and I know you shouldn't mess with scar treatments whilst on roaccutane, but I was wondering if I could do something about them once I'd come off. Also I have a really bad habit of over-exfoliating when my skin starts to get a bit rough and peely. Could that be causing the enlarged pores?! Sorry the pics aren't great and the lighting is a bit rubbish. It sort of looks like hyperpigmentation at first glance, but there are dented scars below the redness. Can anything be done? Thanks in advance! EDIT: Sorry I can't get any clearer pictures. The scars aren't that deeply indented tbh, and they're hidden by all the redness! I know it could be a lot worse but I was wondering which treatments, if any, would be suitable for small ice picks...
  23. Hey guys So I finished my Absorica course in August and my dermatologist said I should be doing peels to help with the redness and scarring. The peels I've been doing for the past 4 months and they've helped tremendously. My skin has never ever looked so smooth and clear. I don't know what happened but I recently did a peel 2 weeks ago and I got a bad reaction on my forehead. My skin was irritated and it took an extra 5 days to heal. It was really red, flaky, and bumpy. After it healed, everything was back to normal. So suddenly one day I start to notice tiny bumps on my forehead. There's like 20 of them. It's barely noticeable, but I obviously see it because my skin's not smooth. They're not whiteheads or pimples...but just super tiny bumps. I noticed I got them after I exercised, so does the heat/sweat have anything to do with it? Does anyone know what this is and what I should do?
  24. Hi Everyone, I finally broke down and went to a new dermatologist last week. He prescribed Aczone, Tazorac and Sulfacleanse. His aesthetician (who I know personally) said a chemical peel would also help. I'm aiming to rid myself of both active acne and specifically dark scars/hyperpigmentation. I haven't started the Aczone or Sulfacleanse yet, I've used the Tazorac every other night since my appointment last thursday (3 times so far). I am wondering what I should expect from my first chemical peel? This is what the pamphlet says for the type she suggested for me: Ultra Peel I & Sensi Peel $100 Effectively treats aging and sun damaged skin, leaving your complexion supple and hydrated. Best for all skin types and sensitivities. On the website it has a little more info: Sensi Peel $100 Gentle yet effective treatment for even the most sensitive skin types. Light exfoliation that combats aging, sun damage, acne, and even reduces inflammation. Ultra Peel I $100 Effectively treats many skin types & conditions, especially dehydrated or mature skin, leaving the skin plump and supple. Helps improve pigmentation, fine lines & wrinkles, sun damage, and acne. Does anyone know what I should expect from my first chemical peel? How much downtime? If you are curious about the current condition of my skin, I posted pictures in Thanks!
  25. Hi, I had two dermalogica bio active peels about 9 months ago. Before I had fairly good dark skin with a red undertone (I'm Jamaican and Indian) with some superficial scars on my cheeks. After the peel my skin just has this weird texture and color and I'm not sure what happened to it and no one seems to notice but me. Am I crazy? The peel is a Dermalogica Bio Active peel which goes on in 4 layers. First is 20% salicylic acid, second is an enzyme layer and two layers of 30% lactic acid and 15% tca. Please let me know your thoughts, I've become really depressed because of this and I no longer feel like I look the same.