@screwscars Rullan is a expert at peels, ... he teaches drs how to do them. We have had several people do TCA cross. I am not sure about A deep tca peel yet as no one has said they did one. Remember the down time like fully ablative laser is 2 weeks and redness lasting a few months. 

One deep peel alone won't fix all your scars, ... scar work is progressive and requires multiple things. He does dermabrasion on the scar borders with this peels. 

If Rullan recommended it then he must feel it will help you.

The peel can thin down the skin during healing which grows back with time,...we are not dealing with excess thermal damage here from energy,... unlike laser we are treating set top layers into the dermis and not going into the fat.

Rullan is a expert. He even wrote journal articles on how to peel. 

Ask the office for after care instructions and go through them, this will give you a good idea of what to expect.
 

Quote

Hey guys,

 

Just had a phenol peel. MAJOR downtime...around 9 days before you can really do anything. WELL worth it, though. Got rid of about 85-90 percent of crater like scaring which is mostly what I had  Highly recommened, if done with the right doc.

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I believe Kit flew from Singapore to Israel to have the Exoderm Peel performed, which is a type of deep Phenol Peel. Kit said the procedure did wonders for his wrinkles but he is less than thrilled with the results of the treatment on his scars.

 

If you research Exoderm there are some pretty amazing results shown in some of the pictures on scars (however I believe the most dramatic example shown was a patient who underwent the process three times). The best results of this peel are apparently obtained when combined with manual dermabrasion. Dr. Rullan, out of California, and he believes it is the best resurfacing tool out there. However again, he combines the peel with dermabrasion. There was another poster by the name of Steve who had Dr. Rullan perform the procedure and he says he derived a 40% improvement.

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hi.. Im the steve that she is referring about.. I got my exoderm lift done in march of 2002, with some pretty good success.. OVerall ive probably achieve about a 50% or slightly higher improvement..

Exoderm works wonders on wrinkles and shallow scars after one lift.. If done mulitple times it will probbaly do wonders for deep scars as well..

Hi all, I just had the phenol peel performed by dr rullan on Tuesday. I am determined to give a full account, as I found such limited info and follow-up info from treatment from other users and people on the internet. I will post before and after pics. Its been 3 days and I had the skin scraping yesterday. Once Im feeling more up to it I will give a detailed account and answer any questions you all may have. At this point Im still in a significantamount of pain. Dr rullan wonderful and his assistant Amy is literally an angel.I have done basically every other laser and treatment and this by far is the most aggressive and painful. Im hoping in a few days I will be throughthe bulk of the pain and in a good enough space to add more details. Just wanted to let you know it is coming. Thanks all!

Thanks for the update

A phenol peel 30 years ago gave me horrible scars and changed my life significantly. I had a practitioner who didn't know what he was doing. I suspect he had never done it before. You're in safer hands with Rullan but I myself would not risk it again.

Hi @screwscars

Thank you so much for the willingness to keep us updated! Im in my late 20s andhave similar scars as yours, with the exception of a few boxcars.Ivetried so many things. ButIve also received subcision andcross from Dr. Rullan, which has helped the deep scars! But I havent found anything to really improve the surface texture or boxcars. Herecently suggested the phenol peel. I havejust read so many reviews on here from the past withworse or very little results, and with such a high price tag, I just couldnt bear that. He said his updated methodfor the peel treatsice pick, box car and even rolling and everyone has been loving their results recently! I even saw photos in office. But I havent seen anyonesaccount of it on thissitein recent years.All that to say I cannotwait to see your results and hear about your journey. Im also curious about the pain level because I try not to take any pain killers.

1 hour ago, Smile7 said:

Hi @screwscars

Thank you so much for the willingness to keep us updated! Im in my late 20s andhave similar scars as yours, with the exception of a few boxcars.Ivetried so many things. ButIve also received subcision andcross from Dr. Rullan, which has helped the deep scars! But I havent found anything to really improve the surface texture or boxcars. Herecently suggested the phenol peel. I havejust read so many reviews on here from the past withworse or very little results, and with such a high price tag, I just couldnt bear that. He said his updated methodfor the peel treatsice pick, box car and even rolling and everyone has been loving their results recently! I even saw photos in office. But I havent seen anyonesaccount of it on thissitein recent years.All that to say I cannotwait to see your results and hear about your journey. Im also curious about the pain level because I try not to take any pain killers.

I did not receive any pain meds. I wanted to jump out of a window. It was the worst pain I have ever been in, by far. But Rullan knows what he is doing. It might be worth the risk with him.

11 hours ago, Smile7 said:

Hi @screwscars

Thank you so much for the willingness to keep us updated! Im in my late 20s andhave similar scars as yours, with the exception of a few boxcars.Ivetried so many things. ButIve also received subcision andcross from Dr. Rullan, which has helped the deep scars! But I havent found anything to really improve the surface texture or boxcars. Herecently suggested the phenol peel. I havejust read so many reviews on here from the past withworse or very little results, and with such a high price tag, I just couldnt bear that. He said his updated methodfor the peel treatsice pick, box car and even rolling and everyone has been loving their results recently! I even saw photos in office. But I havent seen anyonesaccount of it on thissitein recent years.All that to say I cannotwait to see your results and hear about your journey. Im also curious about the pain level because I try not to take any pain killers.

Hi! I know how you feel! I had all the same thoughts. So Im on day 11 now and my skin is healing great. I will wait until a month before I post pics. I will also give a full detailed account at that point. But feel free to message me with specific questions bc Ill give you my phone number. I was dying for someone to talk to who had done itso I know how you feel.

As far as pain, you are sedated for both days. I will tell you though that it is not pleasant. During the procedure I had no pain bc of the sedation, but my face was on fire. He gives you pain meds, benzodiazepines, and sleeping meds. You could do it without the pain meds, but I would recommend the other two. Lmk if you want to speak further. I can send you pics, I just dont want to post here too soon.

Hi all, I wanted to give a brief update with two pics. It has been about 18 days since my phenol peel. My face is still red but much less than I was anticipating. I tried to get the œafter pics in the same lighting and they were taken in the same place. I™ll take some more soon in different lighting. I™m sure there™s still microswelling etc, but I am very pleased with the initial results. My skin overall feels much better. Some precancerous spots I have are gone as well as wrinkles under my eyes. This is an honest review and I have no affiliation with Dr Rullan. Eventually I will post a full review once I™m fully healed. Keep in mind my scars were very textural when I got the peel. I have done a number of treatments to lift them to the surface. 

@screwscarsThank you so much for posting a update, good to hear the treatment went well!Can I add your post to the sucess stories.

I often tell people at the end of their journey once they lift the(pits / scarring) to do a deep phenol peel like this for texture and your case is a good example. Since your scarring was textural it helped I can see 😉

Could youtell usyour Phenol Peel experience with the procedure and any tips or hints you can give others who wish to undergo this procedure; Things you wish others would know about this.

Thanks,

BA

4 hours ago, beautifulambition said:

@screwscarsThank you so much for posting a update, good to hear the treatment went well!Can I add your post to the sucess stories.

I often tell people at the end of their journey once they lift the(pits / scarring) to do a deep phenol peel like this for texture and your case is a good example. Since your scarring was textural it helped I can see 😉

Could youtell usyour Phenol Peel experience with the procedure and any tips or hints you can give others who wish to undergo this procedure; Things you wish others would know about this.

Thanks,

BA

Yes definitely! I'm happy to help...especially as I couldn't find a ton of info on this procedure. In about a month or so I plan on giving a pretty in depth review of my experience. I wanted to wait until my skin healed a bit more to ensure that I was documenting facts and not my emotional experience. Until then I will say that since taking accutane over ten years ago, my skin has not had a break-out and I have developed no cysts. This is important because due to the recovery of this peel (and lasers) the vaseline that you must put on your skin can cause break-outs. I wasn't too concerned about this because I had been down that road with lasers and I never broke out. Dr. Rullan also gives 2 oxygen facial treatments during the recovery time and those greatly reduced the redness and formation of any milia.

In addition, my scarring in the before picture was probably the "best" yet worst lighting aesthetically for my scars. I say that because when I initially sent Rullan these pics he immediately suggested the phenol. However, when I had my in-person appointment he told me that my scars looked much worst in the picture than in-person. This is an important thing to note because it may appear that I've had a miracle result (I feel very pleased), but in regular lighting the average person may not notice a huge difference either way. Ultimately I chose to follow through with the peel because of my significant history with skin cancer and premature aging and wrinkles from sun exposure and lack of oil production from accutane. Aside from the scarring, my precancerous cells have had a remarkable result and I can tell you I don't have a wrinkle of my face (which I love) or any sun spots. I only used the thick vaseline treatment for 1-2 days (After the 7 day green mask they apply after the procedure) and went right down to the soothing serum they provide. Because my scarring was very textural at the end, my face always felt really smooth, but even more so now. Also, it feels oily again and fully hydrated (which I actually love). I developed no acne and only one very small milia which has gone away. The fully ablative laser that I got a few years ago was a much longer recovery time and delivered questionable results. Although I have had severe cystic acne in the past, my skin has always healed well and quickly with all the treatments that I've done (4fraxel lasers, 1 fully ablative, micro needling, infini, 2 subcision with sculptra, subcision without filler, bellafill, voluma- all over the course of 7 years); therefore I wasn't too concerned about healing well from this peel.

Overall, this has been an amazing treatment. Again, I feel that I am so pleased with my results because of the road that I took to get here. If this was the first treatment that I had done, I know that I would still be looking at much more scarring. Dr. Rullan is great because he is not going to suggest something that doesn't work, and he won't tell a patient to do the peel unless he feels that it will yield considerable results. I appreciate that about this doctor. I plan on posting pictures of my recovery in a month or so as well. The procedures (2 days)even with the pain medication etc, are not comfortable. Unlike lasers which are uncomfortable during the process, but really aren't too painful afterwards (even when your face looks like someone too a blowtorch to it), this peel is uncomfortable afterwards. I remember thinking "My face feels like someone is holding a match to it all the time."My eyes swelled shut and I could barely open my mouth for a week. Sleeping was uncomfortable and there is little one can do to distract from the pain because you have to just lay in bed. Nevertheless, I feel that acne scar sufferers are much more equipped to manage this pain or discomfort. If we've gotten to this point we have had a long history dealing with painful acne and multiple scar treatments performed without any anesthetic. The pain and discomfort for me was very much worth the results.

There were some posts in 2006 with people saying no improvements and worse scarring from this procedure. You had such a positive experience. Does anyone have any insights on thesenegative outcomes? Thank you.

21 hours ago, Solutions29 said:

There were some posts in 2006 with people saying no improvements and worse scarring from this procedure. You had such a positive experience. Does anyone have any insights on thesenegative outcomes? Thank you.

I found the same things and it made me nervous. This is a very intense procedure and so honestly I would only feel comfortable going to Rullan. Administration, method, experience are all extremely important. Also Rullan has a double day procedure yeilding better results.

@Solutions29 @screwscars Deep peels have been popular for many years, the standard patient is older and want's to fix deep lines and folds. They fell out of favor when they were using them to treat all acne scar suffers without doing anything else (there was still scars to address before this step). Also they are not as popular with darker skin types as they create hyperpigmentation, but Rullan found a way to treat this population. 

Recently they are making a resurgence for textural scarring as laser can't seem to give as good of a result as a master peeler. Many times it is a plastic surgeon who does this with a face lift or fore rejuvenation. They are hesitant with the younger crowd to do them, and it takes more skill and training than a laser. That all goes out the window with a acne scar suffer as they have many concerns of pre-mature aging due to scars. Many new Dr's are doing quite weak laser peels with the erbium that do not go deep enough. The newest Derms who come out of colleges are indoctrinated in lasers and marketing materials by device manufactures and think peels are old school. Sadly they cannot reach the sucess of some of these chemical peel masters with generalized settings and quick treatments for high $$$$$$$$. I think where Rullan excels here is he is a master at doing this training other Dr's how to peel and he does acne scar work for patients making it a perfect alternative to laser. This is his sole specialty. 

https://www.realself.com/phenol-peel   

IF a derm or plastic wishes to learn they need to take Rullan's training course ;-P 

 The Peeling Society for Chemical Peel. 

Here is a deep peel in action for texture

Thank you beautiful ambition for your feedback and advice. We are blessed to have you on this site!

@screwscars Thanks for taking the time to write such detailed reviews! We all greatly appreciate the effort. 

I had a few quick questions: 

1) What scar type(s) did you have?

2) Did Dr. Rullan ever mention what Fitzpatrick skin type you have? Was it a deciding factor for him to perform the procedure?

3) How useful were the oxygen facials for redness relief? (ie. like 50% improvement from end of procedure?)

4) When you discussed the pain experienced, was that pain you felt on top of the pain medication? Just trying to gage how painful the recovery was on a scale. 

Thanks!

Has anyone with a darker skin type hadthis procedure in recent years? We would appreciate you sharing your experience.

@SquawkingStars @Solutions29 @screwscars

I am sure Screw scars can answer your questions better with her own experience but I wanted to share this as I have been asked this repeadily. 

• Dr Rullan specializes in chemical peels, as mentioned above he trains other Dr's how to use them, so your Dr (in general) may not know how to do any of this.
• Rullan uses Phenol for his TCA Cross, he is the only one I am aware of currently
• Rullan uses a term called "Chemabrasion," This is a deep peel while also using dermabrision (Sanding of the borders of the scars). These are also called deep peels, exoderm, phenol, baker gordon modified. 
• The best cases / results treated their acne scar pits first first before going straight to a peel, raising them as much as possible. Acid peels, or fully ablative erbium laser peels are best done for texture and not atrophic scars. The ones who still have pits, I would have done this peel as the last step in my journey, not the first unless I had mild textural scars to begin with. Rullan's office online sales staff who schedules procedures at his office may offer you the peel, without him examining you. Get a face to face consultation to confirm before any peel and many need many sessions of phenol cross for their icepicks, or sucbision before getting the peel. 
• The darker the skin pigment, the weaker the peel will be because of possible complications, as such some have to repeat getting 3 of them over time. Note I see no peel results for those who are over Skin Type V (dark brown skin - tans very easily, very rarely burns), Ask Rullan if you have darker pigmented skin VI  (deeply pigmented dark brown tans very easily, never burns).
• Rullan also specializes in ethnic skin types and uses a weaker version of the peel for this demographic, steriod injections for swelling, and other special after care
• PRF/PRP and Oxygen facials are used for quicker healing these days with treatments.
• You must prep the skin pre-peel with the below nightly products, especially the tretinorin and hyperpigmentaion products, this is continued after your scabs come off from the peel as well.
• Peels have a long down time, be prepared for redness for many months (makeup, concealer, tinted sunscreen, or dermablend surgery makeup at Dept Stores), are great options even for guys. The skin can have a waxy texture after the peel as it is deep. It can also lighten the pigment a little bit darker skin types. 
• It depends on how you heal, so if you heal poorly neither a chemical, laser or other peel would be appropriate. The down time is several weeks, and there is swelling post peel, you typically have to have someone to take care of you in a nearby hotel and follow up to make sure your healing ok before flying home.
• Besides Rullan only Plastic surgeon's do these on old ladies who get face lifts as they take massive amounts of skill. As @screwscars the aftercare for several weeks is not easy, this is not a lunch time peel or a quick brightening peel, be prepared for some discomfort for some weeks. The most drastic procedures have lots of down time. I have read with other Dr's who do this a possibility of hypopigmentation (loss of pigment), which comes back over time, but I have not read this with Rullan's work, just general Phenol Peels. 
• This is not a beginner procedure, ... most Dr's come out of med school,... are marketed to by laser companies for this practice, and use company made settings and scripted sales to tell you what a device will do. This is why so many people complain about devices. The surgeon is more important than the device or product. As such they have no idea how to use a laser or a peel. Everyone does TCA peels, ... But this is advanced stuff. Don't have your general derm "try this on you." Rullan has done thousands of peels in all demographics.  

Where Do You Fit on the Fitzpatrick Scale?

Hey @beautifulambitionsince you both mentioned having highly textural scars, how can we tell if we've got those rather than rolling, boxcar, etc.?

@SquawkingStarsTextural. Basically means, the scars are not that deep, they are not fat or collagen deficient pits. Can be anything from linear scars, large pores, shallow rolling or box cars, or light textural undulation. OF course you want to treat acne scars by lifting the deep scars as much as possible before any acid peel as it's for texture at the end of treatment. The OP had textural scars to begin with, ... look at all her treatments she did quite a lot before the peel.

oh my god your skin werent bad before but now is simply perfect
congratulations, if i could have Dr Rullan to treat my scars i would be very happy
thats awesome results

Hi all! I know how it feels when people got procedures and they wouldn™t follow-up with posts. Ha but I™m trying. Anyway I will try and post some 2 month post procedure pics tomorrow. I am very happy with the results as not only my scarring but my skin in general just feels so much healthier. I™m still a little red but nothing like I thought I would be and my cheeks are still sore and sensitive, but again nothing unmanageable. From where I was with my scarring etc, this was a great decision for me. 

On 2/13/2019 at 9:12 PM, SquawkingStars said:

@screwscars Thanks for taking the time to write such detailed reviews! We all greatly appreciate the effort. 

I had a few quick questions: 

1) What scar type(s) did you have?

2) Did Dr. Rullan ever mention what Fitzpatrick skin type you have? Was it a deciding factor for him to perform the procedure?

3) How useful were the oxygen facials for redness relief? (ie. like 50% improvement from end of procedure?)

4) When you discussed the pain experienced, was that pain you felt on top of the pain medication? Just trying to gage how painful the recovery was on a scale. 

Thanks!

I™m sorry I didn™t see this before!  I had mainly rolling textural scars at the end. I also had some icepick scars as well. I™m not sure about the skin type but I am white with significant hx of skin cancer. Oxygen facials were awesome. I say helped 30 percent redness. The big healer though is the green mask you wear. I would wear that for as long as possible. I took mine off a bit early bc I was anxious to see my skin. The pain was interesting. It was painful, but mostly just an uncomfortable situation. Really you just want to try and sleep as much as possible because you are oozing, swollen, itchy etc. If you™ve done other significant treatments, this one won™t be super far off in terms of pain,  but it is more uncomfortable than anything I have done. 

On 3/20/2019 at 11:40 PM, screwscars said:

Hi all! I know how it feelswhen people got procedures and they wouldnt follow-up with posts. Ha but Im trying. Anyway I will try and

Hi @screwscars. I'm considering having this done with Dr. Rullen.Would you be so kind as to post another update.

How much improved are you from baseline (before chemabrasian)?Was the degree of improvement greater than you obtained from ablative laser? Do you think it would befeasible for an out of town patient to have this done without a caregiver accompanying them?

Thanks in advance.

Take a Look at F93d's Excellent thread, a in-depth blog of his scar sucess journey ending with Chemabrasion with Rullan (including aftercare).

https://www.acne.org/forums/topic/376709-subcisioncross-progress-beforeafter-success-story/

Hi all, I wanted to give a bit of an update since my treatment. My skin has healed very well. I have had multiple lasers done, and the phenol peel was the best experience I had healing. I am very happy with the results. I will try and post some pics tomorrow. To be honest I dont think about my skin much any more (I was never super obsessed with it, but just always aware I didnt like it), so I rarely come on this site. With that said, I am more than happy to speak with anyone directly if you are considering the treatment. Please private message me as this is an easier way to reach me (I will give you my phone number). I will do my best to post updated pics tomorrow! I do think its important to mention that my healing time was much less than some likely because I have light skin. I am empathetichow challenging it must be for a person of color to get the best treatment. I do however feel that Dr Rullan, being of color himself, is one of the best doctors to treat ethnic skin. Thanks everyone for helping me in my journey and helping each other. Acne sucks, cancer sucks, scars suckbut at least were not alone.