How I'm handling my acne scarring

Since about the age of 22, upon attempting the Depo-Provera birth control shot, I have had severe cystic acne. The breakouts have changed over the years. I used to get a few deep nodules on my chin and cheeks that took months to heal, every few months – so I usually had 1-3 I was nursing at any given time. Most of the time when I left them alone, they just hurt like hell but generally didn’t pose too much of a cosmetic problem.

Now I get a couple breakouts a year that are very severe acne conglobata, generally on one cheek at a time. They quickly develop into a pus-filled network of abscess’s that take about 6 months to heal to scarring. In the last year I’ve had one on each cheek.

In addition to what happens to my face, I also get ovarian cysts, usually monthly, and have high androgen levels – both things indicative of PCOS. After tweaking and trying just about everything under the sun, my acne breakouts appear to be largely controlled by 100mg of Spironolactone a day to inhibit my androgens, and heavy supplementation of Vit A, D and Zinc.

I’ve not gone the accutane route. That shit freaks me out. I have tried all kinds of prescriptions, topicals, antibiotics, supplementing and home remedies attempting to avoid that option – but this combination, at least for now, seems to be working. Which is really nice. It’s hard to convey to someone who doesn’t know, how painful and maddening it is to have a constant festering wound on your face and how much it hurts – and that’s aside from managing the cosmetic aspect.

So what about the scarring, then?

I couldn’t do a thing about it until I started having calm periods in between breakouts. Once that started happening, however, the scarring left behind was much deeper and long lasting than anything I’d had before due to the type of acne I’d developed. At the suggestion of a coworker, I’ve been pleased with the results of TCA peels.

There is a ton of research to be had on the subject via the wonder of google. I am not one to shy away from experimenting with my body, even when there is some amount of pain involved, and I’m very body aware. So, I’ve done these peels at home. I do not advocate everyone do this. If you can’t follow directions, for instance, or can’t be accepting of a negative result if you screw yourself up, suck up the dough to get it done by a pro. For me, I’d usually rather have my fate in my own hands than those of someone else, even if it means I don’t have anyone to point a finger at if things don’t go my way.

I bought a tiny bottle of 100% TCA off ebay with instructions for maybe $14. The bottle has lasted me about 9 peels and barely seems to have a dent in it, partially due to the dilution of 50% I’ve generally used. I’ve experimented with both lower and higher percentages, and find this to be a good one for my face. I cut my TCA with mainly with lactic and glycolic acids rather than just water – they are mild enough for me to do so. Some times I will do lighter peels if I’m performing or have something important happening, other times I do deeper ones to get quicker results in exchange for an uglier peeling time.

My favorite peel was one of my first, which was deep enough that the peeling was all one piece which got dry, dark, and sloughed off all at once in the shower a week later. It was ugly, but not fussy, dry enough to cover with makeup while on vacation after the first few days (in which you constantly keep the burn lubricated with bacitraycin), and effective. The lighter peels tend to peel like sunburn and have flakiness, but the color change is less severe. I think that peel was actually 100% TCA with marathon rinsing after a couple seconds – when I dilute the TCA I leave the solution on my face longer and often layer it over the course of a few minutes.

Yes, I put 100% TCA on my face. No, I didn’t keep it on longer than about 5 seconds. No, I didn’t die. I also don’t recommend it. If you aren’t quick you can really screw yourself up. Once I did a quick spot peel when I was in a hurry, using 100% TCA on a q-tip. My face was red spotted for 3 months. Read some of the TCA forums. I got off lucky.

My typical TCA peel looks something like the “age spot” example at http://www.tcapeels.com/

My scarring is much worse than the example, so I am doing multiple peels over time. The most often I peel is 3 peels two weeks apart, then a break for a month or three. I started my 4th set of peels today, which prompted me to write this up.

There aren’t a lot of pictures out there of my facial scarring without makeup, and I lost all my snapshots for the last few years in a drive crash not long ago. Here is one photo from last may, that shows the scarring on my left cheek after two TCA peel sets:

I thought maybe it might be helpful for people who deal with this to know that a) There is hope in finding some relief eventually and b) Even seemingly glamorous people who spend time in front of cameras and live audiences go through this, manage this, and continue to do what they love despite it. No doubt about it, acne sucks. There’s also a lot more to life than acne sucking.

Good luck.