DIY peels in a home environment is like Russian Roulette. I do think that a sensible concentration of TCA from 5-10%, 2 coats is feasible. I do not think that 20-30% TCA is safe. The concentrations I use range from 90-100% TCA. Regardless of advice & sensible suggestions, some people would insist on DIY treatments. Hence I have done a video on YouTube as to how to safely TCA with 8%. Watch this if you are inclined to peel at home. Legally & morally, I can not suggest a higher concentration.

AHA peels including lactic, glycolic, & mandelic acid peels can be done at home with absolute caution. Start with 10-15%, increasing as tolerated. These peels are trickier than peels that don’t require neutralizing.

My following suggestions will be based upon ease of use (technical aspects), safety (most importantly) as well as efficacy of treatment. In the context of home use, it is always a compromise.

Dermarollers use a rolling system of needles that range from 256 to 512 super sharp needles. Needle length ranges from 0.1mm all the way to 3 mm. For home use, I suggest 0.1 to 0.2 mm. Max at 0.25 mm. When I perform this procedure to patients, I typically use 0.25 to 0.5 mm. With good traction & countertraction, short needles do the job. The end point is minor pinpoint bleeding. Don’t try super long needles or you may get ‘rip scars’ or linear scarring. Even though I have access to deep Dermrollers, Dermapens/Skinpens, a variety of DermaStamps, & even RF microneedling – nano/microneedles, my usual go to is a shallow depth Dermaroller.

In the context of what I do, I prefer this method over lasers for intradermal delivery of high strength CS to hypertrophic scars. With good technique, rolling is less technical than pens, & is far cheaper.

DermaStamps are a good compromise if you want to go vertically. Preset heights add safety. As you can only stamp and not glide or roll, they are safer for patients who are not technically proficient with needles or rolling.

Derma Pens or Skin Pens: These devices provide vertical needling. Unlike rollers or sampers, pens require a motor. Pen depths are adjustable, typically from 0.1 mm to 2.5-3.2mm. Pens require practice to deliver safe & effective results. This is one device that is dependent on build quality, in this case the motor. Poor technique & or a weak motor means you are at risk of ‘skin tears.’ In the context of at home DIY acne scar revision treatments, I do think that pens can be potentially dangerous.

0.1 to 0.2 mm is adequate for most cases. You can go to 0.25 mm at maximum. As a consultant dermatologist who is used to big surgical procedures, I rarely go past 0.5 mm. Conducted correctly, 0.25 will get the needle into the papillary dermis. Pinpoint areas of bleeding will be apparent. Proper technique with traction & counter traction is paramount.

Daily: SPF in the morning, option for vitamin C (ascorbic acid, 5-15%). Retinol or retinoid in the evening.

Weekly: Exfoliation with either physical or chemical AHA-BHA.

Twice a month: Sensible needling with either a Dermroller or stamping to flat surfaces. 0.1 to 0.2 mm is all that you need if conducted properly. 0.25 mm maximal at home for safety.

The biggest mistake I see daily. If you have ongoing acne you will be chasing scars. Additionally your body’s immune system can not direct all their efforts in revision scars when it is fighting off inflammation from ongoing acne.

Try simple DIY acne management strategies at home. If no better, consider seeing a medical dermatologist. My colleagues @cliniccutis can assist.

Prior to seeing a dermatologist (not me, but a medical dermatologist), you may want to try some DIY acne control including;

1. Acne diet. Low sugar, low dairy, high protein. Unrefined foods over refined.
2. BPO or Benzoyl peroxide washes.
3. Salicylic acid washes. Neutrogena makes a good 2% wash.
4. Retinoids including retinol or retinoic acid.
5. Vitamin B, C
6. Tea tree oil- if you must

Please refer to the acne product guide on this website for more information.

If you have acne & or acne scars that are not responding to treatment, consult a skin specialist. For mild to moderate scars, my clinical team can assess your skin scars & provide you with effective & cost effective solutions. They are trained by myself in the use of ablative lasers, TCA CROSS, TCA Paint, as well as RFM, medical microneedling, vascular laser, Fraxel lasers, Fractional laser, Pico Laser & many more devices.

If you have significant objective scars (in the absence of active acne), I would be more than happy to review your case. I do NOT provide any online consults as this method of assessment is not accurate. For some cases of assessment, touch is an important aspect of understanding skin scars. Thank you for your understanding.

Treatments are more affordable than you think. Simple revision treatments performed by my clinical team, such as vascular lasers, Tixel, simple TCA CROSS & Paint start at $290 USD. Fractional lasers start at $690 for small areas. For a no obligation assessment, book in with my nurses or dermal therapists.

My work is very different from the above as I concentrate on surgical procedures, fillers, grafting & laser work. In the majority of times this carries a Medicare rebate (for the management of severe scars).

My work focuses on severe scar revision, in particular objectively severe scars. I use techniques including surgical subcision, excision, punch grafting, deep peels, ablative lasers, fat transfer & many other surgical procedures to address objective severe scars.

My interest is not subjectively severe but objectively mild scarring. This falls under the realm of BDD or body dysmorphic disorder, a condition best managed in conjunction with a psychologist or a psychiatrist. Significant acne scarring is best measured with photography under normal conditions, & assessed by a third party.

For patients with mild to moderate scarring, my clinical team is experienced in the triage & appropriate management of scarring. They perform all the procedures that I do, apart from surgical aspects or revision.