A TCA peel is considered a medium (15%-35%) to deep (40%) chemical peel. The main ingredient is trichloroactic acid. It helps improve the appearance and texture of the skin and evens out skin tone. When TCA is applied to the skin, it causes the top layers of cells to dry up and peel off over a period of several days to one week. When the old skin is peeled off, it exposes a new layer of undamaged skin, which has a smoother texture and more even color. Progressing from medium to deep peels, the layer of skin removed is greater with each increase in strength of the peel solution.
Lighter TCA peels are usually done in a series of 2 or 3 for best results. This is similar to other light peels that usually involve hydroxy acids such as glycolic, salicylic, or a mixture of other hydroxy acids. Medium depth TCA peels are usually done once or twice a year and do require some downtime – usually about a week – when the peeling is obvious. Frosting (see picture) generally doesn’t occur during glycolic acid or lactic acid peels, but during deeper peels, such as TCA peels.
If you are considering a full face TCA peel, our surgeons sometimes recommends having twilight sedation to make this more comfortable. Treatment to the lower eyelids or small age spots can be done in the office. You will usually peel for about one week with a medium peel. The skin will be a light yellow after the procedure for 1-2 hours. This color will gradually fade. The skin will be slightly redder for 2-3 days after the peel and feel tight. You will begin to peel approximately 48-72 hours after the treatment and the peeling will last generally 2-5 days. You will be able to apply makeup after one week. There is no pain but the skin looks as if it has a severe sunburn. Avoid all sun exposure while healing. You will experience pinkness for 4-6 weeks following treatment and the treated area will be more sensitive to sunlight for 4-8 weeks after so don’t plan any sunny vacations for at least a month. Most people will wait to the fall or winter to have these treatments.
TCA peels are most commonly used:
- to reduce brown spots and age spots
- to improve the texture of leathery, sun damaged skin and impart more glow
- to improve melasma
- to treat some types of acne
- to reduce fine lines