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What is a TCA peel?

Arthur W. Perry, MD
Plastic Surgery
Trichloroacetic (TCA) peel is a light chemical peel. Many people don't relish the idea of two weeks in hiding while waiting for their new skin. Less drastic types of peels were introduced in the 1980s, using trichloroacetic acid (TCA). This procedure hurts when performed, but peels more superficially than when phenol is used. The epidermis and superficial dermis peel, healing in five to eight days. The more superficial the peel, the fewer wrinkles are removed. TCA concentrations range from 15% to 50%, alone or in combination with other chemicals. Higher concentrations result in deeper peels. The TCA peel is useful for pigmentation irregularities, such as sun damaged skin and discoloration from pregnancy. It helps wrinkles and other sun damage. Acne and large pores are improved. Even some premalignant conditions can be corrected.

Literally dozens of factors can be altered in the TCA procedure, resulting in different levels of peeling. The thickness of the skin, the pre-peel use of creams, the type of cleansing the day of the peel, the TCA concentration, how hard the chemical is rubbed in, how many strokes the surgeon uses to apply the peel, and how the peel is cared for afterward all affect the result. The TCA peel is part art and part science.

To try and achieve better results, TCA has been combined with dry-ice peels, Jessner's solution (resorcinol, salicylic acid, lactic acid, and ethanol), methylsalicylate, and glycolic acid. None of the combinations is better thanTCA alone.

Many people do not want any downtime. Not only does it take nearly a week for the TCA peel to heal, but there can be two weeks of redness afterward.
Straight Talk about Cosmetic Surgery (Yale University Press Health & Wellness)

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Straight Talk about Cosmetic Surgery (Yale University Press Health & Wellness)

The public’s recent exuberance toward cosmetic surgery has spurred an unprecedented demand for appearance-changing procedures. But how can an average consumer discern the hype from solid truth? ...
Dr. Doris Day, MD
Dermatology
Tricholoracetic acid can be used for superficial peels or deeper peels depending on the concentration. The goal is to eliminate the surface layers known as the epidermis of dead skin, or go to the deeper layers, to the level known as the papillary dermis. At this level more care needs to be taken since the risk of scarring increases. The peel is used in spot treatments for acne scarring, or to the whole face for people with extensive sun damage. TCA comes in concentrations of 5% to 50% for use as a peel. The higher the concentration of the TCA, the deeper the peel, and the higher the risk of scarring. After the deeper level TCA peels, your skin will initially appear frosty white, and then it will turn a deep red before turning dark brown about three days later and then peeling off over then next few days. Within one week to ten days, new skin that is fresh and radiant will appear. You may want to take some time off work or make sure you don’t have any major social engagements for about one week to ten days after the peel since the process can look unsightly for that one week period. But ultimately, fine lines will be erased, age spots will be diminished, and collagen production will be stimulated. Your skin will look and act younger.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.