TCA Chemical Peels

Tricholoracetic acid (TCA) is a chemical solution. It is a strong acid made by chlorinating acetic acid - and is widely used as a chemical skin peel. This procedure aims to improve the skin's appearance by removing the outer layer of damaged skin to reveal the underlying layer, which is newer and smoother in texture.

TCA chemical peels are more effective than alpha hydroxy acid (AHA) chemical peels (i.e. glycolic acid) in removing superficial skin, but does not penetrate deeply as carbolic acid skin peels (i.e. phenol). It is generally referred to as a "medium depth" chemical peel. The main targets of a TCA chemical peel procedure are those individuals with:

• Fine surface wrinkles
• Pigment discoloration (blemishes and blotches)
• Age (liver) spots
• Superficial acne scarring
• Dark circles under the eyes

The advantage of the technique of tricholoracetic (TCA) acid application is that the degree and depth of penetration within the skin can be controlled accurately according to specific requirements. The concentration of TCA in the chemical peel is an important factor that alters the depth of the peel. Concentration can vary from 15 to 50%, with the higher concentrations leading to a deeper peel.

Medium peels are generally performed as office procedures on an out-patient basis, and require approximately 15-60 minutes. TCA peels will cause a burning sensation that will last about two to ten minutes. Your surgeon may offer you pain pills or sedatives to help you tolerate this burning during peeling agent application. When the desired depth has been achieved, your physician will neutralize the peel by applying iced saline. Once all areas have been neutralized, your skin will return to its normal color in 15 to 45 minutes.

Your face will be covered with an oil-based ointment, steroid ointment, or vegetable shortening to keep your skin moist and promote healing. Post-operative pain medication is normally not required. Within a few days, your superficial layers of skin will turn dark, become stiff, and leathery. The skin will then crack, flake, and peel with flaking usually complete in four to seven days. Once your old skin has sloughed, your new skin will be bright and flushed.

Typically, you will be able to return to your normal activities immediately, and most people can comfortably return to public within a week. Your flushed appearance will fade slowly over several weeks.

Unlike deep peels, medium peels may be performed safely on people with olive and light brown skin. However, people with dark brown skin are at a higher risk of discoloration.

Medium chemical peels will last six months to two years. If you use skin care products regularly after your peel, you will maximize the duration of improvement. Most women who choose medium chemical peels as the mainstay of their facial rejuvenation have a repeat peel every six to twelve months. TCA chemical peels provide an intermediate level of improvement at an intermediate cost and recovery period. They are ideal for individuals who want more than a superficial peel, but cannot afford the expense or recovery time of a deeper treatment.