Trichloracetic Acid (TCA) Peels

Written By: Dr Kristie McNealy                              Reviewed:27 August 2010

Trichloracetic acid peels (TCA peels) are relatively aggressive chemical peels typically used for moderate to deep peeling.

Trichloracetic acid peels improve the skins surface, reduce fine lines and give a more uniform colour to the skin. TCA peels will also improve the elasticity of the skin and may remove precancerous lesions. TCA peels are primarily used on the face but can also be used on neck, arms and hands.

Is a TCA Peel Right For Me?

TCA Peels are commonly used for fine lines and wrinkles, blemishes and uneven skin colour. Full recovery from a TCA Peel can take between 10-14 days. During this time you will need to maintain a stringent post peel regimen and avoid exposure to the sun as much as possible. Patients are advised to limit sun exposure for several months to protect newly exposed skin. While recovery time is shorter than for a Phenol peel you may need more than one treatment for maximum results.

If you have dark skin there is a marginally increased risk of discolouration and your doctor may recommend an alternative treatment.

Before a Trichloracetic Acid Peel

You will be advised to use Retin-A or an alpha hydroxyl acid lotion for about two weeks prior to treatment. You should also stop using exfoliating products for about one month before the peel.

Antibiotics and an antiviral will be prescribed prior to treatment. These are started the day before treatment and continue until you are fully healed.

On the day of your peel you should clean your face thoroughly and refrain from applying any makeup.

The Trichloracetic Acid  Peel Procedure

Your skin will be cleansed again and degreased using acetone. Depending on the strength of the peel local anaesthetic will be applied and you may be sedated.

The doctor will apply the trichloracetic acid and leave it on the skin for around 30 minutes. The acid is then neutralized and cool compresses will be placed on your skin.

After the peel

It’s not uncommon to feel unwell after a moderate or deep peel.  Your skin will need 4-10 days to peel completely depending on the level of peel. Most Trichloracetic acid peels are moderate to deep, so full peeling usually takes 7-10 days.

For about a week you should only clean your face with warm water and a very gentle soap. Don’t use a sponge or facecloth as your face will be very sensitive. Pat your skin dry using a soft towel.

Don’t be tempted to assist the peeling process by pulling off loose or flaky skin; this will increase the risk of scarring.

Your face will be a little red or pink once it is completely peeled.

After the skin has peeled you can begin applying Retin-A cream or an alpha hydroxy acid lotion

You will need to stay out of the sun as much as possible. Use a strong (SPF 25+) cream every morning before going outdoors.

Possible Complications

Complications or loss of pigment is unusual after a TCA peel. Brown discolouration is possible but rare and usually reversible. You can reduce the chances of discolouration by ensuring good sun protection immediately following your peel.

The risks of complications are different for people with different skin colour. The darker your skin, the higher the chance of discolouration. You can reduce the risk by following a pre and post peel regimen. Your doctor will give you more detailed information about this.

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Alternative Treatments

• Skin Peels: Skin peels are cosmetic procedures used to make the surface of the skin look smoother, younger and more evenly pigmented

• Types of Peels: There are a range of skin peels available for different skin types and different depths of peeling.

• Laser Skin Treatment: Laser skin resurfacing uses a laser to remove the outer layers of skin.  As the wound created by the laser heals, the skin becomes smoother, firmer and less pigmented.

• Dermal Fillers: Dermal fillers typically replace levels of collagen or hyaluronic acid in order to plump up the skin, ad volume and restore a more youthful appearance.

• Collagen Injections: Collagen injections are used to remove crow’s feet, smile lines, nasolabial folds (under the nose) and frown lines.