TCA Chemical Peels

TCA chemical facial peels have been used for years to rejuvenate the skin.  They are excellent for skin tightening, softening fine lines, and smoothing out skin color and texture. The TCA (trichloroacetic acid) peel is a medium-depth peel, and is very popular for skin of all colors and imperfections. TCA chemical peels can vary in strength from 10%-50% depending on the skin tone, imperfections, wrinkles, etc. that are in need of improving. TCA chemical peels at higher concentrations produce deeper peeling, as does the number of applications (layers) of TCA applied to a given area.

Properly preparing your skin beforehand along with proper aftercare are all important to getting the most out of the treatment. Here are the 5 most important things to know and do before and after a peel.

Chemical peel

1. Prepare your skin:

Patients undergoing TCA chemical peeling should pre-treat the skin with an alpha hydroxy acid (AHA) product for 3-4 weeks prior to the peel. Products containing AHA encourage exfoliation and faster skin cell turnover. This will result in a more even peel and reduce the risk of hyperpigmentation after the peel. Patients that have any potential for hyperpigmentation (i.e. darker skin tone, history of dark scars) are asked to use a product containing 2% hydroquinone, a “fading cream”, in addition to the AHA product for 3-4 weeks. This will further reduce the risk of hyperpigmentation after the peel. You can get AHA online or at certain pharmacies.  We really like the product from Acne.org. Palmers Skin Success Fade Cream (2% hydroquinone) can be purchased online or at most Walmart, CVS, Rite Aid, Walgreens stores.

Alpha hydroxy acid cream

Alpha hydroxy acid cream

Palmer's Skin Success Fade Cream

Palmer’s Skin Success Fade Cream

2. Prevent complications:

TCA chemical peels may cause an individual to develop a cold sore if they are prone to getting them. Prescription anti-viral medication will be prescribed for a couple days before and after the peel to prevent a cold sore outbreak for all patients with a history of cold sores. Please tell your physician if you have a history of cold sores.

3. Let the skin heal:

In the days immediately following the TCA chemical peel, your skin may take on a dry, brown appearance after the initial redness has faded (usually around days 3-5). This is normal. This is the stage right before the skin begins to shed. Do not force the peeling process by attempting to peel any skin that has lifted.  It is very important that the skin stays intact until it’s ready to slough off on its own, as it is acting as protection to the fresh new skin underneath. Twenty-four hours after your peel, use a very mild cleanser (such as Cetaphil) to wash your face gently with your fingertips. Gently pat your face dry and reapply the antibiotic ointment put on right after the peel. You can also use Aquaphor, Eucerin, or similar thick moisturizer. Do not use abrasive scrubs, cleansers, or cloths on your skin for at least 14 days.

 4. Protect your skin:

After the peel, it is absolutely essential to protect yourself from the sun. The TCA chemical peel makes you very vulnerable to sunburn, which can also cause discoloration of the skin. You must commit to wearing a zinc-based sunblock of 30 SPF or higher everyday in the weeks prior to the peel, and for at least two months after the peel is done. This step is absolutely crucial in terms of your outcome after the peel. Failure to wear sunblock after the peel will result in scarring and hyperpigmentation (dark patches).Make sure the sunblock you purchase contains zinc as one of the active ingredients, as zinc provides a “barrier” protection against sun damage, and is also nourishing to the skin. A few brands that contain zinc: Blue Lizard, Clinique “City Block SPF 40”, ECO Logical Skin Care “Green Screen”.

5. Repeat the treatment:

TCA chemical peels can show good results with only one treatment, but often a few treatments spaced 6-12 weeks apart are necessary to stimulate long-lasting change in the skin.  Many offices, including ours, offer deals when several peels are purchased together.  Once the skin texture has improved and you are happy withe the result, doing a peel once or twice a year may be all you need to maintain the appearance.

If you have questions about TCA chemical peels, call our office for a free consultation at (801)264-4420.  Thanks to Katrina Poulsen, RN for contributing to this article and helping to establish our office protocols for TCA chemical peels.