The use of trichloroacetic corrosive (TCA) as a peeling agent begins with a German dermatologist P.G. Unna in 1882. Over the past 40 years, a number of advancements and applications of the TCA peel have been made. TCA has been used with a variety of agents to achieve deeper peel including solid CO2, glycolic acid and manual dermasanding. Recently, there have been promising reports that using TCA with higher strength can treat deep acne scars. (1)
Types of Chemical peels
Chemical peels are rejuvenation of the skin through removal of the keratin layer of dead skin cells that sits on your skin’s epidermal surface. It also rejuvenates by stimulating the production of new healthy epidermal cells. This technique stimulates your epidermal growth with collagen stimulation in the underlying dermis, gives a tight effect and more even distribution of melanin. (2)
Skin peels are classified by their depth of penetration into the skin. There are superficial, medium and deep peels. The depth to which each specific peel penetrates when applied to the skin affects the clinical outcomes achieved. Not surprisingly, the deeper the penetration of the peel, the greater the changes achieved. However, the depth of the peel also represents the amount of injury caused to the skin and so it will affect the ‘healing time’. Hence increasing depth will increase the risk of possible complications.
The depth reached by TCA peels is affected by a number of factors :
- Type of the skin (thicker skin can tolerate with higher concentration)
- The strength of TCA
- Cleansing before applying the treatment.
- Lower concentration of TCA can be used if blended with other active ingredients.
How does it work ?
A TCA peel dissolves cells in the top layer of your skin (epidermis). After your skin has been affected by TCA, new cell growth is encouraged underneath. Once your top layer of skin has peeled off, a new skin cell becomes visible. You will be happy with the skin as the new layer of skin is smoother and less affected by acne scar and also wrinkles.
Who is suitable for a TCA peel ?
First, you need to understand the classification of healthy skin. Most of the patients come to the clinic because they want healthy skin. Generally, healthy skin is
- Even skin tone
- Able to heal quickly after the injury
- Has good circulation
- Firm and smooth with good collagen and elastin production.
- Free from damage like sun damage or acne.
If you have any of the following symptoms, you may be a good candidate for a TCA peel:
- Acne scar and chicken pox scars
- Ice Pick scar
- Brown spots
- Sun damaged facial skin
- Crow’s feet around eyes
- Actinic keratoses
- Superficial melasma
- Superficial hyperpigmentation
- Depressed scars (CROSS technique)
- Seborrheic keratoses
- Hypertrophic keratosis
- Mixed melasma
- Mixed hyperpigmentation
Benefits of using TCA peel ?
There are actually a lot of benefits using TCA peel.
- Reduce acne and heal acne scar
- Sun damage
- Reduce hyperpigmentation
- Brighter and lighter skin
- Improve skin tone and texture
- Reduce the appearance of lines and wrinkles.
- Renewal of skin’s structure like collagen and elastin
- Treat open pores
- Stimulate new cell
Where is the targeted area for TCA peels ?
TCA peels are usually applied to your face. However it can also be used to improve skin at your body area.
- At your back
- Chest area
- Upper arms
Are there any side effects ?
According to Soleymani et al. people generally can tolerate well with lower concentration of solution. You can expect about 7-14 of healing time (3). Your skin may also
- Become red
- Swell for 24 – 48 hours
- Blister and break open
Some other common side effect that can occur are:
- Temporary darkening of the skin
- Persistent discoloration
- Scaring (the risk is reduced if you choose a certified dermatologist. Avoid non -medical provider)
- Lighter skin color
Here are some steps you can follow to avoid serious side effects.
- Follow all advice and instruction from your dermatologist
- Wear a sunblock and limit sun exposure
- Do not picking treated skin
- Do not apply make up before the skin is ready
What to do after the treatment ?
Our dermatologist will explain in detail after you have done the treatment. Generally you need to use a gentle cleanser and moisturize your skin with moisturizer or ointment. It is also very important to always wear sun protection after the treatment.
Do not try to speed up the peeling process by picking at your skin. Usually the skin will peel between 4 to 10 days. Speeding up the peeling process will cause you to get infection, poor healing and also dark spots!. Your skin care routine can be started again after your skin fully repairs from chemical peel.
How to find a good dermatologist ?
The most important thing is please avoid non-medical providers for a peel as the risk of potential side effects is higher. Do not easily trust the low price that they offer.
The best and safest way you can do is visit Klinik Hana and discuss with our dermatologist and experts about what is the best chemical peel that suits your skin. Our dermatologist is the best in this area and will advise you with the details about the treatment. Don’t try to use your own formulation or natural chemical as it may cause permanent damage to your skin and make it worse.
How many TCA peels does it take to see results ?
Your skin can be improved after one peel. However, for severe scar, hyperpigmentation or sun damage, it needs more than one peel to really get a clear skin. You can schedule the next TCA peel after a few weeks or months of first peel. Once you have obtained your desired result, you can schedule for maintenance. Consult with a dermatologist at Klinik Hana as we know your skin better.
1) Rendon MI, Berson DS, Cohen JL, et al. Evidence and considerations in the application of chemical peels in skin disorders and aesthetic resurfacing. J Clin Aesthet Dermatol 2010;3(7):32-43.
2) Brody, H. J., Monheit, G. D., Resnik, S. S., & Alt, T. H. (2000). A history of chemical peeling. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 26(5), 405–409. Link Here
3) Soleymani, T., Lanoue, J., & Rahman, Z. (2018). A Practical Approach to Chemical Peels: A Review of Fundamentals and Step-by-step Algorithmic Protocol for Treatment. The Journal of clinical and aesthetic dermatology, 11(8), 21–28. Link Here