Minneapolis TCA Peel doctors

Richard H. Tholen, MD, FACS Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4825 Olson Memorial Highway (Hwy 55) Suite 200, Minneapolis
1 answer
Patrick S. Carney, MD Patrick S. Carney, MD
Minneapolis Dermatologist
625 East Nicollet Blvd Ste 200 & 203, Burnsville
Douglas L. Gervais, MD Douglas L. Gervais, MD
Minneapolis Plastic Surgeon
4825 Olson Memorial Highway (Hwy 55) Suite 200, Minneapolis
Mimi Cho, MD Mimi Cho, MD
Minneapolis Dermatologist
3316 W 66th St Suite 200, Edina
Julie Cronk, MD Julie Cronk, MD
St. Paul Dermatologist
1185 Town Centre Drive Suite 220, Eagan

Recent Answers

What Causes Frosting in the Skin with a TCA? What Happens to the Skin?

What happens to the skin that is frosting? I want to know why it turns white.

A: TCA turns skin white as proteins denature.

As others have explained, the change in skin color when trichloroacetic acid (TCA) is used on the skin is the chemical equivalent of heating the albumin in egg whites--these proteins turn from clear to white. In this (chemical peel) usage, frost refers to color, not temperature. In a chemical (TCA) peel, the change in the surface proteins is chemical, not thermal, though it certainly "feels" hot as the nerve endings are stimulated by the acid "burn."

One important fact is that the degree of whiteness is an outward manifestation of how thorough the proteins are being denatured, related to the strength and duration of the acid application. The dead outer layer of denatured proteins slough off after a few days (the "peel") and the living dermis and epithelial cells in the skin adnexal structures (hair follicles and sweat glands) produce both collagen and elastic fibers in the dermis as a new epithelial surface forms on top of it, just like healing a blister or superficial burn.

Just like a thermal burn, the depth of injury determines the degree of healing, and the amount of wrinkle tightening. (Too-deep tissue damage, or deepening the injury with infection or drying can cause scarring, just as a too-deep burn can.) The new cells also must return from the dark peeled color, to red/pink, to normal skin color that can be more even-toned than prior to the peel.

The blue color in the Obagi Blue Peel is just one doctor's (very successful) way of modifying the peel chemicals to try to better control peel depth and safety. But the active ingredient is still TCA.

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
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