Will a Burn from a 20% TCA Chemical Peel Cause Scarring?

In a real sense, most all chemical peels are controlled burns to remove the upper, aged layer of skin so a new layer can replace it. As mentioned before, percentage does not always control depth and good post peel care is critical to prevent changes in pigmentation.

In certain individuals, even 10% TCA can cause scarring, though this is unlikely to occur. Although permanent scarring and discoloration from 20% TCA peel is uncommon, it can occur. Usually any dark pigmentation from this peel gradually fades, returning to the normal skin color after several weeks to months. Areas that are more likely to scar are areas of persistent redness. Certain measures such as cortisone creams can be used to decrease the risk of permanent scarring.

It all depends on the depth of penetration. A 20% TCA peel could go as deep as a 35% if several paths are made during the treatment. A well trained practitioner knows the end point of the application and stops before reaching it. If you have some burn from it, protect it with a sunscreen and antibiotics till complete healing. Mild discoloration could go away.

All 20% TCA peels burn when applied. This feeling has nothing to do with scarring. These peels rarely cause"scarring" on the face but can cuase problems on the neck. Increased pigmentation can be avoided by choosing the right patient to peel, pre-peel treatments and sun avoidence after your peel. Decreased pigmentation is very uncommon from such a peel. 

Usually we do 20% TCA peels to not go as deep and thus prevent hypopigmentation or scarring. If one exceeds the normal depth of peeling with this agent, they can both occur. This can be prevented by choosing a surgeon with the experience to know how to recognize the proper application for the depth of peel desired.