Was the 50% TCA Chemical Peel Too Strong?

After a 50% TCA I would expect your whole face to be red, swollen and tender (not just your cheeks). If there is pus or oozing then you need a topical prescription antibiotic such as Bactroban 3 times a day. Most redness and swelling at 5 days is to be expected and can easily be treated with prednisone 20 mg twice a day and a topical steroid cream such as triamcinolone cream 0.1% twice a day. Blisters and sores around the mouth would indicate a reactivation of your cold sores or fever... more

I hate to second guess qualified physicians, so my first question would be if your friend is a board certified dermatologist or plastic surgeon familiar with aggressive peels and how to manage the wound healing period and any complications. 50% TCA is aggressive and seldom used (but not incorrect under certain circumstances) because of safer options of layering peeling agents of lesser concentration. The other issue is who compounded the TCA and how old is the batch since it can get more... more

Redness, swelling and some crusting for 7-10 days after an aggressive chemical peel is expected, but worsening redness after 5 days is concerning for possible infection e.g. cellulitis. A contact dermatitis or other complication is also possible. I would advise you to follow up immediately with the individual who applied the peel (if he or she is a qualified practitioner experienced in dealing with post-peel complications). The faster a post-peel complication is appropriately managed,... more

In my practice I routinely do 35% TCA peels. I do not suggest TCA Peels more aggressive than this because the risk becomes significant. For patients who need something more aggressive than a 35% TCA Peel, I would suggest a different, safer alternative such as Laser Peel.