TCA Peel Overview
Dr. Amy Curtis explains the different types of chemical peels.
A TCA peel is a chemical peel used for skin resurfacing. A solution of trichloroacetic acid (TCA) is applied to remove the outer layer of skin. This allows new, healthier skin to emerge. TCA chemical peels are commonly used to treat sun damage, facial wrinkles, uneven skin tone, and pigment abnormalities.
How TCA peels compare to other chemical peels
A TCA peel is a light-to-medium strength peel. There are different types of chemical peels which vary according to their specific ingredients and strength. The depth of the peel is determined by a number of factors including how long the peel is left on the skin and whether it is applied lightly or rubbed more vigorously onto the skin.
In addition to the face, TCA is also applied on the neck and other areas that have been exposed to the sun. TCA peels are often preferred for small areas, like around the mouth and eyes, because the TCA formula has less bleaching effect than some other peels. This can also make TCA peels a better option for patients with darker skin.
Mild TCA peels can be repeated frequently in order to achieve cumulative effects, or TCA can be used to achieve a medium or even a deep peel, depending on the acid concentration and manner of application.
If you have any of the following conditions you might be a good candidate for a TCA peel:
- wrinkled or sun-damaged facial skin
- vertical wrinkles around your mouth
- "crow's feet" lines around your eyes
- fine wrinkling of your upper eyelids
- brown spots or blotchy skin color
- certain precancerous skin growths
- acne or chicken pox scars
- superficial facial scars from a past injury
Like the other resurfacing methods, the TCA peel is effective in treating wrinkles, blotchiness or age spots, and scars from acne or other causes. Certain other characteristics of your skin, such as its thickness and texture, may influence whether you are a good candidate for this chemical peel.
Preparing for TCA peel
Your provider may place you on a pretreatment program where you will apply special creams, lotions, or gels. You may also be given oral medications to take prior to your peel.
Your skin resurfacing treatment may be performed in your provider's office, a free-standing ambulatory facility or a hospital. You should arrange for someone to drive you home after the procedure and probably assist you for a day or two.
Your provider will carefully examine your skin to determine which resurfacing technique, or combination of treatments, will provide you with the best results. Your skin type, the severity of any sun damage, the extent of uneven pigmentation and the depth of skin imperfections will be evaluated. Fine lines, coarse wrinkling or deep acne scarring each may require a different approach to treatment.
You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries, and medications that you currently take. Be sure to tell your provider if you have ever had X-ray treatments of your facial skin such as those used in the treatment of acne or if you have had a prior chemical peeling procedure. Current or past use of Accutane, as well as Retin-A and other topical skin preparations, must be reported. For your safety, it is important that you provide complete information.
Related: Read real TCA Peel reviews from people who had it done.
When the treatment is completed, your resurfaced skin may be covered with a protective ointment. In some cases, dressings, tape or a bandage may be applied.
Some people experience discomfort after a deep chemical peel. Any discomfort can usually be controlled with medication. A few days after the procedure, new skin with a bright pink color akin to sunburn will emerge. The pinkness will fade within a few days. Post-operative puffiness will also subside in a few days, but the skin will remain sensitive. Patients should avoid exposure to sunlight and continue to use sun block.
It is important to realize that the amount of time it takes for recovery varies greatly among individuals. During the first few days, you will likely experience redness and swelling to varying degrees. Depending on the post-treatment regimen, a scab may form over the treated area. You will be advised about cleansing your ski and when or if you should apply any ointments. In the case of men who have undergone resurfacing procedures, shaving must be delayed for a while. It is essential that you follow your provider's instructions and avoid doing anything that might interrupt the healing process.
New skin will begin to form after roughly a week. Once the initial redness subsides, your skin may be pink for several weeks to months. Camouflage makeup usually can be used within a couple of weeks, but your provider will advise you. Depending on the type and depth of your skin resurfacing, straining, bending and lifting should be avoided during the early period following your procedure. For deeper resurfacing, you should be able to return to work within a week or two.
It may take some time -- possibly even months -- before you can fully appreciate your new look. The results are worth waiting for and, in the case of deeper treatments, the benefits are relatively long-lasting. More superficial resurfacing treatments may need to be repeated periodically in order to maintain their benefits.
Your skin will continue to age and wrinkles caused by movement of your facial muscles will eventually reappear. Some wrinkles may return sooner than others, depending on their location and the extent of your resurfacing treatment. Despite this, you can expect improvements in skin quality and texture achieved by resurfacing will make your complexion appear younger and fresher for many years to come.
Skin resurfacing procedures are generally safe when performed by an experienced provider. Before the procedure, you should go over all of the potential side effects directly with your provider.
Typically, potential side effects include infection, abnormal healing, allergic reactions, raised or thickened scarring, and unanticipated skin color changes or blotchiness. Deeper peels could also result in a bleaching effect, and delayed healing or scarring.
It is important to avoid direct or indirect exposure to the sun until all the redness or pinkness of your skin has subsided. Even after that regular use of a sunblock is advised. If the area around your eyes has been treated, you should wear good quality sunglasses when outdoors. After some types of skin resurfacing treatments, you may need to be careful about exposing your skin to chlorinated water.
You can minimize certain risks and help to maintain the results of your skin resurfacing treatment by following the instructions of your provider.
The average cost of a TCA peel is $200 according to data from hundreds of RealSelf members. The cost can vary widely, largely depending on your location and the experience of your provider. The extent of your procedure can also play a role, especially with the use of anesthesia.
Skin resurfacing procedures usually are not covered by insurance. Occasionally, however, if the resurfacing is being performed to treat precancerous skin conditions or improve certain types of scars, insurance coverage may be available. Your provider can explain how to find out if your procedure will be covered.
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