TCA Peels Before Fraxel Laser to Get Full Benefit?

Question

I'm considering getting Fraxel on my face. At one clinic I was told that I should get a TCA peel 30% at least 20 peels each a week apart before doing Fraxel or I will not fully benefit from the treatment. Should I get it on my neck as well?  I was informed that since I'm olive-skinned, I may end up getting dark. I'm confused and need some clarification. All I need is eliminating fine wrinkles, spider veins, some discoloration and getting a dewy, glowy complexion. Thank you for your time.

Jennifer Parker Porter, MD, FACS · Answer

TCA peels are working in a similar manner as the Fraxel treatment.  20 peels spaced a week apart does not sound possible.  Perhaps that is a typo.  Typically our patients with olive skin will begin a home skin care regimen prior to having a Fraxel re:pair treatment.  Some patients will undergo one or two superficial peels (glycolic) prior to the Fraxel treatment when they plan to have the treatment in a delayed fashion.  I would discuss this further with your doctor to clarify the treatment plan.

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian 
Realself100 Surgeon

David Hansen, MD · Answer

"Shaving down the sides of the nose" is not a clear statement. Doing a septoplasty and turbinate reduction is for improving the nasal airway and is not a cosmetic operation. Doing procedures to change the external appearance of the nose (Rhinoplasty) is a different operation that may or may not be done at the same time as the septoplasty. It needs to be clear if you are asking for cosmetic surgery , and if so, what you want changed such as thinning or reducing the dorsum, refining the tip, making the nose smaller, etc.
Make sure you are clear on the plan before agreeing to surgery.

Michael A. Persky, MD · Answer

Hi Meeting Point,
That was meant to be 2 peels, not 20, correct?
You can get excellent results with Fraxel repair without having TCA peels. If your physician recommends two TCA peels for optimal results, like chicken soup, it can't hurt.
To minimize your chances of hyperpigmentation, wear sun block, wide brimmed hats, and avoid sun exposure religiously.
Enjoy your rejuvenated skin.
Dr. P

Elizabeth F. Rostan, MD - Account Suspended · Answer

A. Fraxel and TCA peels: I cannot see the need for that many TCA peels prior to a series of fraxel laser treatments. Sometimes I do combine other laser treatments with Fraxel in order to enhance results. Some examples of lasers used in combination with Fraxel are:

Vbeam pulsed dye or Gentle YAG 1064 for bood vessels or redness
GentleLase long pulse alexandrite or a q-switched alexandrite laser (ex: alex trivantage) to treat pigmented spots - freckles, melasma
Smoothbeam non-ablative laser for depressed scars

Additionally, I commonly use 90% TCA to the base of ice pick type acne scars (CROSS technique) immediately prior to Fraxel to help with these difficult to treat deep scars.
B. Darkness after Fraxel: Even with olive skin, the risk of darkness or what is called medically PIH - post-inflammatory hyperpigmentation - is very rare even after moderately aggressive Fraxel treatments. If you aer concerned about PIH or have experienced darkening after skin wounding previously, then discuss with your physician adjusting the settings of Fraxel laser to minimize the risk of PIH. PIH is also very treatable if it does occur.

TCA Peels Before Fraxel Laser to Get Full Benefit?

Answers (5)

Answer: Fraxel Laser and TCA Peels

Answer: Fraxel Laser and TCA Peels

Answer: TCA not needed with Fraxel

Answer: TCA not needed with Fraxel

Recommended reading

Everything you need to know about Fraxel Laser

Our mission is to create a world where every investment in modern beauty is Worth It.

TCA Peels Before Fraxel Laser to Get Full Benefit?

Answers (5)

Answer: Fraxel Laser and TCA Peels

Answer: Fraxel Laser and TCA Peels

Answer: TCA not needed with Fraxel

Answer: TCA not needed with Fraxel

Browse related questions

Recommended reading

Everything you need to know about Fraxel Laser

Our mission is to create a world where every investment in modern beauty is Worth It.