15% or 20% TCA Peel Effective for Fine Eye Lines?

Question

I've been using Tazorac for the past two years for very fine lines around my eyes, but I'm looking for slightly more dramatic results. Is a 15% or 20% TCA peel effective for fine lines around the eyes? Does the recovery period for a TCA peel at 15% or 20% differ markedly from a TCA peel at 25% or 30%?

David Hansen, MD · Answer

Doing a few 15-20% TCA peels around the eyes do great for fine lines or 1 peel of 30-35% TCA also ($350 each). The recovery time is 1 week with all TCA peels. The first day you look like you had a sunburn, then the next 2-3 days, the dead skin getting ready to come off turns dark, then the 5th - 7th day you are shedding like a lizard.  After 7 days you are just pink and makeup covers it well.  You can use makeup and moisturizers throughout the whole 1st week, just be gentle when you apply them and don't scrub your face. Be sure to use a prescription cortisone lotion such as desowen lotion at least twice a day for 1-2 weeks and sunscreen as well.  
The stronger the TCA, the more reaction occurs, such as you get more red and swollen and then darker before you peel and then you peel a lot more also. That is why some patients choose a few 15-20% TCA peels rather than 1 stronger 30-35% TCA peel to get to the same end point.

Chad L. Prather, MD · Answer

When attempting to improve fine lines of the face, particularly around the eyes or mouth, a medium depth peel is usually necessary. Light peels (such as TCA alone) are great for improving texture and pigment, but usually won't achieve the depth necessary to tighten collagen and decrease those fine wrinkles.
The most popular medium depth peel is a combination Jessner's and 35% TCA peel. This usually results in a 1 week downtime period of skin healing, followed by a few weeks of slight redness. Improvement in sun damage is immediate after healing, and improvement in wrinkles occurs over the next few months. While it would be great to achieve disappearance of wrinkles with less downtime, usually a medium depth peel is necessary rather than a light TCA only peel. In the case of wrinkles, light peels with less downtime just don't achieve the effectiveness most patients desire.
Be sure to see a qualified aesthetic physician (dermatologist or plastic surgeon) when trying to accomplish this much with a peel. Safety is paramount, and this is not the type of peel to have done in a salon, spa, or by a non-aesthetic physician.

John P. Di Saia, MD · Answer

Hello,
TCA peels can be effective in improving eyelid wrinkles. The recovery time varies with the depth of the peel, but then again so do the results. The lighter peels can be done with little or no anesthesia, so some patients choose them to keep things simpler figuring they will repeat them if they wish later.15% TCA might be a bit light unless it is left on a very long time. 20% is probably minimum. Some of this is technical as well though.

Bryan K. Chen, MD · Answer

Depending on your skin type, a TCA peel may be a very effective choice for crows feet wrinkles.  The results are even better if you have Botox (or Dysport) to the crows feet 2 weeks prior to your visit to decrease the muscle activity in that area for better healing.  The rate of healing from person to person is somewhat variable, but in general with a 15-20% TCA peel, you can expect 3-7 days of recovery, whereas with a 25 to 30%, you can expect 7-10 days of recovery time.
Good luck.

15% or 20% TCA Peel Effective for Fine Eye Lines?

Answers (4)

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