Medium Depth Peel. Will Jessner & TCA 35% do the job?

Had Jessner combined with TCA 25% and not happy with results on fine lines around eyes. Texture & tone are better but its the lines that bother me. They are static as I have regular botox and fillers. I'm in my mid 20s, Irish fair skin and smoked for 10 years but have quit 3 years ago. Use retin a and sunscreen. Was this a superficial peel, I was told it was medium. I frosted, began peeling day 2 after the peel and fully peeled by day 5. My skin wasn't raw. Will jessner & TCA 35% do the job.

Doctor Answers 7

Best peel for fine skin lines

Thank you for asking about your lines around your eyelids.
  • Thin, Irish skin does crease easily and can be hard to treat.
  • You are doing everything right -
  • Wait 3 - 6 months after this peel and if the results are not what you want, have a Hester peel of the lids.
  • It causes considerable swellilng and redness but if properly done, gives you the best chance of a good result.
Always consult a Board Certified Plastic Surgeon.  Best wishes. Elizabeth Morgan MD PHD FACS

TCA 30-35 + Jessner

My standard is 30 to 35 %, however over the years I have replaced most of my peels with lasers. Better control, less downtime and complications. Never the less, peels can give excellent results in many situations, including sun damage and wrinkles- pigmentation. All the bestDr Davin Lim Laser and aesthetic dermatologist

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 62 reviews

Lip Aging -- fillers, lasers, radiofrequency, microneedling/PRP

I find that lasers work better for lines around the mouth, but if you have not seen improvement with jessners + TCA 25 try TCA 30/35.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 168 reviews

Chemical peels

Thank you for your question ciaren. Chemical peels work well for facial rejuvenation and improvement of wrinkles. TCA works well in concentrations of 10-35%. Gary Monheit developed a technique where Jessner solution is applied immediately before 35% TCA. This allows for deeper penetration of the TCA and a more aggressive peel. While traditionally 35% TCA is used, any strength can be used, and the higher the concentration, the more aggressive the peel. It is common to start with lower strengths and then gradually go stronger on peels. Usually a series of peels provide the best results. Now with fractional laser technology such medium depth peels (as well as deep phenol peels) are being performed less frequently. Please follow up with your doctor for specific recommendations. Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 1 review

Medium Depth Peel?

A 25% TCA peel is generally considered a superficial peel.  Combined with Jessner's, it is a more aggressive superficial peel. If considering a medium depth peel (35% TCA plus Jessner's), you might also want to consider a series of moderate energy fractionated CO2 laser resurfacing treatments.  A peel will work well in the right hands, but the combination of ablation and thermal energy from the laser is considered the gold standard for skin resurfacing.  Only a consultation will provide the information necessary to make the right decision.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 82 reviews

Medium depth peel

Great question.  What you are describing, otherwise known as a Monheit Peel, works great, and it does more than what your 25% TCA did.  I like that you are currently on retina A, and are using botox to help with dynamic rhytids.  Irish fair skin will do well with a Monheit, however, sometimes you may need a little more depth to really polish those rhytids.  The best way to know is to see them and unfortunately without pictures its hard to make a recommendation.  Another option is certainly a medium Hetter peel (phenol based, percentage of croton oil changes the depth over a baker gordon) or a fractionated, ablative CO2.  I suggest you go and do a consultation with someone who is comfortable with each of these as every patient is different and obviously benefits from one vs the other.  I hope some of this helps.  Best of luck.

Miguel Mascaro, MD
Delray Beach Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

The more peels you do, the better your skin gets.

Many patients need several peels to accomplish what they want. Everybody should be doing at least 1 medium peel a year anyway but to get to the results you want may require a few to start with. If it is the lines around the eyes that is still bothering you then do a few jessner's plus 35% TCA peels just around the eyes. Then in the end, do a full face peel to blend the results nicely. It is very common to start with a lighter medium peel and move up as your skin tolerates a stronger medium peel.

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.8 out of 5 stars 37 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.