How Effective Are Frequent TCA Peels for Melasma?

I've had TCA peels for my diagnosed melasma, the process is slow but there are some improvements. How effective will frequent treatments be?

Doctor Answers 7

Superficial chemicals are a great treatment for melasma

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Superficial chemical peels like TCA (lower strengths), glycolic acid, Jessner's solution and salicyclic acid are a great treatment for melasma...and in my opinion, they are the best. treatment for melasma. You will need a series to obtain the desirable result. It is also helpful to be on a good skin regimen which usually consists of a retinoid like Retin-A, a bleaching agent with hydroquinone and a great sunscreen.

I hope you find this answer helpful.

Austin Dermatologist

TCA and Melasma

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Melasma is a very stubborn problem where you must deal with the treatments to alleviate the melasma, but, also prevent new areas from forming and recurrence of the melasma. TCA treatments can have varying strengths. The lower the percentage, the weaker the peel and the less deep the peel will penetrate. If it is a 10% TCA peel it can take several peels to get to the level of the skin where the melasma has originated, and still may not alleviate the melasma.
Combination products that include Hydroquinone, Retin A, and a hydrocortisone if there is an inflammatory component will help decrease the melasma and prevent recurrence. Also, sunscreen is essential.

Philip S. Schoenfeld, MD, FACS
Chevy Chase Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

TCA peels are very effective for melasma

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In the right hands, TCA peels are very effective for melasma. In the wrong hands they can lead to a worsening of the condition. Choose a dermatologist with lots of experience in pigmentary problems.

William P. Coleman III, MD
Metairie Dermatologic Surgeon

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TCA Peels

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It is much more effective to combine a good skin care (Obaji) , with peels to treat melasma.

The skin is prepared for 6 weeks then start a series of peels and add triluma and TCA peels. Maintain with Obaji skin care and sunblock. If you are on hormones such as birth control and can stop then do so.

Samir Shureih, MD
Baltimore Plastic Surgeon

Melasma can be hard to treat

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Melasma is caused by various factors such as hormones, sun and skin type. The more pigment in the skin the greater risk of developing melasma.

I would recommend talking to a knowledgeable dermatologist about all your option, including skin creams, lasers, peels and sun screens. In order to obtain a lasting result, I recommend adding a pro-active skin care regimen.

I hope this helps.

Dr. S

Lenore Sikorski, MD
Orange County Dermatologist
4.4 out of 5 stars 25 reviews

Several TCA peels and triple bleaching creams do great for Melasma

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Several light TCA peels at $175-250 each at 2 week intervals followed by twice daily cortisone lotion for 2 weeks and daily sunscreen and nightly triple bleach cream works amazingly to resolve melasma. Once clear then you use the triple bleach weekly and a daily sunscreen to prevent recurrances. 


David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

Use bleaching preparation plus TCA peels

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You may want to consider the combined use of TCA plus a hydroquinone, Retin-A, and steroid preparation which may provide additional and more rapid response to treatment.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 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.