Best Option for Skin Resurfacing: TCA 30% or Phenol Croton Oil Peel? (photo)

Question

First and foremost, I should like to thank all the doctors who have answered my question regarding eyelid surgery so diligently. Their views have lead me to question my first intention to go for eyelid surgery. I am considering a chemical peel instead and hesitate between the TCA 30% and the exopeel. I am concerned about the risk of scarring and hyperpigmentation with a TCA but the cost difference between both treatments is...substantial! Any advice is welcome. Thank you in advance.

Kenneth D. Steinsapir, MD · Answer

An exopeel is basically a variant phenol/croton oil peel.  As such, it has a substantially higher risk of scaring than a 30% TCA peel which is marginally a medium depth (more like an aggressive superficial peel.  WIthout meeting you, I would be concerned that the deeper peel is probably going to be excessive.  We have a saying that less is more.  One can always be made deeper but undoing a peel that scars is very challenging.  Please proceed with caution.

Manuel A. Lopez, MD · Answer

The 30% TCA peel is considered a medium depth peel vs. the phenol peel is generally considered a deep peel. Anytime you traumatize the skin (which a peel is controlled trauma) there is a risk of scarring and hyper/hypopigmentation. The aftercare is extremely important in both case as you need to avoid sun exposure and keep the healing tissue covered with ointment. Also at concentrations less than 50% the risk of scarring from TCA is very low. I recommend you discuss the pros and cons with your provider but both peels are good options. Best wishes.

Best Option for Skin Resurfacing: TCA 30% or Phenol Croton Oil Peel? (photo)

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Best Option for Skin Resurfacing: TCA 30% or Phenol Croton Oil Peel? (photo)

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Everything you need to know about Chemical Peel

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