One High-strength Chemical Peel Vs. Several Low-strength Peels

Question

To help with pigmentation issues, dull skin, and fine lines, I'm considering having either a series of 3 to 4 7% TCA + 2% salicylic peels, or just a single TCA peel at a higher strength (25% to 35%). What would you recommend? What are the advantages and disadvantages of a series of low-strength peels vs. one higher strength peel?

Kenneth D. Steinsapir, MD · Answer

Several weaker peels does not equal one stronger peels.  The mild peel that you are describing is very mild.  It will modestly freshen the skin.  It is associated with almost no downtime.  However, the results simply will never equal the effect of a TCA 25%.  Two 25% TCA peels will never equal the effect of a single 35% TCA peel.

David Shafer, MD, FACS · Answer

Yes, several lower strength peels and be useful if you do not want to undergo a higher strength peel.  It is really up to you whether you want to undergo one long recovery (1 week or so for the higher strength peel) or several shorter recovery (1 day or so for the light peels).  Cost may also be a factor since one peel may end up being less expensive then several lower strength peels.  Good luck.

Sigmund L. Sattenspiel, MD · Answer

For those people who have significant sun damage with many areas of hyperpigmentation and telangiectasia (red spots) in association with multiple wrinkles (deep and moderate lines), I recommend CO2 laser resurfacing or a good deep chemical peel with a phenol solution. These are the gold standard treatments for these conditions. 
TCA at 25 to 35% will not appreciably help. Stronger TCA may help but there is a risk of scarring at the higher concentrations. For mild etchings of the skin in association with a dull and coarse complexion and mild pigment issues, I recommend an ongoing treatment with a good glycolic acid program consisting of monthly or bi-monthly chemical peels combined with the use of home glycolic preparations two or even three times per day. The glycolic acid
should be unbuffered with a low pH and a concentration of 50% (or 75% ) for the peels and 10% for home use.

Steven Wallach, MD · Answer

Without evaluating you specifically, light peels can be performed to give a gradual appearance with almost no downtime. However, it may not give you the results you want.  A deeper peel may be better and get the results that you want sooner.

Darryl J. Blinski, MD · Answer

First of all, 25 to 30% TCA is a medium peel not a high strength peel. I would always start with a stronger peeling to get the initial result than use lighter peels as a follow up. 
From MIAMI Dr. B

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One High-strength Chemical Peel Vs. Several Low-strength Peels

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Answer: One high-strength chemical peel vs. several low-strength peels

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