Strong Disagreement with Plastic Surgeon's TCA Post Peel Advice

I am 28 with minor sun damage on my face which I wanted reversed so i saw a plastic surgeon who put me on 0.1% Retin-A +4% hydroquinone & gave me an 8% TCA peel today.He's asked me to continue using the products immediately & get another 8% tca peel next week.His regimen sounds too aggressive & even dangerous.I'd like to allow my skin to heal naturally for at least 2-3 weeks.He told me he has 20 years experience and knows what he's doing,but honestly I am freaking out.Any recommendations?

Doctor Answers 5

Strong Disagreement with Plastic Surgeon's TCA Post Peel Advice

Very hard to advise since we can not examine you or the skin. It does sound slightly aggressive. Why not wait 2 to 3 weeks between treatments, saying your work delayed a return. Just a thought. From MIAMI 

Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Patients need to follw TCA peels with their own common sense

Patients need to follw TCA peels with their own common sense. In an age where doctors and patients alike practice braggadagio it is best to use common sense in post peel therapy.

Edward Lack, MD
Chicago Dermatologist
2.8 out of 5 stars 5 reviews

Stick with Dr's advice on post-peel management

There are a number of different approaches to managing skin care with TCA peels and they are often tweaked according to each specific patient. The 8% TCA is not especially strong so overall it doesn't sound overly aggressive.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 53 reviews

Minor Sun Damage Can Easily Be Treated With the Obagi NuDerm System

One of the most effective ways to reverse sunspots due to the effects of chronic sun damage to your skin is by using a combination of two prescription strength medications: 4% hydroquinone and tretinoin cream. Prescription strength 4% hydroquinone is better than any OTC product for lightening dark spots in the skin. Combining prescription-only tretinoin cream with hydroquinone will make it even more effective. I recommend the Obagi Nu-Derm System which uses both tretinoin cream and hydroquinone to visibly lighten age spots as well as the fine lines and wrinkles that are due to chronic sun exposure. The Obagi system significantly enhances the penetration of these two medications making them much more effective. 

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

8% TCA peel

Dear Soniak - I would agree that the 8% TCA is not overly aggressive at all - and I would suggest to you that the routine outlined by your practitioner is not unreasonable.  The Retin-A and the Hydroquinone are prepping the skin for the peel.  My instructions if I were to offer such a skin routine would including stopping these two products 2 days prior and not starting again for 2 days after the peel.  The weekly application (for 2 applications) of the 8% TCA is likely to generate a nice result in a safe manner.  Keep us posted.

Paul E. Kelly, MD
Hamptons Facial Plastic Surgeon
3.8 out of 5 stars 5 reviews

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