Will a TCA Peel Under the Eyes Help with Small Syringomas?

TCA can be applied by your doc to each individual syringoma to flatten them down and usually needs a few treatments a month apart.  Your doc can also burn them down with lasers or electrofulguration as well.  They always come back but may take several yrs to regrow once flattened completely. Sincerely,

David Hansen,MD

TCA peels are not very effective for syringomas.  I prefer a combination of hyfrecation and selective fractional co2 laser. 

It seems that the two prior doctors who responded to your question disagreed with one another.  I am going to try to reconcile these answers for you. Syringomas under the eyes are a common problem.  In my opinion, the TCA peels that I commonly employ range in concentration from 15-30%, and this would likely not be beneficial in treating your syringomas.  I would not want to apply a higher concentration of TCA than this diffusely in the periocular area (around the eyes), because of concerns about skin contracture and scarring.  On the other hand, focal (not diffuse) application of a higher TCA concentration directly to the syringomas, as advocated by one physician, might be quite beneficial in relieving this annoying problem.  As an alternative, they could likely be removed surgically and yield an excellent cosmetic result.  I hope that this explanation helps you.  

Syringomas are benign tumors located in the dermis.  TCA peels do not penetrate that deeply.  The best was to remove syringomas is to individually vaporize the tumors using a small spot CO2, erbium, or combinaiton CO2/Erbium YAG laser.  I have been treating syringomas with this method for over twenty  years.  It is possible to completely remove syringomas in a single treatment with excellent cosmetic results.

I doubt that TCA peels would work very well since microscopically these lesions can be very deep seated despite giving a very localized appearance.  TCA CROSS may work, but I have not heard of this being used for syringomas, but would be an interesting approach, but difficult to administer because of a lack of a pore like in an ice pick scar.  Lasers can work, but over time, unpredictably, they will recur.  But temporary relief may be worth it.  I have personally seen an improvement with fractionated CO2 lasers, but it is not a complete improvement, but a lessening of their prominence.