Is a 20% to 30% TCA Peel Effective for Removing or Reducing Vertical Lip Lines?

The more peels you do the smoother the skin. Typically 3 TCA 30-35% chem peels would probably work in most cases. You would do them about 1 month apart . The fractionated CO2 laser or real dermabrasions also would be fine and require a few. The TCA peels run about $350 each. The CO2 laser or a real dermabrasion runs about $1000 each.

Lip wrinkles can be pretty stubborn.  You have to do something pretty aggressive to get them out.  Either a moderately strong chemical peel (40% TCA, or Hetter modified croton oil peel) or laser resurfacing can be used.  If weaker peels are used, repetitive treatments will be needed.

Vertical lip lines llocated above and below the lips, also  called "lipstick bleeding lines" (because lipstick typically bleeds into them) or "smoker's line" (although many nonsmokers have them), is a common problem resulting from chronic overexposure to the sun, genetics and the passage of time.

At one time, not that long ago, this problem was difficult to treat. Medium (such as TCA) and deep chemical peels and ablative laser surgery were the only approaches and these procedures were frought with prolonged downtime (recovery time) and the risks of scarring, prolonged redness lasting months, and permanent loss of pigmentation.

Today, most cases can be improved quickly and easily, with little downtime and few potential risks. My favorite approach is to start with Botox or Dypsort instilled in literally microdroplet amounts to the upper and lower lip regions to diminish the movement-related contribution of the muscles (i.e. dynamic wrinkles) around the mouth. If necessary, to supplement this effect, prolong it, and to deal with wrinkles present at rest (i.e. static wrinkles), I very superficially inject iny amounts of a filler material (such as Juvederm or Restylane).

Other current treatments that I have found helpful for this problem and that also engender little in the way of downtime and risk include radiosurgical skin tightening, mesotherapy, and medical microneedling.

This peel may soften them but unlikely to make them go away. At our office, we use TCA 35% and even that potency does not make the lines go away. We have had much better success/ luck with ablative fractional CO2 laser resurfacing; it is not uncommon to have to perform multiple sessions but it works great to soften/ efface the lines, and you see an effect at 6 months out due to new collagen formation.

Hello,

Upper lip lines (from smoking, sun exposure) might be improved with TCA peels, but I recommend a CO2 laser on these for more improvement usually.

 

Best Regards,

 

John Di Saia MD

We do a lot of aggressive chemical peeling in our practice, and I find that a strong TCA 35% peel can significantly improve vertical lip lines as well as other facial lines.   I personally think that one aggressive medium strength peel done by a well-trained dermatologist in the office can give results as good as those from several treatments with fractionated ablative lasers.  

Lasers are not all they care cut out to be. Sometimes we combine chemical peeling with other treatment modalities such as Botox, fillers, light electrodessication, or dermabrasion to maximize the results of the chemical peel or to address wrinkle lines that neither chemical peels or lasers can completely remove. Please feel free to look at our website for great TCA 35% peel results. Hope this helps!

The best option for peri-oral lines is deep resurfacing which even 50% TCA cannot deliver. Fractional CO2 is now the best option, although deeper dermabrasion may help a little. Combining a little Botox so the mouth does not "purse" as much will enhance the effect of CO2 resurfacing. Make sure you use sunscreen and that you do not smoke. These are the primary cause of such wrinkles.

The effectiveness of any peel is dependent on the degree of wrinkling that is present and the depth of the peeling action. The finer and less deep the lines the more effective a 20% TCA peel. As the lines become coarser, the depth of the peel needs to increase and a 30% TCA might be needed. Very coarse lines as seen in heavy smokers and patients with a lot of early sun exposure and sun burns might not be fully smoothed by TCA and you might need to combine ti with other modalities like dermabrasion or laser peels that are calibrated to a deeper level. Of course as the effectiveness increases, so does the possibility of complications like scars, slow healing and pigmentation issues. If you are risk adverse and the lines are quite deep, you might want to accept the fact that you might need a repeat peel after 6 weeks and go slow. Discuss all options and risks carefully with your doctor.