TCA Tattoo Removal

I am using TCA (currently at 20%) to fade/remove a tattoo on my arm. My question is, do these peels go deep enough to fade/remove a tattoo? If not (other than laser) is there another approach with minor risk of scarring?

Doctor Answers 12

Light Therapies Work Best For Tattoo Removal

Prior to the introduction of light-based therapies, a variety of procedures were used for getting rid of them. These included dermabrasion, salabrasion, cryotherapy, chemical peeling. and surgical excision.
Each of these techniques relied upon stripping away the epidermis, the topmost layer of the skin, and exposing the pigment-laden dermis. Following exposure, the ink would be extruded as part of the healing process.

Unfortunately, chemical peeling with TCA 20%, which abrades the skin very superficially,  even with repeated use, is unlikely to do much to eliminate the deeply situation pigments within a tattoo.

Lasers and other light therapy devices, such as the Infrared Coagulater (IRC), are the treatments of choice today. Lasers work by emitting short, intense pulses of light that pass through the skin and target the ink. The energy from the laser light fragments the large particles of tattoo pigment enabling the body’s natural immune system to more easily scavenge the pigment and carry it away. This process usually takes several weeks, and multiple treatment sessions are often necessary to achieve maximal clearing.

Since black pigment absorbs all wavelengths of light, it is ironically the easiest pigment to remove. Colors, such as green, do not absorb as well, and sometimes a variety of lasers, with varying wavelengths, are needed to effectively treat a multicolored tattoo.

Potential complications include permanent scarring, temporary or permanent loss of pigment or excessive pigmentation. Fees for laser treatments may range from $1000-$3000 or more, depending upon the number of treatment sessions required, and the size, shape, colors, and location of the particular tattoo.

IRC uses non-laser infrared light to heat the area containing the pigment. It is quick and easy to perform, and generally requires fewer treatments than lasers. Most small tattoos can be treated successfully in one to three sessions. IRC’s efficacy also does not depend upon the particular color of the pigments involved. For these reasons, it is my favorite method for dealing with small tattoos.

The procedure is quick and simple. The area is first numbed with local anesthesia. Next, very short pulses of infrared light are directed at the tattoo in a gridlike fashion, leaving tiny spaces between each treated site. Since each burst of energy is just a fraction of second, an entire treatment session requires only a few minutes to complete. It is within the course of the next few weeks, as he wound heals, that the pigment is extruded.

To complete the removal, the intervening spaces are generally treated between two to four weeks later. Fees for a series of three sessions generally run about $1500. As with laser treatments, potential complications include scarring and temporary or permanent pigmentary changes. Most people, however, are quite gratified and relieved to be free finally of their tattoos. 

New York Dermatologic Surgeon
4.9 out of 5 stars 29 reviews

Maybe but I don't recommend a TCA peel for tattoo removal

Light TCA chemical peels (10-20%) probably won't do anything to a professional tattoo since they are deep in the dermis. A homemade tattoo is usually more superficial and deep both since you can't keep the needle at the same level as a professional machine can. Doing 4-6 TCA 20% peels at 2 week intervals will lighten a homemade tattoo but not remove it completely.

Lasers are so great at removing tattoos with almost no scarring that it is the only way to go. Stop peeling and go get the tattoo removed by a laser. You will be so glad you did.

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 42 reviews

Lasers are the safest and most effective way to remove a tattoo

The TCA peel probably won't work because it only effects the superficial dermis and does not target the pigment of the tattoo.

Older methods that didn't produce scarring include:

  • excising the tattoo and putting a skin graft on it
  • dermabrasion

Lasers are the safest and most effective way of removing tattoos even though they can cause skin discoloration.

Usha Rajagopal, MD
San Francisco Plastic Surgeon
4.6 out of 5 stars 38 reviews

20% TCA peel won't work on a tattoo.

Please don't use chemical peels to try to remove a tattoo.  Generally it won't work unless you burn really deep into the dermis, which will result in horrible scarring.  Please seek out a professional and preferable one with a pico-second laser.

Anh-Tuan Truong, MD, FACS
Chicago General Surgeon
5.0 out of 5 stars 45 reviews

Best Method for Tattoo Removal

The best method for tattoo remove is through the laser.  Chemical peels and other modalities do not penetrate deep enough to remove the ink from the tattoo that is in the deeper dermal layer of the skin.  Please consult a board certified dermatologist with the latest laser to safely and effectively remove your tattoo.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

100% won't work

20% TCA peels are relatively weak, but multicoating can increase penetration, however will definitively give scarring. Do not do this. 
TCA peels, gly peels, dermabrasion, salt abrasion are all HISTORICAL methods of removing acne scars. 

Laser is the only safe method to remove tattoos, and using a QSwitch laser, either nano second or pico second is the option. Lasers target specific colours in the tattoos, fragmenting them to smaller bits. Over time your immune system removes them. 

Dr Davin Lim 

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 74 reviews

TCA Tattoo Removal

Peels do not usually penetrate deep enough to give permanent results. Other than laser, you can have it surgically excised. Please consult a board certified plastic surgeon for your individualized treatment plan.

Tim Sayed, MD, MBA, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 16 reviews

Leave tattoo removal to lasers

My first thought is why would you be using a TCA peel for a tattoo in 2013 when there are great lasers out there which, when done properly, can effectively remove the tattoo in a scarless fashion?  And 20% TCA is not a very strong strength of TCA and probably is not strong enough to remove any of the deeper components of the tattoo and if you go much stronger, and are off the face like you are, you significantly increase the risk of scarring, and this would not be good.  Find a good laser doc and get it done right.

Michael Gold, MD
Nashville Dermatologic Surgeon
4.0 out of 5 stars 18 reviews

TCA tattoo removal

You are not likely to see much benefit from TCA peels for tattoo removal. For a peel to remove tattoo ink it will have to be a high concentration and that will lead to scarring. Laser treatment is a safer and should much better. With the correct laser, there would be injury limited to the tattoo ink itself  without damaging surrounding skin.

Roy G. Geronemus, MD
New York Dermatologic Surgeon
3.8 out of 5 stars 15 reviews

TCA won't completely remove tattoos.

Regardless of whether or not the tattoo is professional or self-applied, TCA (trichloro acetic acid) is a mild acid (used mainly for superficial facial peels) that will not go deep enough (at this 20% strength) to remove all or even most of the tattoo ink. TCA removes only the epidermis and very upper dermis. Healing takes about a week or so, and unless the patient develops an infection or damages the tissues while healing, there is usually very low risk of scarring or pigmentation change (skin color change). Unfortunately, the tattoo ink will in almost all cases be deeper than TCA can effectively treat.

Q-switched Nd-YAG lasers (1064nm) generally work the best for most tattoo ink colors, though blues and greens are more difficult to remove and will take more treatment sessions. Most Q-switched YAG lasers also have a frequency-doubling capability (532nm, or half the wavelength) which allows efficient treatment of reds, oranges, and yellow tattoo inks. THe Q-switched alexandrite laser (755nm) is somewhat more effective for treatment of green and blue tattoo inks, but this laser is expensive, finicky, and prone to breakdowns, and is rarely seen in regular use for tattoo removal.

Don't waste your time with TCA; although low, as noted above, there is a risk of skin infection, scarring, or color change, particularly if you try too hard or increase the concentration of the TCA. Laser treatments are still the best, though multiple treatment sessions are necessary, they are somewhat costly, and there is about a 10% overall risk of scar, skin color change, or residual ink even with the best laser treatment.

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 254 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.