35% TCA with Phenol Peel - New York, NY

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I was debating a deep chemical peel for awhile now...

I was debating a deep chemical peel for awhile now. I had researched extensively the phenol/croton oil peel in particular because the results I saw that people achieved were incredible.

I am a 36 year old female with very mild acne scarring on my cheeks, some hyperpigmentation issues along with some melasma that recently started to form... I guess years of sun exposure while driving my car with no sunscreen left the left side of my face with more hyper-pigmentation and wrinkles than the right side. It was by no means terrible, but I knew that the aging process was creeping up steadily.

My skin can tolerate acids quite well, as I have been doing them with derms and on my own for years. At home I can do 2 layers of 15% TCA without any redness or very obvious peeling. I've done 25% TCA under my eyes with so-so results. Basically all these peels just kept my skin looking just okay, and even nicely smoothed out wrinkles... but they never changed the texture of my skin permanently, or some of the stubborn hyper-pigmentation.

So I went to my plastic surgeon and opted for the croton oil peel. He basically laughed in my face and told me to wait about 15 years. He told me that what he would do is mix a small percentage of phenol with TCA to tighten and remove discolorations.

I went in on a Saturday evening (he opened the office just for me that night... so I could go home in the evening without people seeing me) and he layered the TCA/phenol until my face turned bright white and I started to yell "uncle". Then he put some wet gauze on me till the burning subsided. About 20 minutes later I lathered on some Oxygenetix foundation (research it... its actually concealer that is made for post-peel/surgery. Aids in healing and you can sleep with it on... its amazing) and wet my merry way.

I had no pain, but the next day my skin was brown and gross and no amount of concealer would hide it. I bought an aloe branch that I kept cutting open and slathering all over. Also Emu oil and the Oxygenetix kept my face hydrated. By Monday night, all the dead skin had come off (so quickly!), leaving bright pink skin in its wake. I do think I peeled so rapidly because I had been using a light glycolic acid 2x a week and also a 15% TCA once every 2 weeks pretty much all summer so my skin was ready. (I know, I know. Summer sun is not so good for peeling but I knew that I was prepping my skin so I was very careful with sunscreen and all that)

So today is Tuesday and I am still bright pink and tight and feeling very good about taking the lesser peel because I see already dramatic results. ALL the melasma is gone, immediately following the peel, I could see where the TCA/phenol pulled it to the surface cuz that's what sloughed off first. Also the texture is sooooo much better (like a baby's bottom :) I'm still a tiny bit swollen, not much - more under the eyes than anywhere else... but I went out today with a hat and tons of sunscreen and Oxygenetix concealer, and I prolly looked to most like I had a sunburn. Thank god for the fast peeling as I was getting so bored at home for the last 3 days... never mind the 2+ weeks that would have been if I had the actual full face phenol/croton oil peel. My doc says that is a peel you can do once in a lifetime and it will last... so its better to do it when there are really heavy issues with the skin. I thought my issues were heavy, but I am glad he talked me out of it and made me do less.

Hoping the pink lightens in the next few days as I would like to be out with my boyfriend already... As of right now, if you don't know if the phenol-croton oil is right for you, try a mix of the TCA with phenol. It works well and the downtime is much, much less. I may do this every year or so with a tiny bit more phenol added each time, as your skin acclimates to the chemicals in the peels and never quite absorbs it as dramatically in subsequent peels. So its okay to go slow with the phenol and the results can be quite remarkable. Plus IMHO, less downtime and less risk of scarring and hypo-pigmentation is better.

Hope this helps. I will post pics on 9/5 which will be 5 days post peel. I'm hoping to be much less pink as I want to see my boyfriend and he doesn't know I did this. (also helps to have a boyfriend that tells you all the time how beautiful you are...)

Post-peel update - 30 days

Okay... so it is almost exactly 4 weeks later post-peel. I haven't posted pics because of what happened shortly after my peel. After about 5 days, I started to break out. Bad. Cystic acne that wouldn't stop surfacing. I had been using shea butter (bad idea), which I don't believe caused the breakout per se, but with any kind of deep peel, your sebaceous glands go a little nuts during the intital healing process... so any kind of oily aftercare is not the best route. So after about 10 days, I went to get a facial because I needed some extractions. That part was okay. But never, ever EVER let anyone put any kind of light on healing skin. The estetician put an LED on my skin and left me for about half an hour. My skin then hyperpigmented like CRAZY! So on top of the acne, my face turned brown in certain large spots. Needless to say, I was like a crazy person trying to figure out how to make it better. It was really hard to look in the mirror without getting really depressed and for the first time, I really regretted my decision the go through with the peel in the first place.

I ended up going to a really good dermatologist to get some injections for the breakouts, and that helped. He also put me on oral and topical steroids and antibiotics. But the hyperpigmentation made me want to rip my hair out. I was really scared that I had marred my face forever and it was terrible. I cried like a sissy. I didn't want anyone to see me. I was scary-looking enough to frighten children and even tons of make-up couldn't hide it.

In desperation, I decided at about 2.5 to do 2 rounds of glycolic acid peel and then some microdermabrasion to even me out. It was not an easy process, but the glycolic/microderm/Obagi blender/steroid/antibiotic recipe helped (and quickly too) and for the most part, the dark hyperpigmented areas got reallyyyy dark then flaked off. There are some parts that aren't completely even but its still1000 times better than what it was. I wouldn't recommend anyone go crazy like that, but I was desperate for something to work and thank god my skin is resilient to peels, esp glycolic.

So now it's 30 days. My advice is 1. Get on antibiotics beforehand (to deal with the potential bad breakout, plus any potential infection that could affect vulnerable skin. Get some topical or low dose oral steroids (or both) for inflammation, because trust me, there will be plenty of that. (Now as a holistic healthcare provider, I am not someone to take any meds EVER... but in this case, had I known what was in store, I would have gladly taken them for this type of procedure.)

And never put an LED light on new skin. NEVER! Regardless of what anyone tells you. It will ruin your face! You need to wait at least a month before any kind of light can touch your face.

Almost 30 days later, my skin is almost back to normal. I can see finally see the difference I was waiting for. But it took this long. Even without those post-peel issues, my skin was dry and flaking and uneven and scary. Anyone who tells you 2 weeks and then you're healed and ready to face the world with porcelain skin is lying to you. For about 2 weeks, I looked a lot older than I was, and it seemed like nothing had changed. But now I can see the differences. Tighter skin. Smoother. Less noticeable pores. Softer. The new skin is poking through and I can see what they mean when they say the results still surface weeks after the peel. I am happy with the results now and I am thankful the horrid HYP is almost gone. A few more glycolic peels and microderm and I think I'm gonna be even happier.

So just know that the healing process is hard. Emotionally hard. And that it takes some time to heal. Expect that. Use aloe. A lot. Fresh. Anti-biotics. Steroids. Water. Arnica pellets. DMSO cream with aloe helped me a lot too as a moisturizer. And for crying out loud, pleas stay away from LED lights (3 people told me it was okay btw, all estheticians...) I thank god everyday that I didn't scar too bad from that. I'll reiterate. It was horrible and looked like it was never going to heal.

A little more than a 1 year later...

So happy with the results. If you can stand the difficult recovery, I definitely recommend it!
New York Plastic Surgeon

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