TCA Chemical Peels

Trichloroacetic acid  or TCA is a chemical agent used to produce what we know as a chemical peel.  This procedure is used to treat sun-damage, hyperpigmentation, freckles and fine lines. At the correct strength it improves the appearance of melasma, acne scarring and age spots.  This type of peel removes the upper layers of the skin and encourages the lower layers to remodel existing collagen fibres and produce more new ones, gradually improving skin texture and tone over time.

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  • TCA peels are a safe way of addressing sun damage, fine lines and hyperpigmentation
  • This type of peel can be performed on the face, neck and decolletage areas
  • TCA peels are prescribed by specialist dermatologists
  • Recovery and results are dependent upon the concentration of TCA and skin type of the treated area

TCA or trichloroacetic acid peels are a time-tested method of treating sun damage, uneven skin texture, and lax skin tone. TCA peels offer a predictable response and result. TCA peels carried out by our specialist dermatologists take approximately 10-15 minutes in the comfort of a modern and well-equipped Cutis Clinic operating theatre. We recommend 1 to 3 peels over a 6 to 10 week period.

The TCA peel procedure is structured as follows:

1. Pre-peel procedure

Clients are supplied with a kit containing a vitamin A prescription and a pre-peel home kit. The combination of these two prescriptions improves healing and peel efficacy.

2. Peel procedure

Your skin is cleansed and disinfected with a light exfoliating scrub. A pre-determined concentration of TCA is evenly applied by way of a sterile applicator until the necessary tissue depth is attained. Application is complete within 10 minutes.

3. Post-peel procedure

Another home kit contains a simple cleanser, barrier cream and sunscreen. Instructions are provided in regards to application.

Recovery from the immediate effects of TCA peels depends on two vital factors. These are the concentration of TCA used and the treatment site.  The most common concentrations used are  20-30% for the face and feature a typical recovery time of 6 – 8 days.  TCA peels of the chest area generally take 10 – 12 days to heal.

Day 1-3

The most superficial skin layer peels off in thin sheets. Pigment lifts to reveal new skin. You will need to regularly moisturise the skin during this phase.

Day 3-5

Peeling continues. The underlying wound is red and may become itchy.

Day 5-8

Peeling ceases and the skin starts to recover. The treated areas are still red; however, new skin is starting to replace the shed skin. Make-up can be worn after the first week.

TCA peels are great for treating skin pigmentation and uneven texture. Conditions such as freckles, solar keratosis, sun damage and melasma also benefit from TCA peeling treatments. In addition, higher strength TCA peels can decrease the appearance of fine lines and tighten the skin, increasing its tone due to its positive effect upon dermal collagen production.

TCA at very high concentrations can  be used to treat certain types of acne scars.

TCA peels are most commonly applied to the face, chest and hands but treatment areas are, of course, dependent on the location and severity of the hyperpigmentation or UV damage. As a guide, a single facial TCA peel improves textural and pigmentary changes by approximately 60-80%. Peels of the chest and hands have more conservative results where a single peel will reduce pigmentation by approximately 30%. We recommend a series of 2-3 peels for the chest area and hands.

The effects of TCA peels can be compared to those of laser treatments; however, several differences apply. Direct comparison is difficult due to numerous variables including TCA concentrations and laser beam depths. The following statements apply to the majority of cases:

  • Healing is more rapid with fractionated laser compared to the healing rate of TCA peels
  • The side effects of fractionated photorejuvenation  are fewer when compared to those associated with TCA peels
  • A single medium-depth TCA peel with a 7-9 day recovery period is equivalent to a series of fractionated laser treatments
  • TCA peels cost less than laser treatments
TREATMENT METHOD PIGMENT RESOLUTION SMOOTHING OF SKIN EFFECTS ON SKIN TIGHTENING N° OF TREATMENTS NEEDED RECOVERY PERIOD
TCA peels Excellent Excellent ++ 1-2 7-9 days
Fractional photrejuvenation Excellent Excellent ++++ 1-2 5-9 days
IPL/BBL Effective Minimal Nil 4 4 days

Please contact us for pricing.

Prior to a TCA peel we request that you arrange an initial consultation with one of our specialist dermatologists.  This consultation is required to obtain a full medical history, to examine and assess the proposed treatment areas, and to discuss the risks and benefits of TCA peels. Your dermatologist may also inform you of other treatment options.

**TCA peels are not covered under private health insurance or Medicare

Side effects are proportional to chemical agent concentration. Common side effects include redness and itching and are experienced by the majority of clients who undergo high concentration TCA peeling treatments. These side effects subside over days (itch) or weeks (redness). Additional side effects are extremely rare. The entire range of potential side effects can be seen below:

Redness

Universally seen with deeper peels. Most marked within the first 2-3 weeks and decreases over the next 2-4 weeks. Make-up can be worn after the skin stops peeling, usually at around 7 days

Itching

A common side effect in higher concentration TCA peels ( >20%). Acne or folliculitis may be occur in higher strength peels and contribute to the itching sensation. In these cases, antibiotics help alleviate the symptoms.

Infection

Viral, bacterial or fungal infections are uncommon. Your post-peel follow-up will pick up on any early signs of infection. You may be prescribed  anti-viral medication prior to deeper peels as a precaution, especially for those with a history of cold sores.

Pigment changes/Demarcation lines

TCA peels are designed to minimise the sharp demarcation lines commonly seen after IPL treatments. A technique known as feathering is used to blend in the treated skin with the surrounding areas, minimizing demarcation.

Scarring

Very uncommon. To minimise  scarring, clients with a history of keloid scarring are excluded from TCA peel use.  Scarring may occur if infections are not treated or if treatments are too aggressive. Your specialist dermatologist will ensure that the depth and concentration of TCA peels are perfect for your skin condition, blemish location and skin type.

In the age of IPL, fractionated laser resurfacing and fractionated photofacial treatments, TCA peels still remain a common treatment at the best dermatology and cosmetic clinics. This is because TCA peels are predictable in outcome, and quick to perform.  They remain an effective method for the treatment of solar keratosis (sunspots), uneven skin texture and skin laxity (loss of tone).  By varying both the concentration of the TCA agent and the aggressiveness of the pre-peel prep, Cutis Clinic dermatologists can tailor your recovery and results.

The downside to peels are the longer recovery period and more intensive aftercare compared to the latest innovative treatments such as fractionated photorejuvenation laser treatments. Nevertheless, TCA peels continue to be a popular choice for client and dermatologist alike.