Over the course of the last year or two I have been discussing the option of combined treatments for my patients. Whether it is for acne, rosacea, anti-aging or hyper pigmentation or melasma, I find myself suggesting chemical peels as an addition to either medical grade home treatments or in-clinic procedures, and more often than not, both.
As my patients and my peers know well, I have a penchant for TCA peels. Whether used alone or layered with another peel (such as modified Jessners or Mandelic) with the exception of rosacea, I find my patients receive the best possible outcome for each of their concerns.
What it is: A TCA Peel is a type of Chemical Peel used as a skin resurfacing technique. Trichloroacetic Acid (TCA) solution is applied to the face to remove the outer surface layers of skin. A TCA Peel allows new, healthier skin to emerge.
TCA (trichloroacetic acid) peels are medium-skin-depth treatments (much more effective than glycolic acid peels). They help with sun damage, facial wrinkles, uneven skin tone, and pigment abnormalities.The concentration of the peel varies according to need, and downtime is 2-7 days depending on the strength used.
Many patients can benefit from having TCA applied not only on the face but also on the neck and other parts of the body that have been exposed to and damaged by the sun. For spot peeling of limited areas such as around the mouth or eyes, TCA formulas are often preferred because they have less bleaching effect than solutions containing phenol, a much less popular peeling agent. For the same reason, some surgeons have found TCA to be effective in treating darker-skinned patients.
Milder TCA peels can be repeated frequently in order to achieve cumulative effects, or TCA can be used to achieve a medium or even a deep peel, depending on the acid concentration and manner of application.
Any of the following conditions may make you a good candidate for a TCA Peel:
- Wrinkled or sun-damaged facial skin
- Vertical wrinkles around your mouth, such as those that cause lipstick “bleed”
- “Crow’s feet” lines around your eyes and perhaps some skin laxity in your lower eyelid area
- Fine wrinkling of your upper eyelids
- Brown spots or blotchy skin colouring
- Certain precancerous skin growths
- Acne or chicken pox scars
- Superficial facial scars from a past injury
Like the other resurfacing methods, the TCA peel is effective in treating wrinkles, blotchiness or age spots, and scars from acne or other causes. It can be used on the entire face or specific areas. Certain other characteristics of your skin, such as its thickness and texture, may influence whether you are a good candidate for this chemical peel.
My preference when treating acne scars is to alternate monthly treatments of Profractional laser resurfacing or Dermaroller with the TCA peels. By treating deep in the skin to create new skin with the laser/ roller and then treating from the surface to get rid of the top layers of unwanted skin, I can achieve quicker, smoother results, and perhaps also allow for a more cost- effective end point for my patient.
For off-the-face treatments such as back scars or post inflammatory hyperpigmentation on the legs or arms, I like to do a pass of microdermabrasion before the peel. By first tackling the upper dead layers of skin, the peel is able to penetrate deeper, allowing for better efficacy. It should be noted that numerous peels may be necessary, at about 3-4 week intervals.
A consultation with your dermatologist or medical esthetician can determine if peels are right for you. All your questions will be addressed, what you need to know pre and post treatment, as well as realistic expectations will be discussed.
As a medical esthetician who also has these peels done on my face, I am confident that once my patients see the outcome of even one of our peels, they will be coming back for more!
~ Sheri Roselle, Medical Esthetician at Toronto Dermatology Centre