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Dermatologists Swear by TCA Peels—Here's What You Need to Know

Dermatologists Swear by TCA Peels—Here's What You Need to Know

The term “chemical peel” evokes various emotions and facial expressions from my patients. For some, the term brings back memories of glowing, freshly exfoliated, hydrated skin. For others, the term conjures a previous bad experience or dramatic images they’ve previously seen on the internet and the thought “not for me.” In this article, we’ll demystify TCA chemical peels. I’ll explain what they are, who they're best for, what it feels like to undergo one, and the potential benefits.

What Is a Chemical Peel?

A chemical peel is a procedure that chemically exfoliates the skin. Chemical peels range in depth from superficial, medium, and deep chemical peels. Superficial chemical peels exfoliate only the top layer of skin, while medium and deep chemical peels exfoliate into the upper and mid dermis, respectively.

Superficial chemical peels are effective for texture irregularity and evening of the skin tone, while medium to deep chemical peels are effective for skin tightening and diminishing fine lines and wrinkles.

In general, the time to heal and potentially adverse reactions increase with the depth of the chemical peel. For this reason, medium and deep chemical peels are typically avoided in darker skin tones, due to increased risk of scarring and hyperpigmentation.

What Is a TCA Chemical Peel?

TCA stands for trichloroacetic acid.

The term TCA chemical peel is somewhat vague because TCA peels can vary from very light to deep chemical peels, depending on the concentration of TCA and whether it is combined with another type of chemical peel. For reference, 10%–30% TCA provides a superficial peel, while 30%–40% TCA provides a medium-depth chemical peel, and 50% or above TCA provides a deep chemical peel.

Benefits of a TCA Chemical Peel

The benefits of the TCA peel will depend on the depth of the chemical peel. Superficial TCA chemical peels provide improvement in skin texture, a decreased number of whiteheads and blackheads, and evening of skin tone. Medium-depth TCA chemical peels provide improvement in fine lines and wrinkles.

TCA is not the best agent for deep chemical peels, as it can become somewhat unpredictable, but deep TCA peels would provide improvement in wrinkles and skin tightening.

How to Prepare for a TCA Chemical Peel

It is, of course, important to follow the specific directions given to you by the person who is to perform your chemical peel. I would caution against having medium-depth chemical peels performed outside a dermatologist office. Deep chemical peels should be performed only by a board-certified dermatologist or a plastic surgeon.

It is important to review your calendar before scheduling a chemical peel. Skin will typically peel for 4–10 days with a chemical peel. Check your calendar and make sure you don’t have any important events or dates within your peeling window. Although you can wear makeup during your recovery, peeling skin is sometimes difficult to hide.

It is also important to avoid sun exposure as the skin is healing. So don’t plan to get a peel right before vacation. It’s also advisable not to have a fresh tan on the day of your procedure.

Your aesthetician or physician will likely want you to hold your nightly retinol or retinoid a week before your treatment, but this should be confirmed. For superficial peels, it is sometimes useful to prime the skin with retinol or a retinoid before.

If you have a history of cold sores, your physician will prescribe you a prophylactic medication to minimize the changes of an outbreak for medium-depth chemical peels.

What to Expect During a TCA Chemical Peel

The actual treatment process is fairly quick. It’s best to show up to your appointment without makeup. If you are coming from work and tend to wear heavy makeup, it’s a good idea to bring your favorite effective makeup remover so that you can remove your makeup yourself.

As the first step, they will degrease your face with acetone, which smells a lot like nail polish remover. This feels a little cold and weird, but it’s an essential step, because it allows the peel solution to interface with your skin effectively.

In the next step, the actual peel will be applied to the face with either a cotton tip applicator or a gauze pad. This is usually accompanied by tingling and warmth in the treated areas. Often, one area may respond more vigorously than another. A fan is typically enough to mitigate discomfort in a superficial peel.

The number of layers applied will depend on the desired depth of the chemical peel and your skin’s reaction. The person applying your peel will watch carefully for the desired end point.

Once the desired end point is reached, usually within 3-5 minutes, the skin is cooled with cold water. A thin balm is applied to protect the skin, and the procedure is over.

Aftercare

Aftercare will be explained in detail after your procedure, but in general it’s important to keep it simple and gentle. You’ll cleanse your skin with a gentle cleanser, and moisturize with a bland ointment or moisturizer. It's important to also practice diligent sun protection.

Depending on the depth of the peel, the skin will likely peel between four to 10 days. It’s important not to attempt to speed up the peeling process by picking at the skin, as this can increase chances of infection, poor healing, and dark spots. Regular skincare can be resumed once the skin has been fully repaired from the chemical peel and feels back to normal (normal but better).

TCA Chemical Peels vs. Other Chemical Peels

TCA peels are the most versatile chemical peels of all chemical peels. From a professional standpoint, that makes it a great tool, because it can be used at various concentrations and application techniques to treat almost any condition. However, from a patient perspective, the only thing that matters is if it is the right procedure for you. In general, the most important step in selecting a chemical peel is choosing a provider who knows what they’re doing. My colleagues and I all have different go-tos for treatment of similar conditions.


Jessner's Peel: A Chemical Peel With a Long Track Record of Success

Jessner's Peel: A Chemical Peel With a Long Track Record of Success

What Is a Jessner's Peel?

Glowing skin is a beauty goal for millions of people. Skincare products and sun protection are excellent tools for helping skin look great. If you have stubborn concerns like acne, discoloration, or age-related skin changes, you may find that over-the-counter products aren't enough.

What Are Chemical Peels?

Glowing skin is a beauty goal for millions of people. Skincare products and sun protection are excellent tools for helping skin look great. If you have stubborn concerns like acne, discoloration, or age-related skin changes, you may find that over-the-counter products aren't enough.

What Are Chemical Peels?

Noninvasive skin resurfacing procedures like chemical peels are an effective way to treat common skin issues. They're very popular, with almost a million Americans getting chemical peels every year. During a peel, your doctor places chemical solutions on your skin to dissolve the top layers and reveal fresher skin beneath the surface. The process can reduce the appearance of fine lines, dark spots, and acne scars.

There are several different degrees of chemical peel: superficial, medium, and deep. The difference between them has to do with how many layers of skin the peel penetrates. Superficial peels have modest results but very little downtime. Medium and deep peels are more dramatic, but the recovery is more complicated.

A Jessner's peel is a type of chemical peel to improve the appearance of your skin. Like other chemical peels, a Jessner's peel breaks down the surface layer of skin. The cells die off and slough away after the peel. Your body then begins a healing response, which brings new, fresher-looking skin to the surface.

On its own, Jessner's solution is a superficial peeling agent. Doctors often combine it with more intense ingredients to produce a medium peel. These peels are effective at reducing the appearance of dark spots, fine lines, and acne scars.

Jessner's Solution

Jessner's solution was invented nearly 100 years ago. A doctor named Max Jessner developed the formula as a way of treating benign skin conditions. His original formula contained several acidic ingredients that effectively break down the skin's surface layers and encourage new brighter skin to take its place.‌

The ingredients in the original Jenner's solution were equal parts salicylic acid, resorcinol, and lactic acid, mixed with an ethanol base. More recently, doctors have created a modified version that contains higher concentrations of lactic acid and salicylic acid, with a smaller amount of citric acid. They replaced resorcinol because it can cause irritation and hyperpigmentation, especially for people with darker skin tones.

Jessner's solution alone can produce superficial skin peeling with mild effects. Dermatologists often combine Jessner's solution with trichloroacetic acid (TCA) or glycolic for a more intensive peel. Jessner's solution prepares the skin by removing top layers of the epidermis so the other ingredients can penetrate more deeply.‌

Peels using Jessner's solution can treat a number of skin concerns, including:

  • Acne or acne scars

  • Age spots or other discoloration, including melasma

  • Dull complexion

  • Fine lines

  • Freckles or sun damage

  • Rough-feeling skin

Your doctor will talk to you about how to care for your skin before and after a peel. To get the best results, you may need to use prescription skincare products such as tretinoin to get your skin ready for the peel ingredients. This ensures that the peel penetrates evenly all over your face, so you have consistent results.

You may need numbing cream on your skin before the peel to alleviate discomfort. Your doctor may also prescribe antibiotics to prevent infection while you're recovering. You will need to be very careful how you treat your skin for several days. Your doctor will let you know what products are safe to use while you're recovering. Your skin may be red and swollen for several days after your peel. The skin will then become dry and flaky or crusty before starting to shed. It takes about a week for a full recovery.