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TCA Peels

What is chemical peeling?

Chemical Peeling is exactly what it says- peeling of the skin using a chemical. A chemical peel removes the outer layers of the skin. This freshens the skin, removes sunspots and rough scaly patches, and reduces freckles, fine wrinkles, and irregular pigmentation. It is safest and most effective on the face. There are many types of peels available. In general, Glycolic peels are the lightest, and then Jessner peels, and finally, TCA peels, in order of increasing strength.

What is the history of peeling?

Cleopatra and the ancient Romans used various food acids to peel their skin. In the early 1900s, European and American women underwent ‘non-medical’ peels in salons with secret formula, which were probably mild acids. In the early 1950s, the phenol peel was developed. This was a fierce, deep peel that could remove years of wrinkles, but also gave peeling a bad reputation for complications - pigmentation, depigmentation, and scarring. Today, Trichloroacetic acid (TCA), being a more gentle acid, is used because it rejuvenates the skin without the risk of serious side effects. Jessner Peels are also now popular. They are not as deep as TCA peels, and therefore have less ‘down-time’.

How does it work?

The solution is applied to the skin, causing a mild acid burn to the top layers, i.e. those layers that are most sun-damaged. As these layers peel off over a week or so, new, fresh, unblemished skin forms from the deeper layers. Peeling stimulates the growth of healthy new skin cells in place of tired old sun-damaged skin. This process is to be sharply contrasted with sunburn, which removes the outer layers of skin, but causes UV damage to deeper cells, thereby accelerating the ageing process and the risk of skin cancer.

What conditions can be treated with peels?

Fine wrinkling can be reduced with chemical peeling. Most brown marks, freckles and pigmentation can also be removed or lessened, especially age and liver spots. Scaly patches and rough skin (keratoses) can be removed. Very thick keratoses may need additional treatments for complete removal.

Chemical peeling is not suitable for people who will continue to have excessive sun exposure.

What are the risks of peels?

Pigment changes can be caused by a peeling people prone to this complication due to their skin type. Those known to develop brown discoloration after injury such as a mild burn should have a test area peeled first before undergoing a full chemical peel.

Any increased pigmentation usually resolves with time. It can be largely prevented by strict use of sunscreen for three months after the peel, and skin preparation before the peel with special creams and serums. Cold sores can be activated in those prone to this kind of condition. Anti-viral medication can prevent this. The most common causes of scarring are infection, and pulling off the skin before it is ready to peel. Both of these are avoidable.

What is the procedure?

The skin may have had preparation with Vitamin A, Alpha Hydroxy Acid (AHA) or other preparations. Firstly, the skin is thoroughly cleansed. The solution is then applied to the face and monitored. If burning or stinging is a problem, a cold pack or fan may be helpful. Often the treatment is carried out in sections.  

What happens afterwards?

The skin will go red over the first 24hours. Once the initial burning has worn off it is not painful, but feels tight. Over the next few days, the skin dries and looks like brownish leather. Vaseline should be applied several times a day to prevent cracking. Water will do no harm but soap should be avoided. The skin will begin to peel between 3 and 7 days later, and must be left to come off at its own pace. As soon as the skin has healed, make-up may be applied over any new, pink skin. Sometimes a secondary peel occurs during the second week in the form of dry, scaling skin. Sunscreen is mandatory for at least three months, and plain moisturisers, such as sorbolenne, are helpful.

TCA Peels are available for both face and hands- ask in Clinic

Pre and Post treatment

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