TCA Peel: The Ultimate Guide
TCA peel is a customizable chemical peel used to treat various skin concerns. Here’s everything you need to know about this procedure before booking an appointment.
TCA peels are chemical peels with a wide range of applications. It can be used to treat practically any skin imperfection.
But when it comes to chemical peels, different areas, skin color, thickness, and texture are all very important factors that affect the levels of absorption, and therefore your suitability for the treatment.
So, the TCA chemical peel isn’t suitable for everyone. Let’s explore the possibilities of TCA peel and help you decide if it’s the right chemical peeling for your skin.
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What Is a TCA Peel?
Trichloroacetic acid peel, or TCA peel, is an exfoliating skincare treatment whose solution is composed of different strengths and combinations of nontoxic acid ingredients.
When the trichloroacetic acid peel is applied, the chemical starts to dissolve the top skin layer and encourage new cell growth deeper underneath. So, when the epidermis, the outermost layer, peels off, new, healthier skin emerges.
Since this new layer hasn’t been affected by any environmental harm or has had the time for imperfections to emerge, it gives the appearance of a smooth, healthy complexion.
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What Is a TCA Peel Good For?
There are many benefits of TCA peel, some of which are:
- It can be safely used on most skin types, especially normal to oily, and sun-damaged, and dull-looking skin. On sensitive skin, you can start with gentle TCA peels, and gradually increase potency.
- TCA peels are typically applied to your face, but can also be used on the back, neck and chest, shoulders, hands and arms.
- The treatment is quick – the application process takes less than 15 minutes.
- The peel intensity can be adjusted. TCA acid responds well in combination with other acids, ingredients, or even treatments.
- Healing is usually quick as most procedures use low-intensity TCA acid. But even more intense procedures require less recovery time compared to other chemical peels.
This list is definitely not final – the benefits you’ll get depend on the imperfection you want to work on.
How Intense Are TCA Chemical Peels?
The concentration of TCA acid in the solution determines TCA peel strengths. And while a trichloroacetic acid peel can vary from very light to deep chemical peels, TCA peels are usually considered medium strength.
This means they should only be applied by a certified skin care professional.
The absorption of trichloroacetic acid peel directly correlates to the intensity of the redness and frosting (the skin turning white right after a peel) that appear during the treatment.
These signs are important indicators of how deep the peel penetrates, giving TCA chemical peels a great advantage – this makes the skin reaction easy to follow and consequently the treatment safe.
The faster, more solid, and uniform the frosting, the deeper the peel has penetrated.
Let’s review the potential of different concentrations.
Superficial – TCA 20 Peel
Light peels usually vary around 10-15%. These concentrations are considered superficial chemical peels and can help treat hyperpigmentation and sun damage, clean pores and increase the absorption of products.
Light TCA chemical peel is often used to treat other areas of the body. TCA 20 peel is a good solution for wide-area applications since there is no absorption.
Contraindications of superficial TCA peels are very rare but can include activating herpes flare-ups or other skin diseases in the area treated.
Medium – TCA 30 Peel
Medium TCA peels1 contain 30-40% of TCA acid. It’s used to treat deeper wrinkles and scars as well as precancerous growths.
Peels with a lesser concentration can be applied to the face, neck, hands, or any other area of the body. Peels with a concentration higher than 20% are not suitable for treating areas other than the face as scarring is more likely to happen.
The recovery from TCA 30 peel requires 7-10 days and following an aftercare regime. These peels give dramatic results that last up to 2 years. They can be repeated multiple times, but need a minimum period of 60 days between them.
Deep – TCA 80 Percent
TCA at 50% or higher is considered a deep chemical peel. They can be used to treat specific scars or lesions in very small areas of skin at concentrations up to 70%.
But this intensity carries the risk of postprocedural complications. TCA 80 percent peel can cause scarring due to deep necrosis (death of the skin tissue).
Only a dermatologist or plastic surgeon with board certification should carry out deep chemical peels. This intensity is considered a serious medical treatment and carries high risk followed by a long recovery process.
Combining TCA Peel with Other Acids
TCA acid is often combined with other ingredients and acids to create a customized solution. Most often, Jessner’s peel or glycolic acid are used, given that they achieve similar results.
But TCA acid is also used in combination with other treatments. For example, chemabrasion, which entails traditional (micro)dermabrasion scraping on the areas that have already been treated with TCA.
A light TCA peel can also be combined with a microneedling treatment to help promote collagen production even more.
What Conditions Does TCA Peel Treat?
It can help smooth out fine lines and wrinkles, clean out congested pores, correct discoloration, and remove superficial blemishes. Plus it increases collagen production, which improves skin elasticity and leads to healthier, smooth skin.
So, TCA chemical peel can help you treat several following skin conditions.
TCA Peel for Acne
TCA peel helps clear pores and get rid of blackheads and whiteheads. But, while it can help temporarily reduce blemishes, this treatment can’t help you prevent acne in the future.
It doesn’t address the root of the problem which is the overproduction of sebum.
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TCA Peel for Acne Scars
Although not the best choice for treating acne themselves, this peel has proven to be a very effective treatment for post-acne scarring. It helps reduce the dark spots left over from the breakout, while simultaneously smoothing out the skin texture.
A TCA peel for acne scars seems to work best when treated with a CROSS technique2. This technique involves the targeted application of TCA acid into each individual depression to reconstruct scar tissue and even out the skin tone.
The CROSS technique has proven to be more efficient in treating acne scarring compared to a full-face peel. Tagged areas are treated with higher concentrations which would’ve taken much longer to heal otherwise.
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TCA Peel for Hyperpigmentation
All forms of hyperpigmentation, including freckles, age spots, dark patches, and melasma, can be successfully treated with this peel.
TCA peel for hyperpigmentation uses a stronger concentration of TCA acid to help break up the pigmentation and encourage those pigmented skin cells to move to the surface where they will eventually shed away.
TCA chemical peel is one of the strongest peels available so it works even if the pigmentation is in the deeper skin levels.
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TCA Peel for Melasma
Melasma is a hyper-pigmentary condition characterized by uneven light or dark-brown patches that appear on skin that has been exposed to the sun.
TCA peel for melasma reduction has proven to be the super efficient, but this condition can also be treated with other chemical peeling agents, like Jessner’s solution, glycolic and lactic acid.
TCA Peel Under Eyes
When used in very low concentrations, a TCA peel under eyes can help revitalize the skin and make the eye area look younger. The resurfacing will help minimize wrinkles and tighten the skin under and around the eyes.
It will also help balance out uneven skin pigmentation.
TCA Body Peel
If you’re considering getting a TCA body peel, you need to find a professional that is experienced in this area. TCA body peel3 is quite different compared to the one on the face.
Non-facial areas do not recover as well as the face does, and the desired results are not as predictable. It is crucial to remember that, in order to prevent any possibility of potential toxicity, you should never apply the peel to more than a small area at a time.
Given that the TCA body peel has to be at low concentrations of TCA acid, it might be better to consider an alternative chemical peel to achieve the desired effect. Consult an expert.
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How Many TCA Peels Does It Take to See Results?
After one treatment, your skin will look better overall. However, to address severe scarring, hyperpigmentation, or UV damage and get completely clear skin, you’ll need a couple of sessions.
Depending on how your skin responds to the procedure, you can plan a second peel a few weeks or months following the first one. It’s important you set realistic goals regarding the results.
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Limitations of the TCA Chemical Peel
Contraindications of the procedure include, but are not limited to:
- Keloid scarring and general proneness to scarring
- Skin conditions such as psoriasis, eczema, or rosacea
- Pregnant and breastfeeding clients
- Clients with darker skin tones (Fitzpatrick skin type V and VI)
- Clients that are continuously exposed to UV rays
- Clients who have taken oral acne medication (Isotretinoin – Zenatane, Amnesteem, Claravis, etc) in the past few months
- Active cold sore flare-up
If you have any of the conditions listed above, consult with a doctor to assess suitability.
How to Prepare for a TCA Peel
Prior to getting a TCA peel, you may need to alter your skincare regimen a bit. Stopping the use of retinoids a week leading up to the appointment. Avoid sun exposure and don’t skip the SPF.
If you have a history of cold sores, you’ll likely be prescribed a prophylactic medication to reduce the likelihood of an outbreak following medium-depth chemical peels.
What Happens During a TCA Peel?
The procedure is fairly quick and will probably take around half an hour to complete.
The first step will be cleaning the area you’re about to treat and degreasing it with acetone. This way the solution can interact with the skin more effectively.
After that, the technician will apply a protectant, usually a thick ointment, to prevent chemical burns in sensitive areas. It’ll be applied to the corners of your eyes, nose, and lips since the solution tends to accumulate in these areas.
In this step, the treatment provider might also apply some numbing cream as well. Depending on the intensity of the peel, you might even get sedated.
Then, the actual treatment begins. The chemical peeling solution gets applied and the technician starts monitoring the skin’s reactions.
Most people report feeling the warmth and tingling, but depending on the intensity you might feel some slight burning as well.
Note that you shouldn’t be in any actual pain, so if the solution is hurting your skin report it to the technician immediately.
As mentioned, TCA peel is characterized by frosting, so it’s easy to monitor the progress of the penetration. The number of layers applied will depend on the desired depth of the chemical peel and your skin’s reaction.
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The skin is cooled with cold water once the desired depth has been reached. The treatment is finished by applying a thin layer of ointment to help preserve the skin.
The procedure is done in a single session, but if you’re looking to resolve a specific problem you can get the treatment done multiple times. You just need to allow enough time to pass between each session.
What to Expect After a TCA Peel
TCA peel results may be noticeable right away for superficial treatments, but they could also take 3-4 days to fully show if the procedure is a bit more intense.
The peeling process also depends on the depth so it could vary between 4-10 days. It’s important not to try and speed it up by picking at the skin as this leaves you at a higher chance of developing dark spots or an infection.
Here’s a quick TCA peel day by day breakdown according to the intensity of the peel.
Light TCA Peel Recovery
Healing time is rather short and takes from 1 to 7 days. During this time you’ll experience some redness and flaking.
Light TCA chemical peel usually doesn’t require much aftercare and results can be visible after a few days. They can be repeated after 2-5 weeks have passed.
Medium TCA Peel Recovery
Medium chemical peels are a bit more serious and even require a follow-up visit. Your skin will be red and you might even experience swelling for the first 48 hours after the procedure.
The peeling starts soon and can continue to peel in 7 to 14 days. During this time, you need to follow an aftercare routine that includes daily soaks and ointment application. It can also include taking antiviral medications for 10-14 days.
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Deep TCA Peel Recovery
Deep peeling is very intense and so is the recovery process from it.
The healing time takes up to 3-4 weeks during which the area treated will be bandaged. This procedure requires visiting a dermatologist for a few follow-up visits during the first week or so.
Aftercare should be strictly followed until the skin is healed completely. This usually means a very strict regimen of daily soaks and ointment application for the first 2 weeks, after which it gets a bit easier.
When doing a deep trichloroacetic acid peel you need to avoid the sun completely for 3-6 months.
Aftercare rules will be explained to you in detail by your treatment provider, but in general, it’s important to keep it simple and gentle.
How Safe Is the TCA Peel? Risks + Side EffectsWhen it comes to safety, the risks are proportional to the concentration of TCA acid. Superficial TCA peels carry minimum risks, but medium to deep peels become substantially riskier. The common risks and side effects for these treatments include4:
- Flare-up of eczema and rosacea – TCA peel is moderately reactive so it’s advisable to do a patch test before continuing with the full treatment
- Cold sore flare-up
- Bacterial or fungal infection
- Redness and irritation that can last several days
- Post-inflammatory hyperpigmentation after TCA peel – more likely with medium-depth peels and in darker skin tones
- Risk of scarring
- Risk of swelling
If the peel is too intense, post-inflammatory hyperpigmentation after a TCA peel isn’t uncommon.
In fact, in individuals with darker skin types and those that are in prolonged sun exposure it can be considered a common adverse effect. It’s the most typical side effect of a TCA peel.
How Much Does TCA Peel Cost?
American Society of Plastic Surgeons estimates that the average cost of a TCA peel was $693.
TCA peel cost is influenced by your location, the size of the region you want to be treated, the intensity of the peel, and the technician’s experience – among other factors.
Keep in mind that medium and deep chemical peels are significant medical procedures – which will have a significant impact on the cost. So, the full-face trichloroacetic acid peel can potentially cost anywhere between $300 and $1,000.
Can You Do a TCA Chemical Peel at Home?
TCA peel, and in general any kind of chemical peel should be performed by a professional.
Using professional-grade chemical peeling solutions at home, by yourself, could lead to serious and irreversible skin damage – chemical burns, skin discoloration, and permanent scarring.
This depth of penetration is what differentiates an at-home chemical peel from the professional one.
At-home chemical peels are very superficial in order to make them safe. They are formulated differently so that non-professionals can use them. They don’t provide the same dramatic results, but they can help improve your skin appearance slightly.
TCA peel at home can be a substitute for a light peel. There is no at-home equivalent to a medium-depth peel as that high concentration can’t be substituted for at-home use.
If you’re considering a trichloroacetic acid peel, it’s best to consult a dermatologist beforehand to determine whether your skin qualifies.
TCA Peel – Main Takeaways
Given that chemical peel treatments are customized according to the client’s needs , the acid used isn’t determined solely by its own characteristics. Rather, the technician considers the skin’s properties and the problems the client wishes to resolve.
For the majority of skin issues, such as acne, hyperpigmentation, melasma, uneven skin texture, and fine lines and wrinkles, a TCA chemical peel is a very good choice.
With a variety of depths and treatment options, TCA ranks as one of the most adaptable types of chemical peels. Whiteheads, blackheads, uneven skin texture, and pigmentation can be treated effectively with superficial procedures, but fine lines and wrinkles respond better to medium-depth peels.
However, it’s crucial to have this peel carried out by a skilled professional.
- Monheit, Gary D. “The Jessner’s-trichloroacetic acid peel: An enhanced medium-depth chemical peel.” Dermatologic clinics 13.2 (1995): 277-283.
- Khunger, Niti, Deepali Bhardwaj, and Monica Khunger. “Evaluation of CROSS technique with 100% TCA in the management of ice pick acne scars in darker skin types.” Journal of Cosmetic Dermatology 10.1 (2011): 51-57.
- Cook, Kim K., and William R. Cook Jr. “Chemical peel of nonfacial skin using glycolic acid gel augmented with TCA and neutralized based on visual staging.” Dermatologic surgery 26.11 (2000): 994-999.
- Anitha, B. “Prevention of complications in chemical peeling.” Journal of Cutaneous & Aesthetic Surgery 3.3 (2010).