A TCA (trichloroacetic acid) peel is a type of chemical peel used to improve the appearance and texture of the skin. TCA peels work by removing the outermost layers of damaged skin. They are commonly used to treat a variety of skin concerns, including fine lines, wrinkles, acne scars, sun damage, and uneven pigmentation. TCA peels come in different strengths or concentrations of the acid, ranging from superficial to deep, and can be tailored to suit individual skin types and concerns. Stronger formulas create a deep peel, which removes more of the underlying layer of skin as it deeply exfoliates.
TCA peels are suitable for individuals seeking to improve their skin’s appearance, to have more youthful looking skin. They are particularly beneficial for those looking to improve the overall texture and appearance of their skin. As TCA peels can be customized to different skin types and concerns, they are suitable for a wide range of individuals and Fitzpatrick skin types.
There are several contraindications to consider before undergoing a TCA peel:
1. Active infections: Individuals with active bacterial, viral (Herpes Simplex/Cold Sores), or fungal infections on the skin should avoid TCA peels until the infection has cleared, as the peel may exacerbate the condition or lead to complications.
2. Recent isotretinoin (Accutane) use: If you have have taken isotretinoin for acne treatment within the past six to twelve months may have an increased risk of adverse reactions, such as excessive scarring or delayed wound healing, and should avoid TCA peels during this time. A minimum of six months without isotretinoin must be observed prior to undertaking a TCA peel.
3. Pregnancy and breastfeeding: TCA peels are not recommended for pregnant or breastfeeding individuals.
4. History of abnormal skin scarring: Patients with a history of keloid or hypertrophic scarring may be at increased risk of developing additional scarring following a TCA peel and should avoid the procedure.
5. Active inflammatory skin conditions: Individuals with active inflammatory skin conditions such as eczema, psoriasis, or rosacea.
6. Recent sun exposure or tanning: Patients with recent sunburn or excessive sun exposure should wait until their skin has fully healed and returned to its normal state before undergoing a TCA peel.
7. Allergies or sensitivities: Patients with known allergies or sensitivities to TCA should avoid the procedure to prevent allergic reactions or adverse skin reactions.
TCA peels remove a uniform layer of skin cells from the epidermis and, in the case of higher concentrations, the dermis layer. The epidermis is the top layer of skin, and the dermis is the layer immediately below it.
The procedure involves applying the TCA solution to the skin. It is left for a determined timeframe and the skin is observed. The TCA peel can progress deeper into the skin to give you a stronger peel by layering . Additional layers may be applied for a deeper effect. As with any skin treatment, it is better to start low and go slow so additional layers and strength of peel are typically progressive based on previous skin response and skin health. It is always safer to apply more layers of a lesser percentage than increase the percentage – skin is a marathon, not a sprint so never rush to the next percentage.
Dead skin cells are removed, stimulating new skin cell growth. Over the following days post treatment, the outer layers of skin will gradually peel away, revealing fresh, rejuvenated skin beneath.
During a TCA peel, you may experience varying sensations depending on the depth and strength of the peel and your individual skin sensitivity. Initially, you may feel a tingling or stinging sensation as the TCA solution is applied to the skin. This sensation typically subsides after a short time. As the peel progresses, you may experience a warm or burning sensation, which is generally mild to moderate and manageable for most individuals. Some people describe it as feeling like a sunburn. Measures to help alleviate any discomfort can be applied during treatment , such as using a cooling fan. After the peel, you may notice tightness and redness in the treated area, similar to the sensation of windburn, as the skin begins to peel and regenerate. Overall, while there may be some temporary discomfort during and after the peel, many individuals find the results well worth it!
Pre-care and aftercare are crucial aspects of ensuring a safe and effective TCA (trichloroacetic acid) peel experience:
Pre-care:
1. Skincare regimen: Follow any pre-peel skincare instructions provided by your practitioner, which may include avoiding certain medications, products containing retinoids, or exfoliating treatments for a specified period before the peel. In addition your skin should be adequately prepped with Vitamin A and if you are prone to post inflammatory hyperpigmentation or are treating conditions such as melasma, a tyrosinase inhibitor must be used.
2. Sun protection: Protect your skin from sun exposure and wear sunscreen daily, as sun-damaged skin can affect the results of the peel and increase the risk of complications.
3. Hydration: Keep your skin well-hydrated by drinking plenty of water in the days leading up to the peel, as hydrated skin tends to heal more efficiently.
Aftercare:
1. Sun protection: Avoid direct sun exposure and wear sunscreen with a high SPF to protect the newly revealed skin from UV damage.
2. Moisturize: Keep your skin hydrated with a gentle, non-comedogenic moisturizer to soothe and nourish the skin as it heals.
3. Avoid picking or peeling: Resist the urge to pick at or peel off any flaking skin, as this can lead to scarring and complications.
4. Gentle skincare: Use mild, non-irritating skincare products post-peel to avoid further irritation or inflammation.
5. Patience: Be patient and allow your skin time to heal and regenerate. Avoid strenuous exercise, saunas, and hot showers that may increase inflammation.
Following these pre-care and aftercare guidelines can help optimize the results of your TCA peel and minimize the risk of adverse reactions or complications. It’s essential to follow the specific instructions to achieve the best possible outcome.
The downtime for a TCA peel can vary depending on the depth and strength of the peel and individual skin sensitivity. Superficial or light TCA peels typically have minimal downtime, typically lasting a few hours or days to a maximum of a week. During this time, you may experience redness, mild swelling, and peeling similar to a sunburn. It’s common for the skin to flake or peel off gradually.
Deeper TCA peels, which penetrate more layers of the skin, may result in more significant downtime. For a medium depth peel, a person will typically need between seven and fourteen days for medium concentrations. The higher the concentration, the longer the downtime. Recovery may involve more intense redness, swelling, and peeling. It’s essential to follow post-care instructions to ensure proper healing and minimize the risk of complications. Extra precautions will also need to be taken in the sun post peel.
Overall, the downtime for a TCA peel will depending on factors such as the strength, number of layers and depth of the peel, individual skin response, and proper post-care.
The frequency of a TCA peel will depend on the depth and strength of the treatment. For example, i f only 1 layer is applied at a lower percentage, you may be able to do a peel in two weeks. If you did a 2-3 layer peel at a higher concentrate, the wait time should be around four weeks. For 4-5 layers at a higher concentration, then you could consider up to seven weeks between treatments. Once your skin has been analysised we will develop a recommended treatment plan with appropriate intervals for skin healing.
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