Before laser resurfacing treatments were invented, skin rejuvenation or resurfacing was done with chemical peels.

TCA or trichloracetic acid is a superficial or mid-depth peeling agent that has been used for more than 20 years and is still in wide use today. The main ingredient is related to vinegar (acetic acid). When applied to the skin, it causes the top layers of cells to peel off over 3-7 days, revealing a new layer of undamaged skin.

When are TCA Peels better than laser treatments?

TCA peelsMelasma or abnormal pigmentation caused by sun, pregnancy or birth control peels can be made worse with IPL or laser treatment. The heat generated in the skin by either treatment can cause increased pigmentation in darker skin types. A home skin brightening program for several weeks, followed by a TCA peel can work better than laser for melasma.

Are TCA peels safe?

Millions of patients have been treated safely with TCA peels. The TCA is applied to the skin for 5- 15 minutes and then washed off, limiting exposure. A recent NY Times article cited some safety concerns about TCA causing cancer in animals. The lab animals were exposed to TCA over a long period of time, which differs from how TCA is used in a peel. At this time there are no studies linking cancer and TCA in humans. My dermatology colleagues and I continue to use TCA. I agree that care needs to be taken to limit exposure and avoid more than several treatments in a year.

Are TCA Peels safe to do at home?

There are several vendors, including Obagi, that market a slow release TCA to use as a home peel. The concentration of TCA in these proprietary products is not publicized. I do not recommend TCA as a home exfoliation product. There is concern about exposure or over-treatment, which can damage the skin. There are safer products such as the all-natural clay and sea salt masque, Deep Thermal by Societe,  that accomplishes the same result with less risk.

Will TCA Peels work for sun damage?

TCA peels are very effective for treatment brown spots or age spots as well as to treat melasma. Coarse or rough skin will also be improved. Fine lines and deeper wrinkles may be better treated by CO2 laser.

Can TCA Peels improve acne scars?

The usual medium depth TCA peel does not penetrate deep enough to treat acne scars. However, acne scars can be treated with high concentration TCA 70% or more applied directly into the scar several drops at a time. This treatment works best in patients with fair skin.

Can estheticians perform TCA Peels?

Estheticians are licensed to perform only superficial TCA peels, typically 10-15%. Superficial peels using TCA are done in a series of 3-5 treatments for best results. This treatment is similar to light peels with glycolic or salicylic acid. Deep melasma may not improve with a superficial TCA peel, but abnormal pigment or melasma on the surface is likely to improve.

What areas can be treated?

tca peel before and afterTCA can be used to treat the neck, chest, arms and legs in addition to the face. Healing will be slower in these areas (up to 2 weeks) and results are not as predictable due to the thickness of non-facial skin. Large areas of the body should not be treated at once to avoid toxicity and risk of infection.

How much do TCA Peels cost?

The cost of a TCA peel varies based on the strength or depth of peel and which areas are treated, face only or face and other body areas.The range of costs is $150-$900 (TCA peels performed by our esthetician, which are 10-15% are priced on the lower end).
If you are concerned about sun damage or abnormal pigmentation, a TCA peel may be right for you, schedule a consultation with a board-certified dermatologist and find out if this chemical peel treatment is right for you.