About TCA

What is TCA?

TCA - Abbreviation for trichloroacetic acid

What are TCA peels used for?

TCA peels are most commonly used:

  • to reduce brown spots and age spots
  • to improve the texture of leathery, sun damaged skin and impart more glow
  • to improve melasma
  • to treat some types of acne
  • to reduce fine lines

What are TCA peels?

TCA is a non-toxic chemical (trichloracetic acid), which has been used to perform skin peels for over 20 years. It is a relative of vinegar (acetic acid.) When TCA is applied to the skin, it causes the top layers of cells to dry up and peel off over a period of several days to one week. When the old skin is peeled off, it exposes a new layer of undamaged skin, which has a smoother texture and more even color.

Some dermatologists, in fact, still prefer TCA peels for treating sun damage or melasma, usually in combination with prescription creams. TCA peels are safe in the hands of an experienced dermatologist. TCA peels may be a good option, particularly if you have melasma, because many lasers are difficult to use when treating melasma.

How do TCA peels work and what are the different depth peels?

All peels work by removing a layer of sun damaged skin. Superficial or “light” peels remove only the top layer, mostly the layer of dead skin called the stratum corneum. Progressing from medium to deep peels, the layer of skin removed is greater with each increase in strength of the peel solution. The stronger the peel solution the greater the risk of complications like uneven pigment or even scarring.

TCA peels can be done at different depths from shallow to deep. Most dermatologists now are using laser technology instead of deep TCA peels, but light to medium depth peels are still in widespread use.

Lighter TCA peels are usually done in a series of 2 or 3 for best results. This is similar to other light peels that usually involve hydroxy acids such as glycolic, salicylic, or a mixture of other hydroxy acids. Medium depth TCA peels are usually done once or twice a year and do require some downtime – usually about a week – when the peeling is obvious

What areas can be treated with TCA peels?

The face, neck, chest, back, arms, and legs. TCA peels may be very cost effective on the body because larger areas can be done at less cost than a laser. However, the risks of problems may also be greater unless the dermatologist is very experienced with TCA peels on the body.

When considering peels of non-facial areas, it’s important to realize that these areas do not heal as well as the face, and the desired results are not as predictable. It is important to note that you should never peel more than a small percentage of the body at one time in order to avoid any chance of potential toxicity.

What are the pros and cons of TCA peels versus treating the same problem with a laser?

Many dermatologists use lasers now rather than TCA peels because the lasers can be controlled more precisely, limiting complications. Peel solutions can be less predictable because the exact strength of the solution, the prepeel clean (defatting), and the ability of the skin to absorb the peel solution are all variables that can be difficult to precisely control.

Still, some dermatologists who are experienced get excellent results. Deep TCA peels, because of the risk of uneven absorption, blistering, and possible scarring, should be performed only by board-certified dermatologists or plastic surgeons who are experienced in this procedure.

Also, many patients with sun-damaged skin have some redness or dilated blood vessels that need to be treated as well. The IPL laser systems can treat both the redness and the sun spots at the same time.  Sometimes peels and lasers may be used in combination.

Another advantage to lasers is that many problems can now be treated with immediate return to normal activities. Medium depth TCA peels usually require some time off to heal.

How long do the effects of TCA peels last?

This depends on the depth of the peel and the extent of your continuing sun exposure.  Your dermatologist should be able to give you an estimate.

When will I see results from my TCA peel?

As soon as you finish peeling you will see results. Your skin should continue to improve for 30-60 days as long as you are protected from the sun.

How much do TCA peels cost?

This really depends on where you live, the depth of peel and the areas you are peeling. TCA peels can run from $300 to $1,000 for a full face peel and are often done in a series. A full face, neck, and chest will cost more.

What does a TCA peel feel like?  Is it painful?

The peel goes something like this.  When you arrive, you will be put in a room and be asked to get comfortable on an exam table. Your skin will be cleansed several times with liquid cleanser, alcohol and possibly acetone.  It’s important that all the oil be off the skin so the peel solution will penetrate evenly. Then the peel solution is applied and sometimes this is done in two stages. There is some stinging and a sensation of heat while the peel solution is active. Sometimes a small handheld fan is used for cooling in this stage. Then an ointment is applied to speed healing and post care instructions are given.

What will I look like right after the treatment, and what will the healing time be?

You will usually peel for about one week with a medium peel. The skin will be a light yellow after the procedure for 1-2 hours. This color will gradually fade. The skin will be slightly redder for 2-3 days after the peel and feel tight.

Avoid all sun exposure. You will begin to peel approximately 48-72 hours after the treatment and the peeling will last generally 2-5 days. There is no pain but the skin looks as if it has a severe sunburn.  You will be more sensitive to sunlight for 4-8 weeks after so don’t plan any sunny vacations for at least a month.

What are the possible side effects and complications of  TCA peels?

Your provider will give you specific instructions on pre-treatment and post-treatment care and expectations. And if you are going to take any pain medications, you will need someone to drive you to and from your appointment. Your provider will also give you a list of side effects, but here are some possible side effects or issues:

  1. Pain. There is usually no discomfort after the peel, but, in case there is mild discomfort, pain medications can be provided.
  2. Redness. A pink or red coloration of the skin may persist for 2-8 weeks after a TCA peel. In rare instances, redness may persist up to six months. This can occur all over or only in certain spots.
  3. Wound Healing. TCA peels cause a superficial wound to the skin that takes approximately 5-7 days to heal. Once the surface is treated, it may be pink and may be sensitive to the sun for approximately 2-8 weeks.
  4. Pigment Changes. The treated area may heal with increased or decreased pigmentation. This occurs most often in darker pigmented skin. The darker or lighter areas usually fade in three to six months, though pigment change can be permanent.
  5. Swelling. Immediately after the TCA peel, there will be mild to moderate swelling of the skin. This is a temporary condition and will resolve over two to three days.
  6. Scarring. There is a very small chance of scarring. This includes hypertrophic scars or, very rarely, keloid scars. Keloid scars are very heavy, raised scar formations. To minimize chances of scarring, it is important that you follow post-operative instructions carefully. It is important that any prior history of unfavorable healing be reported.
  7. Eye Exposure. There is also a risk of harmful eye exposure with TCA peels. Your provider should give you protective eyewear. It is important that you keep your eyes closed and have protective eyewear at all times during the treatment.
  8. Sun sensitivity.  You will be sensitive to the sun for 6-8 weeks after the treatment and will need to protect your skin daily from the sun with sunscreen, hats and sunglasses.
  9. Accutane. Generally, you should not have a medium depth peel if you have used Accutane in the last 12 months.
  10. Cold Sores. If you are prone to herpes (cold sores, fever blisters), you may need a prescription for acyclovir or famvir prior to having medium depth Peel. You will need to avoid exfoliating treatments during a herpes breakout.

How should I care for my skin after TCA peels?

Your doctor will give you specific instructions but some general guidelines are as follows.

Wash nightly with a gentle cleanser like Cetaphil and remove any makeup very gently. Apply a thick, bland moisturizer like Cetaphil Cream, Vanicream, or Skinceuticals Epidermal Repair. Ask your doctor when makeup can be applied. You will need to increase your use of a moisturizer after the peel as your skin will be temporarily drier.  Many doctors ask you to avoid all sun exposure for 2-8 weeks.

How to Apply a TCA Peel

A TCA peel is a skin treatment that works by applying trichloracetic acid to your face. TCA peels can be used to treat a number of conditions, including acne, irregular skin tone or texture, hyperpigmentation, fine wrinkles, and scars, including acne scars. This treatment can be performed by a dermatologist, but it is quite expensive. In order to save money, you can apply a TCA peel at home. In order to apply a TCA peel, you will need to prepare your skin for the peel, apply the peel, remove the peel, and follow post-procedure care instructions.

1. Determine if you are a suitable candidate for a TCA peel. TCA peels can have positive impacts on your skin by removing signs of aging and acne. However, there are certain instances when you should not apply a TCA peel. Do not use a TCA peel if you:
  • Have cuts, broken skin, or received a recent facial surgical procedure.
  • Have a sunburn.
  • Have active Herpes simplex 1 sores.
  • Are pregnant or breastfeeding.
  • Have taken Accutane in the last year.
  • Have recently received chemotherapy or radiation treatment.

2. Use products that contain alpha hydroxy acids 5-7 days before the peel. In order to prepare your skin for a TCA peel and make the treatment more effective, you should use a face product that contains AHAs, such as glycolic or lactic acids. There are a variety of creams, lotions, and toners available for your skin. Begin using this product approximately five to seven days before applying the peel.

3. Read all the instructions provided with the peel. TCA peels can be purchased through online retailers or through a dermatologist. Once you have acquired a TCA solution, you should read and follow all of the instructions provided by the manufacturer. TCA peels can be highly acidic so it is very important that you follow all directions.

4. Test the TCA on a small patch of skin. This way you will be able to determine if the acid solution is too strong or if you are allergic to the solution. For example, if you want to apply a TCA peel to your face, you should test a small patch of skin under your ear. This area is out of the way and will not be overly visible if you have a negative reaction. Always test the skin near the area you want to treat.
  • Rinse the test patch of skin once it starts to burn.

5. Wait 48 hours to apply the peel. This way you will know how the peel will react on your skin. If the spot that was tested becomes itchy, red, or bumpy, you should not apply the peel to your skin. This is likely a sign that you are experiencing an allergic reaction.Enter your text here...

Applying a TCA Peel

1. Cleanse your skin. Immediately before you apply a TCA peel, you need to completely clean your skin. If you are applying the TCA peel to your face, you should remove all of your make up. Washing your face will help to remove any surface oils allowing the TCA solution to peel away a layer of skin.

2. Remove surface oils using a prep solution. Some TCA peels will come with a prep solution that should be applied to your skin prior to administering the peel. These solutions help to fully dry out your skin and remove any lingering surface oils.[7]
  • If you did not purchase a prep solution, you can apply witch hazel or diluted rubbing alcohol to your skin using gauze.
3. Apply petroleum jelly around the eyes, mouth, and nose. If you are applying a TCA peel to your face, you want to protect some sensitive areas from the acid. In order to do this, use a cotton swab to apply a bit of petroleum jelly to your lips, and the skin around your eyes and nostrils. This will prevent the acid from damaging these sensitive areas.[8]
  • You may want to wear safety goggles to prevent any TCA solution from dripping into your eyes. You will still have to apply petroleum jelly to your nose and mouth, however.

4. Put on latex gloves. While working with the TCA solution, you want to be careful that the acid does not touch other areas of skin. As a result, you should always wear latex gloves to protect your hands from the acid. This is especially important if you are applying the TCA using gauze because it will likely come into contact with your fingers.

5. Pour the TCA solution into a small dish. Place a small dish on your counter and pour some of the TCA solution into the dish. This will make it easy for you to dip your brush or gauze into the solution while you are applying the TCA to your skin.

6. Use gauze to apply TCA to your skin. Dip a piece of gauze into the TCA solution. Then squeeze the gauze gently. You want the gauze to be wet, but not dripping. This will prevent the solution from running into your eyes. Then apply a thin layer of TCA to the desired area of skin. If you are applying the TCA to your face, you may want to divide the area into sections.[10]
  • For example, start by applying the TCA solution to the right side of your face, then the left side, and do the forehead last. This will help prevent you from overlapping the solution.
  • You can also apply TCA using a makeup brush, but a brush is more likely to cause dripping.
7. Wait 2-5 minutes. Once the solution has been applied to your skin, you should wait approximately two to five minutes. The time will vary depending on the strength of the solution, the number of peels you have performed, and your own skin type. It is normal for your skin to turn red and sting a bit while the peel is on your face.[11]
  • If your skin begins to frost (i.e. turn white) or sting uncomfortably, you should begin neutralizing immediately by washing the solution off with water.
  • This is more likely to occur when using a stronger TCA of 15% or higher.

Removing a TCA Peel

1. Apply a post-peel neutralizer to your skin. If you begin to experience frosting, you should apply a post-peel neutralizer to your skin. This typically comes with the TCA peel kit. Apply the neutralizer to your skin using a gauze or a soft cloth dipped in the neutralizer.[12]
  • You can also make your own neutralizer by mixing 2 tablespoons of baking soda with 1 and a half cups (355 ml) of water.

2. Wash your face with water. After the peel has been on for five minutes, you should wash it off by splashing water onto your face. You can also apply water by dabbing your skin with a wet cloth. This will help to remove the TCA from your skin and will help to neutralize the area.

3. Apply a healing ointment. Once your skin is dry, apply a healing ointment to the skin. For example, try using emu oil or Bacitracin to help heal your skin following a TCA peel. You should re-apply this solution a few times a day for at least 48 hours following the peel.

Recovering from a TCA Peel after 7 days

1. Use SPF 30 sunscreen to protect your skin. Your skin will likely peel for approximately five to seven days following the procedure and during this time you should avoid exposing your skin to the sun. Make sure to use a sunscreen with an SPF of 30 or higher during this time.

2. Drink lots of water. TCA peels will dry out your skin. You can replenish the liquids in your skin by drinking lots of water. Try and consume at least eight cups of water per day following the application of a TCA peel.

3. Avoid picking at your skin. If you used a stronger TCA solution, you skin will likely peel for a few days following the treatment. Do not pick at your skin. Instead, let it peel on its own. Picking the skin can lead to skin damage.

4. Wait 10-14 days for the final results to appear. Do not apply another peel during this time. Although your skin may stop peeling prior to 14 days, the solution is still working on your face and the results will not fully appear for 10-14 days. Once the results are visible, you can determine if another treatment is necessary. TCA peels are quite strong, so if you notice positive results after the first peel, you likely do not need to perform another peel.

TCA.IE highly recommend: 

Professional 30% Pure Medical Grade Trichloroacetic Acid (TCA Peel) + Jessner's (Lactic Acid, Salicylic, Resorcinol) Chemical Peel, 30mL each, with Powerful Ultra Healing Moisturizing Lotion

TCA Peeling Amazon

How to TCA peel – Tutorial by Dermatologist

How to TCA peel – Tutorial by Dermatologist