TCA Peels
TCA peels, trichloroacetic acid peels, are medium strength chemical peels that rejuvenate and repair
your skin. They improve skin discoloration, reduce fine lines, and even out skin texture. They also cause
your skin to physically peel, however, the results are usually well worth the peeling!
What do TCA peels do?
TCA peels are medium depth peels, ranging from 8% to 30% strengths. Though their concentrations
might not be as high as other chemical peels, TCA peels are considered much deeper peels than lactic
acid and glycolic acid peels.
TCA peels brighten and even out your skin tone by reducing the appearance of hyperpigmentation (dark
spots, acne marks, sun spots, freckles and skin discoloration. They revitalize dull-looking skin, helping
skin look soft and smooth. Because of their deep exfoliating effects, TCA peels can clean out congested
pores to refine the surface of your skin. TCA peels are also great for improving fine wrinkles and treating
sun damage. TCA peels can be used on the face, neck, or back of the hands. They can also be used
just as a spot peel. One TCA peel will give better results than one glycolic acid peel, but more than one
TCA peel is still necessary for the best results. Results generally last around 6 months, but they can last
even longer when supplemented with glycolic or lactic acid peels every few weeks.
What to expect from a TCA peel:
Pre-peel: Before you get the TCA peel, there are a few things you should do to prepare your
skin for it. Some professionals recommend using retinoids or an AHA serum for two weeks prior
to the peel to prime the skin for a more even and penetrating peel. However, this is optional.
Three days before the actual peel though; you must stop the use of all exfoliants (manual or
chemical) and especially avoid using any harsh products (such as hair removal or grainy scrubs)
on the day of the peel and for the duration of the peel. Day 1: (Day of the Peel)
What happens during a TCA peel is this: Your skin will be cleaned (you probably want to skip wearing
makeup to your TCA peel session) and thoroughly dried. Some places will apply a prep solution (kind of
like an astringent) to remove any residual facial oils and prime your skin for the peel. After the prep
solution dries, petroleum jelly will be applied around your eye sockets, nostrils, and lips to protect these
more sensitive areas of your face. Finally, the TCA solution will be applied to your skin.
During the peel, your skin will tingle, feel prickly, and turn hot. TCA peels don't hurt but they are
uncomfortable. There will be a fan to help cool your skin and ease the burning sensation. For some
people, "frosting" actually occurs. This is where parts of your skin turn white during the peel.
If you are getting a TCA peel for the first time, you will probably only have one layer of peel solution
applied to your skin. For more experienced peelers, two or even three layers may be applied for a
deeper peel. A second layer will give you approximately a 25% boost in strength. Definitely do not get
more than one layer if you've never had a TCA peel before because you could really risk burning your
skin. If a second layer of the peel is applied, it's usually applied 5 minutes after the first layer and left on
your skin for another 3 minutes.
How long the peel solution should be left on your skin depends on the strength of the peel and your
experience with TCA peels. The more TCA peels you have the more likely you can leave the peel on for
a longer amount of time.
Most TCA peels self-neutralize in around 5 minutes. However, neutralizing solutions are used to fully
ensure that the peel has stopped working. After the peel is neutralized, your skin is then very, very,
gently cleaned Do not scrub or use any abrasive products on your post-peel skin because it is very
fresh and sensitive! Once your skin is completely dry, a thick layer of sunscreen will be applied.
Your skin maybe pink for the rest of the day and some people even experience slight swelling. The
redness from a TCA peel can be covered up by makeup.
After the TCA peel, drink lots of water to keep your skin hydrated.
Day 2: The morning after a TCA peel
The morning after you get your TCA peel, your skin will be pink/red, feel tight, and start to look crepey.
Some parts might even appear mottled and turn brown (usually in the areas where you frosted). The
crepey-ness of your skin will look especially pronounced on the forehead, cheeks, and any place where
you move your face the most.
To clarify, crepey skin looks like dry wrinkles. It can look glossy on the surface but feel dry underneath.
If you don't make any facial expressions, you might not even see it, but it is very noticeable if you
wrinkle your nose or furrow your brows. This crepe-like skin represents skin that is about to peel. It also
means that the TCA peel is working!
On the day after you get the TCA peel, you still have to be very gentle with your skin while cleansing
and continue to apply sunscreen and drink lots of water. At this stage of the peel, the goal is to keep
your skin hydrated and protected. Again, you can cover up the side effects of the peel with makeup
(most people don't start to flake and peel until day three), but it's best to leave your skin alone.
When you get a TCA peel, you expect to peel right away, but it actually takes some time for your skin to
start shedding. So don't expect to peel on the second day. You can, however, encourage your skin to
peel faster by regularly spritzing your face with tepid water and apply moisturizer. Absolutely do not
pick at any of the crepey skin or brown spots because you don't want your skin to peel before it's ready!
Days 3-4: When your skin starts to peel
For most people, visible peeling starts on days 3 or 4, after the TCA peel has had time to work on your
skin. However, some people may peel earlier or later. It all depends on your skin and how it reacts to
the TCA solution.
On day 3, your skin won't be as red anymore, but you still have to be super gentle with it. It will feel very
dry and look extremely crepey because you essentially have a layer of dead skin sitting on your face.
The dryness might be uncomfortable and even itch. If this is the case, you can apply an anti-itch cream
to ease the irritation.
How much your skin peels from the TCA peel will depend on the strength of the TCA solution and how
your skin naturally reacts. Most people peel in little bits and pieces, but for those who get really strong
peels (i.e. multi-layer peels, high TCA concentrations, or peels with lots of frosting), it is possible to peel
in sheets. It can be disappointing when you expect your skin to shed like a snake but it only flakes here
and there. However, keep in mind that even if your skin doesn't peel off in giant skin sheets, it doesn't
mean the peel isn't working. Everyone's skin is just different. Whatever you do, don't pick off any of the
peeling flakes because you could end up scarring your skin. It can be quite a slow peeling process, but
be patient and let your skin peel naturally.
Using a moisturizer can actually mask some of the peeling. If your skin is really dry, you could maybe
see it physically peel, but keeping your skin well moisturized keeps those dry skin flakes hydrated, so
even though your skin is peeling, it's just not as pronounced. This doesn't mean moisturizing your skin
will make it peel any less than if it were dry. Moisturizing your skin just allows your skin to peel more
comfortably, even if not more noticeably.
In general, it's better to keep your skin moisturized at all times, peeling is more pronounced when your
skin is dry, but dry skin is also itchy and uncomfortable. Avoid the sun! Some people don't peel at all,
even 3-4 days after they get the TCA peel. This probably means that the peel wasn't strong enough for
your skin. If this is the case, you can get another TCA peel done on day 5.
Depending on the strength of the TCA peel, you can peel for up to 3-10 days.
On day 10, you should be done with the majority of the peeling. Your skin may look slightly pink (your
normal skin colour will resume in the next few weeks as your skin continues to recover) and you may
have little bits and pieces of skin that are still peeling, but your complexion should feel smoother and
look brighter. The results from a TCA peel are sometimes not very dramatic try not to expect too much
from one TCA peel. Some of your old pigmentation spots and fine wrinkles may look better, but you
might feel disappointed that you didn't get better results. Don't worry your skin will gradually improve in
the next few weeks after you finish peeling. It takes upto four weeks for your skin to heal and recover
and it takes multiple TCA peels to get your desired results. You are not going to get perfect skin from
just one peel. If you do see good results after one peel though, you don't have to get more done.
How you take care of your skin after you finish peeling is as important as how you take care of your skin
during the TCA peel. Two weeks after you finish completely peeling, you can resume any AHAs, BHAs,
or retinoid treatment products. After you peel, you still have to wear a good sunscreen because your
"new" skin will be extra sensitive to the sun. You can get another peel done one month after you finish
completely peeling. However, after three consecutive TCA peels each spaced one month apart, your
skin needs a break for 3-6 months before you do another peel.
Who should not get TCA peels?
TCA peels do not work for everyone. If you fall into the below categories, do not get a TCA peel done:
If you are using Roaccutane (Accutane) or have used it in the last 18 months
If you are pregnant or lactating
If your skin is prone to keloids (or raised scars)
If you have dark skin
If you have herpes simplex and/or are prone to cold sores
If you are undergoing chemotherapy or radiation treatments
If you are HIV positive or have AIDS
Roaccutane (Accutane) makes your skin more sensitive and can even slow wound healing. With a TCA
peel, where the top layer of your skin is burned away with an acid, you need proper skin healing
function to prevent infection and permanent damage. That is why those who have been on Roaccutane
or oral isotretinoin are not good candidates for TCA peels.
Those who are pregnant or lactating may want to avoid TCA peels as well. It is unknown how much
trichloroacetic acid would be absorbed by the skin during the peel. Many doctors tell their pregnant
patients to avoid using AHAs and BHAs.
If your skin is prone to keloid (or getting raised scars after a wound is healed), you should definitely
avoid TCA peels because by "damaging" the skin on your face with the peel, you risk getting keloids
anywhere you peel. Darker skin should also avoid getting TCA peels because TCA peels can cause
uneven pigmentation (either through hyperpigmentation or hypopigmentation).
Side Effects and Precautions of TCA Peels
Burning your skin
Persistent facial redness (erythema)
Skin pigmentation changes
Scarring or infection
Post-peel breakouts
Sun sensitivity
These side effects sound scary, but they are generally avoidable if you properly care for your skin
before and after a TCA peel. To what degree the above side effects will affect you also depends on your
skin type and the strength of the peel.
Using too strong of a TCA solution and leaving it on your skin for too long contributes to skin damage
and persistent redness. Therefore, it's always good to start slow and build your way up. Never use a
strong TCA peel before you have acclimated your skin to weaker ones.
It's also best to get TCA peels performed by qualified and experienced professionals.
If you haven't taken good care of your skin during the peeling process, redness or pink skin can linger
around long after you've finished peeling. Taking good care means: not picking at any skin flakes, not
using AHAs or retinoids until your skin has completely healed, not exfoliating right away, not using
harsh scrubs, avoiding swimming (chlorine pools and oceans), avoiding tanning beds, etc.
Staying out of the sun is very important!