Phenol and TCA, or trichloroacetic acid, are two potent ingredients used in chemical peels. These can be applied in various strengths, depending on your cosmetic concerns and how long you want results to last. However, the biggest difference between phenol and TCA is that one chemical gives you more dramatic results, states the American Society for Plastic Surgeons.
Trichloroacetic Acid Peels
TCA is typically used for medium chemical peels, states the ASPS, although the American Academy of Dermatology lists it as one of the substances that may be used in deeper peels. TCA peels remedy fine lines, surface blemishes and discoloration. If your dermatologist uses a TCA peel, the results from the peel likely won't be as pronounced as one that uses phenol. You may require more than one TCA peel to get the results you want. Although a milder chemical, TCA may cause color changes in your skin, says the ASPS, although not to the extent of phenol.
Phenol Peels
Phenol is the most potent substance that can be used in a chemical peel, and it's used for deep peels, says the ASPS. A phenol peel may be appropriate if you want to tackle deeper wrinkles, sun-damaged skin or precancerous skin lesions. The ASPS states that phenol is used almost exclusively on the face, because using it anywhere else may put you at risk for scarring. Your skin may also be lighter after a phenol peel, so skin tone is taken into consideration before this treatment.
Medium Peels
A medium peel reaches into the middle layer of the skin to remove damaged cells, states the AAD. Your healing time after a medium peel may take up to two weeks, during which time you may need to soak your skin daily and apply special ointments, creams and lotions. Right after treatment, your face may be swollen and red for a couple of days, including your eyelids, after which blisters may develop and break. The skin eventually heals and peels off, but until that time, sun avoidance is necessary, says the AAD.
Deep Peels
Deep peels, for which phenol is used, reach further into the skin's middle layer. Anesthesia is not required during a deep peel, says the ASPS, although you may be offered a sedative to keep you calm and comfortable. Your skin is usually bandaged after a deep peel. Healing time may take up to three weeks, during which time your dermatologist may have you soak your skin several times a day, as well as apply thick ointments and creams. You may need to stay out of the sun for up to six months, as the brand new skin that emerges after treatment cannot produce pigment, says the ASPS. Phenol peels may pose a hazard for those with certain heart conditions, so it's important to communicate your medical history with your doctor prior to this treatment. The AAD notes that a deep peel can be done only once on the same patient.
Considerations
TCA and phenol peels may offer the results you're looking for, but they won't improve some cosmetic imperfections, such as loose or sagging skin, deep scars and spider veins on the face, cautions the AAD. And, according to the American Osteopathic College of Dermatology, chemical peels have become less popular with the advances made in laser resurfacing. Chemical peels are usually safe when provided by a medical professional, although there is a slight risk of infection and scarring. To make sure a TCA or phenol peel is appropriate for your cosmetic needs, talk to a dermatologist skilled in the delivery of these treatments.
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