Chemical peels are nonsurgical cosmetic procedures that are used to rejuvenate the skin, treat acne or acne scars, reduce the appearance of wrinkles and correct abnormal skin pigmentation. Your dermatologist may recommend a trichloroacetic acid peel for a variety of skin problems on your face. Before you undergo a chemical peel, discuss the possible risks and after effects with your doctor or dermatologist.
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There are three main types of chemical peels -- superficial, medium and deep peels. Each type of peel uses a different chemical solution, and medium peels use trichloroacetic acid, or TCA. Alpha hydroxy acids are used in superficial peels, while phenol is most commonly used for deep peels, explains the University of Maryland Medical Center.
Sometimes, a medium peel is performed by applying different chemical solutions, followed by an application of TCA. In some cases, TCA peels are performed with pretreatments of AHA creams. Because TCA has analgesic effects, you usually don’t need anesthesia for a medium peel like you would for a deep peel, although you may need a mild pain reliever and sedative for the procedure. The strength of the TCA solution can be adjusted as needed, and often more than two medium peels are performed over time to get the desired results.
In the days or weeks following the application of TCA to your skin, the chemical solution penetrates and the topmost layer of your skin peels off. Chemical peels smooth out skin and exfoliate the damaged outer layers. TCA chemical peels can provide temporary smoothing of surface wrinkles by providing a medium-depth peel. TCA peels can also reduce the appearance of skin pigmentation abnormalities and superficial blemishes or acne. In some cases, TCA peels are used to remove precancerous skin lesions due to sun exposure and severe sun damage. Although you may experience burning, stinging and pain during the chemical peel, you likely won’t experience any significant pain afterward.
TCA chemical peels produce more dramatic results than superficial peels using AHA, but less dramatic effects than deep peels using phenol. TCA medium peels also produce longer-lasting results than superficial peels but not as enduring as the effects of a deep peel. TCA peels are generally recommended for individuals with darker skin in lieu of deep peels. Like a deep peel, a TCA peel essentially causes a second-degree burn on skin, which usually takes up to one week to heal enough to wear makeup, notes the University of Michigan Health System. You may need several days to recover from a TCA peel, and the redness can last for weeks.
You could experience after effects like temporary or permanent skin color changes and scarring from a TCA chemical peel, warns the University of Maryland Medical Center. Skin color changes most often occur in women who are pregnant or take oral contraceptives, or those who have a family history of skin pigmentation problems on the face. TCA peels can also stimulate recurrence of herpes simplex cold sores and fever blisters. After your chemical peel, you must stay out of sunlight until the peeling has stopped and you’re able to apply sunscreen. Cleanse, moisturize and apply any dressings or ointments to your face as your doctor has directed.