- TCA peels use trichloroacetic acid to improve the skin’s appearance
- These peels can be used to treat acne scars, hyperpigmentation and sun damage
- TCA is used for medium and deep peels and may require days or weeks of downtime
- TCA is safe for all skin types if the appropriate precautions are taken
- At-home peeling kits carry the risk of damaging your skin and should be used with care
A TCA peel is a type of chemical peel that uses trichloroacetic acid as the primary peeling agent. These peels are typically stronger than a standard “lunchtime” peel and may require some downtime, however, they offer significant changes to your skin’s appearance.
What Is a TCA Chemical Peel?
A TCA peel uses trichloroacetic acid to remove the top layer of skin on your face, neck, hands or other parts of the body. It is derived from acetic acid, otherwise known as vinegar.
TCA peels can be performed at a variety of strengths, depending on the skin issue being addressed. However, they are most commonly used at medium strengths for full-face peels.
How Does a TCA Peel Work?
TCA breaks up the bonds within keratin, a protein found in your hair, skin and nails. This causes the keratin to stop functioning properly, lighten in color and peel away from the skin. The process can be seen during the peel as the skin turns white, creating what’s called a “frost”.
The concentration of TCA used determines the depth of the peel. Lower concentrations provide more subtle changes in the skin, while high concentrations can significantly improve skin tone and texture.
- 10-15% – used to treat light hyperpigmentation
- 20% – treats sun-damaged or aging skin, mild scars
- 30-35% – treats deeper wrinkles, deeper scars and precancerous growths
While peels of lower concentration can be performed on the face, neck, hands or any body part with sun damage, peels of 20% or higher can only be performed on the face.
TCA Chemical Peel Benefits
TCA chemical peels offer several noticeable improvements to the skin including reduction of acne and acne scars, sun damage, hyperpigmentation and age spots.
Acne and acne scars
TCA can temporarily reduce blemishes, but alpha-hydroxy acid (AHA) peels using glycolic or salicylic acid are more commonly recommended for acne management.
Where TCA has the advantage over AHAs, however, is its effectiveness at treating post-acne scarring. One study found that it was more effective than microdermabrasion, micro-needling and glycolic acid peels.
Atrophic or pitted acne scars, commonly called icepick or boxcar scars can be treated with TCA using the CROSS technique. This involves the pinpoint application of TCA directly into the depression to reconstruct scar tissue and even out the skin. This method is more efficient at treating atrophic scars than a full face peel.
Even in low concentrations, TCA is effective at reversing sun damage to the skin. It has been proven especially useful at increasing skin elasticity and hydration.
TCA peels vs. other chemical peels
TCA peels offer a greater ability to resurface your skin than do light peels: scarring, hyperpigmentation and sun damage can be substantially reduced after only one treatment. At the same time, they do not require the extensive downtime, risks and permanent skin changes of deeper peels.
Are TCA Chemical Peels Right for Your Skin?
All skin types are able to tolerate TCA chemical peels if the proper techniques are used, but caution must be taken with very light- and dark-skinned people to mitigate the risk of permanent skin discoloration or other unwanted side effects.
Contraindications for chemical peels include the tendency to keloid scar formation, taking medication that makes your skin light-sensitive and any active bacterial, fungal or viral infections. People with certain skin conditions such as facial dermatitis may not be good candidates for face peels.
What to Expect During a TCA Peel
Because a TCA peel is stronger than a light peel, there is more preparation and aftercare involved.
The weeks or months leading up to a TCA peel may require a pre-peel regimen, determined by your dermatologist, to improve the outcome of your treatment.
You may be required to stop using retinoid creams or medications because they increase the chemical’s penetration into the skin.
However, you might also be prescribed a retinoid for the same purpose if your dermatologist determines that it will shorten your treatment time and improve your results. The same applies for bleaching agents such as hydroquinone.
If you experience cold sores, you may be prescribed an antiviral to avoid a flareup after treatment.
In the week before treatment, stop using hair-removal products, facial scrubs and any skin-lightening products on your face.
Before the procedure, the clinician will clean your face and protect your hair and clothes. You may have the option of taking a sedative or painkiller
During treatment, he or she will use a cotton-tipped applicator or gauze to apply the TCA solution. The treated skin will begin to whiten or “frost” and you will experience a burning sensation.
After the desired level of frosting is reached, the clinician will apply a cool compress to soothe the skin. A TCA peel does not require a neutralizing solution. Depending on the depth of the peel and your skin’s reaction, the clinician may apply a protective ointment to the skin.
Recovery and aftercare
After your TCA peel, your skin will be red and swollen for several days. This will transition into peeling, crusting and darkening of the skin. You may take over-the-counter pain medication to ease any discomfort.
Your skin will take 7 to 14 days to heal, but redness may persist for several months. You’ll likely schedule a follow-up visit with your clinician to make sure the healing process goes smoothly.
During the healing process, follow a few skin care steps to promote a good outcome.
Use only mild cleansers and other skin care products and meticulously wear a broad-spectrum sunscreen with a high SPF throughout the recovery phase. Do not pick at or peel the skin, which can lead to scarring.
After a TCA peel, your new skin will appear firmer, brighter and more even in texture and tone. Mild hyperpigmentation, fine lines and shallow scars may be completely erased.
How many TCA peels does it take to see the results?
Your skin’s overall appearance will be improved after only one peel. However, if the scarring, hyperpigmentation or sun damage you are addressing is particularly severe, you may find that a series of peels are necessary to obtain fully clear skin.
You can schedule another TCA peel three to nine months after the first.
Safety and Side Effects
Although chemical peels are generally considered safe, medium peels carry higher risks of complications than light peels do and may require downtime even if all goes well.
Side effects that you can expect include swelling, itchiness and burning. You may experience redness or changes in skin color that last for several months after the peel. Very light and darker skin tones have a higher risk of post-peel hyperpigmentation and skin discoloration.
Rarer complications include bacterial, fungal or viral infections and organ damage from deeper peels.
How Much Do TCA Peels Cost?
The cost of the procedure depends on where you live, the area you are having treated and the strength of the peel. With those factors in mind, TCA peels can range from $300 – $3,000.
At-Home TCA Peels
If you are interested in a TCA peel, it is best to contact a dermatologist to assess your skin’s needs and eligibility for a peel rather than proceed on your own.
While TCA solutions in professional-strength concentrations are readily available for purchase on sites such as Amazon, it is strongly advised to avoid these products. Their improper use carries a high risk of chemical burns, skin discoloration and permanent scarring.
If you do choose to perform a TCA peel at home, start with a low concentration of 10-15% to test your skin’s reaction. Never attempt a peel of 20% or higher outside of a dermatologist’s supervision.
Alternatively, you may also use glycolic acid, lactic acid or salicylic acid products designed for at-home use. These products are much safer for your skin and can achieve good results over time.
TCA peels can be used to address several skin issues, including sun damage, acne and acne scarring and hyperpigmentation. Although substantial improvement may be seen after only one peel, multiple peels may be necessary to obtain your desired result.
TCA peels involve a recovery period of a few days to several weeks, depending on the strength of the peel. Side effects include redness, swelling and peeling.
TCA peels are best performed by a board-certified dermatologist. If you choose to administer a TCA peel at home, use a product from a reputable source and avoid any solutions containing more than 10-15% TCA.