TCA Peel: Evens skin tones and removes wrinkles

RSB Dermatology

TCA, which stands for trichloroacetic acid, is commonly used in various strengths as a peeling agent to:

  • Even out skin tones
  • Tighten the skin & reduce wrinkles
  • Shrink ice pick scars and giant pores

It is used in various strengths.

  • 20% TCA is generally used on the face to even out skin tones. This strength does NOT help tighten the skin or reduce wrinkles.
  • 35% TCA is commonly used to tighten the skin and reduce wrinkles.
  • Stronger preparations may be used to shrink large pores or ice pick scars using a method called, "Cross TCA". TCA has been used for other things, such as wart or genital wart treatment.

Dr. Bader has been performing these peels since 1995.

What are the benefits of TCA Peel?

In the right hands for the right indications in the right person, TCA peels are very safe and affordable, when compared with other peels or laser treatments. 

Are lasers better than TCA peels?

The answer is not simple, but yes and no. TCA Peels are great, take training, but do have downtime (takes time to heal).

There are many other treatments that can also even out skin tones and/or tighten the skin. There are many lasers that do this, each having their own risks and benefits. Some heal faster, some heal slower, some do as good a job, some don't. In short, you have to look at all of the options one by one.

For some types of acne scars the CO2 laser is often better.

Lasers are not cheap and in many cases, if a provider buys one, they will want to use it. That does not mean that the procedure is "better" and, in some cases it won't be. You have to compare all of your options.

What is the difference between using 20%, 35%, or stronger

The stronger the concentration of the peeling agent, the deeper the "potential" to damage the skin. In general, one never uses more than 35% except when treating scars.  Anything stronger than 35%, except for ice pick scars using the cross TCA method or other scars in special circumstances, has a high likelihood of scarring. 

One can still get a "superficial" peel with a 35% TCA similar to a 20%. But, one can never achieve a medium depth peel with a 20% TCA on the face as they could with a 35% TCA peel. There are other factors that affect the depth of the peel and one must be experienced with this type of peel.

I don't know. I heard that the CO2 laser is better than TCA Peels. Is that true?

In some ways yes, and in some no. The "newer" way of using the CO2 laser, using the fractional technology, allows for good results and faster healing than was previously done with fully ablative resurfacing. One can certainly achieve similar results for wrinkles with a TCA peel in many cases. 

When it comes to some types of acne scars, the CO2 laser is often a better option.

Aren't peels expensive? How much do they cost?

TCA peels can cost as little at $200 to over $1000 depending upon what is being treated, and how deep the peel is. Superficial peels, which do not help wrinkles, are inexpensive. Medium depth TCA peels, that tighten the skin and reduce wrinkles, cost more, but are much less than the cost of laser resurfacing.