Chemical peeling is one of the most popular cosmetic procedures prescribed to clients in beauty salons. However, fame and frequency of implementation do not always guarantee that the chosen technique will be effective and safe. Certain methods of exposure can only be carried out in medical institutions under the guidance of experienced professionals. Among such procedures is TCA peeling, a unique cleansing of the superficial and middle layers of the dermis.

Operating principle of TCA peeling

TCA peeling gets its name due to the main active ingredient - trichloroacetic acid. This substance is a rather aggressive chemical composition and, when used, penetrates into the middle layers of the dermis. In cosmetology, acid is used due to its following properties:

• Removing the surface layer of the dermis, eliminating dead and diseased cells, improving skin color.
• Stimulating the synthesis of elastin and collagen, which means further increasing skin elasticity and tone.
• Increasing local immunity.
• Reducing the secretion of sebaceous secretions and clogging of pores, cleansing existing impurities.
• Destroying bacteria that lead to inflammation and acne formation.

Simply put, the active components of the peeling preparation destroy old cells and stimulate the synthesis of new ones, which leads to the formation of a healing and rejuvenating effect.

Main indications for the procedure

It is believed that TCA peeling is contraindicated for young skin; its main purpose is to solve a more pronounced existing problem, and to prevent it.

Direct indications for such a procedure are:

• enlarged pores and increased oily skin;
• heterogeneous skin structure, sagging;
• scarring;
• expression wrinkles;
• stretch marks;
• low level of skin elasticity, preptosis;
• freckles and increased pigmentation.

Preliminary preparation

TCA peeling requires mandatory preliminary preparation, which lasts about two weeks. The main recommendations for this time frame are as follows:

• Using creams based on fruit acids.
• Protects skin from ultraviolet radiation.
• Taking vitamins that strengthen the walls of blood vessels.
• Taking antiviral drugs (immediately a couple of days before the session).
• Refusal of scrubs and other peelings (2 – 3 weeks before the session).

In addition, you should be aware that this peeling is carried out during the period of least solar activity, that is, in winter and late autumn.

Main stages of peeling

TCA facial peeling does not take much time, all manipulations are carried out quite quickly. To begin with, the skin is cleansed of fats and impurities, then, using a special brush, an acid-based preparation is applied to the problem area in several layers. The density and duration of application of the treatment mask is determined during the procedure.

I focus on the change in color of the composition, the cosmetologist draws conclusions about the depth of penetration of the product and the possibility of achieving the goals. So, if the product has acquired a dense white color, then the active components have reached the middle layers of the dermis, but if its shade is pale milky, the substance accumulates on the surface and does not penetrate deeper.

After a certain period of time, the acid is neutralized, and a nourishing and moisturizing composition is applied in place of the active mask. Basic manipulations for skin regeneration will be carried out by patients at home independently.

Rehabilitation and possible side effects

In most cases, negative reviews about TCA peeling are due to side effects after the cosmetic procedure. The body's response to the application of a chemical substance is manifested in the vast majority of patients. Fortunately, after a few days all external manifestations disappear, even without special treatment. The most common side effects are:

• Local redness of the skin.
• Excessive peeling.
• Swelling.
• Formation of dark, temporary pigment spots.
• Increasing the sensitivity of the treated area of ​​the face or body to external factors and irritants.

In rare cases, the consequences of the procedure may be more unpleasant. Thus, there are known situations when trichloroacetic acid provoked inflammatory processes, exacerbation of herpes, caused significant pigmentation, seborrhea, and severe allergies.

Of course, side effects mainly depend on compliance with safety precautions and the individual characteristics of the body, however, proper skin care after this peeling is also extremely important.

Photo of peeling by day

All rehabilitation rules can be conditionally divided into basic and special. As for the general postulates, they boil down to prohibitions on being in the sun, visiting solariums, saunas and baths, and rough mechanical impact on the treated areas of the body or face.

Special care is usually prescribed by a specialist and can be individualized. Most professionals strongly recommend that the client purchase an additional set of cosmetics that provide balanced and optimal skin care. If you decide to decline this offer, be sure to follow these guidelines during your rehabilitation:

• Hydration.
• Sun protection before every trip outside.
• Protection against bacteria and toxins.
• Relieving inflammation and swelling.
• Regeneration.
• Anesthesia.

List of contraindications

Medium TCA peeling is considered to be a rather aggressive technique, which is why it has a significant number of contraindications. The list of restrictions is standard, however, at the stage of preliminary consultations, individual characteristics of the potential patient’s body may be identified, due to which peeling will be impossible.

As for general contraindications, they can be either absolute or relative. In any case, in the presence of the following diseases or characteristics of the body, the final decision is made by a specialist with a medical education. This:

• Exacerbation of chronic diseases.
• Fever, chills, increased body temperature.
• Viral infections.
• Skin hypersensitivity and tendency to scar formation.
• A large number of moles or warts in the problem area.
• Taking certain medications (should be checked with a specialist).
• Menstruation on the days of the procedure.
• Cuperosis.
• Pregnancy and lactation.
• Having an intense tan.
• Oncology.
• Inflammatory formations on the skin.
• Nervous system disorders.
• Aggressive interventions suffered in the recent past (for example, another peeling of the same zone).

Advantages and disadvantages of the technique

TCA peeling is certainly a controversial procedure. When studying reviews about it, you can come across both positive and very negative opinions. What are the strengths and weaknesses of such a procedure? The existing advantages include high effectiveness, versatility, short preparation time, rehabilitation and the impact itself. However, we should not forget about the disadvantages, which are:

• the presence of a significant list of contraindications;
• high risk of side effects;
• discomfort during exposure.

Medical product, exfoliation material for superficial and medium chemical peels based on trichloroacetic acid.
The principle of action of TCAPEEL 15% and TCAPEEL 25% peeling is based on the pronounced keratolytic and stimulating effect of trichloroacetic acid. The depth of penetration of the peeling composition is determined not only by the concentration of the material, but also by the number of layers applied to the skin. When you stop applying new layers of peeling, penetration stops, because trichloroacetic acid is quickly neutralized as it moves through the layers of the skin, causing protein coagulation. Thanks to the controlled trauma of the epidermis and the irritating effect of peeling, renewal of the epidermis is ensured, stimulation of reparative and metabolic processes, which leads to an improvement in the physiological status of the dermis, helps to improve its texture, correction of facial and body defects: wrinkles, post-traumatic and post-operative scars, post-acne scars and other disorders skin relief. Acid does not have a systemic effect on the body. The procedure is carried out by a cosmetologist in a clinic, beauty salon, treatment room or other specialized institution.

Benefits of peeling

1. Peeling is used to correct a wide range of aesthetic problems.
2. Depending on the number of layers applied and the concentration of the active solution, peeling can be either superficial or medium.
3. This is an excellent anti-aging treatment for skin with signs of aging.
4. The intensity of the material is well controlled
5. Does not have a systemic effect

Indications for peeling

1. Fading skin
2. Wrinkles
3. Disorders of the microrelief and macrorelief of the skin
4. Photoaging
5. Preparing the skin for plastic surgery
6. Seborrhea

Contraindications

1. Hypersensitivity to material components
2. Infectious skin diseases (trichophytosis, microsporia, etc.)
3. Herpes in the acute stage
4. Violation of the integrity of the skin
5. Chronic dermatoses in the acute stage
6. Excessive insolation
7. Pregnancy and lactation
8. Tendency to develop hyperpigmentation

Preparations necessary for peeling

1. Cleanser Mousse Medic Control Peel (MCP)
2. Prepeel Lotion
3. Exfoliation material TCAREEL 15% or TCAREEL 25% Composition: trichloroacetic acid in concentrations of 15% or 25%
4. Revitalizing cream Vegefarma MCP

Home care products

1. Cleansing mousse or Gentle Cleanser Mousse Mesaltera
2. Prepeel Active MCP Pre-Peeling Cream
3. Revitalizing cream Vegefarma MCP or Thriphalan MCP
4. Sunscreen MediScreen MCP
5. Post-peel cream Postpeel Light or Postpeel Active

Peeling protocol

Stage I. Pre-peeling preparation

For 14–21 days, the patient should apply Prepeel Light, Prepeel Medium or Prepeel Active cream to the skin previously cleansed with Cleanser Mousse at night. In the morning, apply MediScreen sunscreen.

Stage II. Chemical peeling

1 step. Cleansing. Apply Cleanser Mousse to the skin of the face, distribute with light massage movements and leave for 15-20 seconds. Rinse with water. Dry the skin.

Step 2. Degrease the skin with Prepeel Lotion.

Step 3. Apply TCAPEEL peeling material using a gauze napkin or a cotton swab to the skin of the face in the direction from the periphery to the center in the following sequence: forehead, temples, cheeks, nose, chin, eyelids. There is a burning sensation and pain. A “frost effect” appears on the surface of the skin. By its intensity, one can judge the depth of penetration, and by its uniformity, one can judge the uniformity of application of the material to all treated areas. If applied unevenly to individual areas, they can be re-treated with the material. The number of layers applied depends on the concentration of the material used (15% or 25%), as well as on the desired penetration depth. Wait 2-3 minutes between repeated applications. There is no need to achieve a pronounced “frost effect” on the skin of the neck, décolleté and hands. After stopping the application of the peeling material, the subjective pain sensations stop.

Step 4 After peeling, apply Vegefarma MCP or Thriphalan MCP cream.

Stage III. Post-peeling care

The course of the post-peeling period depends on the depth of the peeling performed. If 1-2 layers of TCAPEEL 15% are characterized by the absence of crusts and the development of the peeling process, which lasts 4-5 days, then after peeling TCAPEEL 25% swelling and severe erythema increase within 24-48 hours after the procedure. Films and crusts form. During this period, the patient should not wet the skin of the face. Films and crusts peel off spontaneously within 7-10 days. It is necessary to warn the patient about the inadmissibility of their forced removal. When using both TCAPEEL 15% and TCAPEEL 25%, from the first day after the peeling procedure until the exfoliation process is completely completed, it is necessary to constantly moisturize the skin with Vegefarma or Thriphalan Balm cream and protect it from ultraviolet radiation in the morning by applying MediScreen sunscreen.

Peeling programs

TCAPEEL 15%: the basic course is 3-5 procedures, which are performed at intervals of 2-4 weeks.
TCAPEEL 25%: 1 procedure every 4-6 months.

Expected reactions after peeling

During the procedure, protein coagulation occurs, which manifests itself as a “frost effect.” By its intensity, one can judge the depth of penetration, and by its uniformity, one can judge the uniformity of application of the material to all treated areas. After some time, from several minutes to a day (depending on the concentration of peeling and the number of layers), the “frost effect” is replaced by erythema and edema. If 1-2 layers of TCAPEEL 15% are characterized by the absence of crusts and the development of the peeling process, which lasts 4-5 days, then after peeling TCAPEEL 25% swelling and severe erythema increase within 24-48 hours after the procedure. The next day after the TCAPEEL 25% procedure, quite pronounced swelling and erythema are noted, crusts and films are formed. The leather has a “tanned” appearance. By the second day, the swelling decreases, the film begins to strongly tighten the skin. Intense peeling begins from 2–3 days and ends by 7–10 days. The skin on the hands peels off a little longer. After the coagulation film is rejected, the skin becomes pink. A similar skin color occurs when
sunburn. After a few more days, the skin is completely restored.

Complications

Local complications when using TCA in concentrations less than 30% are rare and can be easily corrected.

The most common complication is post-peel hyperpigmentation and most often occurs in patients with dark skin (Fitzpatrick types III–VI).
Millia, or small, superficial, white epidermal cysts, are very common in the first 3 to 5 weeks after the procedure. They go away on their own or a light superficial microcrystalline peeling is used to remove them. Another complication is an exacerbation of herpes. Therefore, if a patient has a history of recurrent herpes, it is advisable to take a preventive course of specific antiviral drugs a week before the procedure.

TCAPEEL is a painful procedure, so during its implementation, a fan or fan can be used to create intense air flows that alleviate the patient's subjective sensations.

TCAPEEL 25% does not increase the area of ​​telangiectasia. At the same time, due to the pronounced irritant effect of trichloroacetic acid, it increases
clarity of the vascular pattern. This phenomenon is reversible and disappears within 1-2 months after the procedure. In this case, after completing the exfoliation process, it is advisable to prescribe Retioderm cream from the MedicControlPeel line.

The training and methodological center "Martinex" invites cosmetologists with higher and secondary education to training courses on chemical peelings. Trainings are conducted in Moscow, St. Petersburg, cities of Russia and Ukraine.

Modern cosmetology offers a wide range of chemical peels that can solve any cosmetic problem. TCA peeling (trichloroacetic acid) is not widely popular, is prescribed with caution, and at the same time is considered one of the most effective. It acts comprehensively, eliminates serious defects and rejuvenates the skin. In what cases is it worth doing TCA peeling and what do you need to know about its features?

What is TCA peeling

The basis of the TCA cocktail is trichloroacetic acid. The substance has the ability to penetrate deeply into the skin even at low concentrations, and this is its danger. The slightest error in the dosage of trichloroacetic acid is fraught with a deep thermal burn, the consequences of which are difficult to correct.

TCA peeling is not a cosmetic procedure, but a medical procedure, so it is not recommended to do it yourself. The session should be conducted by a specialist who has experience working with trichloroacetic acid.

The peeling cocktail is easily distributed over the skin using a brush.

How does acid affect the skin?

1. TCA cleanses the upper layer of the epidermis well thanks to its powerful keratolytic effect - the acid destroys the bonds between dead cells, exfoliates them and dissolves dirt accumulated in the pores. As a result, the skin looks younger and fresher.
2. Penetrating to the middle layer of the skin and burning old cells, the acid starts the process of dividing new ones. This increases the protective function of the epidermis.
3. The anti-inflammatory effect is to reduce the secretion of sebum - a fertile environment for the proliferation of microorganisms.
4. The destruction of old cells makes new ones work. They increase the synthesis of collagen and elastin - the basis of skin elasticity. Microcirculation and capillary circulation improves, due to which toxins are removed from the skin.
5. Antibacterial action helps eliminate pimples and acne.

Types of TCA peeling

During the procedure, a controlled burn of the skin occurs. Depending on its intensity, there are three types of peelings - superficial, medium and deep.

Table: features of different types of TCA peeling

Type of peeling	TCA concentration	Additional substances	Result
Surface	15%	Citric or ascorbic acid and saponins increase the penetration of TCA into the skin and improve microcirculation	Small wrinkles are smoothed out, the relief is evened out
Median	20%	Lactokines and amino acids improve the ability of cells to produce collagen, increase immune defense and activate regeneration	Penetrates into the deep layers of the epidermis and has a pronounced anti-aging effect (tightens the skin, smoothes out average wrinkles, evens out complexion)
Deep	40%	Saponins and phytic acid reduce the abrasive effect of concentrated trichloroacetic acid and improve skin restoration	Used only in limited areas no more than 1 cm. Eliminates deep cosmetic defects.

Indications and contraindications

Cosmetologists recommend TCA peeling for people with serious facial skin defects. You shouldn't use it as a way to simply freshen up your appearance. For this, there are gentle superficial procedures with AHA acids, Jessner peeling and other techniques that are less traumatic to the skin. It is advisable to use TCA to eliminate the following shortcomings:

• skin irregularities;
• acne scars;
• medium and small wrinkles as a result of photoaging;
• sun or age spots;
• melasma - a benign pathological disorder of pigmentation (looks like an overgrown mole of irregular shape);
• flat moles;
• stagnant acne spots;
• oily skin, prone to pimples and acne;
• age-related skin changes;
• gray dull complexion.

Before scheduling a session, the cosmetologist examines the patient’s medical record in detail. Sometimes laboratory tests are prescribed to identify possible contraindications.

It is advisable to first consult a dermatologist about skin diseases and the possibility of using TCA peeling.

TCA peeling is contraindicated for the following diseases and conditions:

The time when the procedure can be performed without consequences is limited to several months - from November to March. This is due to the high risk of pigmentation formation as a result of active exposure to sunlight. TCA peeling is used with caution on aging skin, as it largely loses its ability to regenerate. And this can cause complications in the form of increased pigmentation and prolonged redness of the skin.

TCA peeling should not be performed on women with dark skin.

Peeling is contraindicated for representatives of color types IV-VI according to the Fitzpatrick table (dark, very dark and dark skin, dark hair and eyes).

Advantages and disadvantages of trichloroacetic acid

Before deciding on TCA peeling, you should think about whether it is really necessary and what will be more of it - benefit or harm.

Table: Pros and Cons of Chemical Facial Treatments

Advantages	Flaws
Highly effective compared to other acid peels	An impressive list of contraindications
Solving multiple problems at once	Painfulness of the procedure
Use at any age (18+)	Duration of rehabilitation after medium and deep peeling
Visual control of exposure time (frost effect)	Difficult to carry out at home without the supervision of an experienced specialist
No severe toxic effects	The need for preliminary preparation
Speed ​​of implementation	Rapid penetration of acid molecules into the epidermis with the danger of uncontrolled burns if the cosmetologist has insufficient experience

If we compare trichloroacetic acid with glycolic acid, which is similar in strength, then TCA is a clear loser. After it, recovery takes much longer, complications occur more often. Glycolic acid causes almost no peeling in some patients. However, in TCA's defense, it can be said that in a small concentration it gives the same effect as a highly concentrated glycolic acid.

The advantages of TCA peeling compared to similar cosmetic methods of exfoliation and rejuvenation, of course, include the ability to do with one procedure, which means saving time and money and avoiding unnecessary discomfort.

When choosing a clinic for TCA peeling, be sure to ask about the experience of the cosmetologist and read reviews about the procedure and its results in this particular institution.

The first stage is preparation

Proper preparation for peeling can reduce pain, shorten the recovery period, avoid possible complications and increase the effectiveness of the procedure. You need to start preparing a month before the event. Therefore, it is better to find a clinic in advance and get individual doctor’s recommendations.

Preparation includes avoiding the use of scrubs and any traumatic instrument (brushes, hard sponges) 4 weeks before peeling. During this time, it is recommended to use a cream with sun protection of at least 50 SPF.

As a preparation before peeling, you need to use creams with an exfoliating effect.

14 days before the session, start using creams containing fruit acids in a minimum concentration. A cosmetologist may even recommend 1-2 superficial chemical peeling procedures with AHA acids. If you are prone to herpetic rashes on the face, taking an antiviral drug a few days before peeling will reduce the risk of their appearance after the procedure. A couple of days before the session, do not go to the bathhouse, sauna, solarium and refrain from removing facial hair.

How is it carried out?

The TCA peeling procedure is the same for all types. Before visiting the clinic, avoid makeup and do not use tonic - its use will reduce the effectiveness of the acid. The first step is cleansing, which the doctor does with a special solution designed to degrease the skin before peeling. Then the drug is applied (the number of layers depends on the type of procedure). The patient feels a slight burning sensation when applying the first layer, the second layer causes pain. They are removed using a fan or fan. Anesthesia is usually not used.

Under the influence of acid, the protein that makes up the surface layer of cells folds and looks like a white coating on the face, reminiscent of frost. Its appearance indicates the effectiveness of the procedure.

Frost is a signal for the doctor to proceed to the next stage - neutralizing the acid with a composition containing soda. The reaction can be quite violent (with hissing), so the neutralizer is also applied in layers. The session ends with washing and applying a cream with an antiseptic, soothing and healing effect.

The appearance of a white coating on the skin is a signal to neutralize the acid

The number of sessions is determined by the cosmetologist depending on the condition of the patient’s skin and the scale of the problem that needs to be eliminated. It is recommended to do no more than two procedures per year, although most often the desired effect is achieved after the first. At least two months must pass between them. The results of TCA peeling last for 6–12 months.

The work of a cosmetologist and the peeling preparation itself will cost an average of 5 to 20 thousand rubles (depending on the region and the level of the cosmetology clinic). Add to this price the cost of care products before and after peeling - 7–15 thousand rubles. Thus, the total cost of TCA peeling can range from 12 to 35 thousand rubles.

Self-conducting

For particularly brave ladies who are not afraid of the consequences of home peeling with trichloroacetic acid, there are some tips:

• use only weak 15% acid for home peeling;
• consult with an experienced cosmetologist first and carry out the same preparation as before a session in the salon;
• Prepare everything you need - a bottle of peeling cocktail, degreasing lotion, a weak soda solution, healing cream, paper napkins and a soft washing gel.

Step by step execution:

1. Clean your face of cosmetics with mild soap or cleansing gel.
2. Wipe the skin with a degreaser.
3. Apply the acid to your face with a brush - first on the forehead, gradually going down to the chin and avoiding the area around the eyes and mouth. Exposure time - no more than 3 minutes.
4. Neutralize the acid with soda solution.
5. Wash your face with plenty of water and apply healing cream.

When deciding to use TCA peeling at home, remember that the risk of complications is quite high even when it is carried out in a salon by an experienced doctor. Skin care after home and salon peeling is the same.

Video: home peeling with trichloroacetic acid

Skin restoration

After the session, you need to be patient - a completely normal appearance will be restored only after a month and provided that all the doctor’s instructions regarding the care of damaged skin are followed. The first period lasts about a week. A few hours after peeling, redness and swelling appear on the face. This condition lasts for 24 hours. After a day, a thin film forms on the face, which after four days turns into a rather dense crust. It moves away gradually and primarily where the facial muscles move more.

During the first week after peeling, intense exfoliation of the skin occurs.

These days, the skin needs to be supported with sprays, foams or creams with panthenol. You can wash your face no earlier than the second or third day after peeling. To restore the skin, you can use caring serums and moisturizing creams with vitamin complexes.

During the healing period (7–10 days), a sauna (bath), solarium or swimming pool is prohibited. You cannot sunbathe, exercise in the gym, or apply steaming compresses or decorative cosmetics to your face.

Over the next 2–3 weeks, complete cell regeneration will occur. The skin needs to be supported with nourishing and moisturizing creams.

Video: stages of healing after peeling with trichloroacetic acid

Possible complications and side effects

Severe swelling as a side effect often occurs in patients with a tendency to allergies. To reduce it, you need to take an antihistamine before the procedure.

Redness is a normal skin reaction to a burn. Hyperemia will last 1–3 days until a brownish crust appears. The tightness of the skin after its formation can be so strong that facial expressions and chewing become difficult. Under no circumstances should crusts be removed forcibly.

Complications after peeling:

• Increased skin sensitivity to ultraviolet radiation leads to the formation of post-inflammatory pigmentation. Use a cream with UV protection of at least 50 SPF for six months after peeling.
• The appearance of a boundary between areas of the skin where it was treated with acid. The complication is rare; foundation helps. The defect can be completely eliminated with a Jessner peel.
• White spots on the skin appear only after deep spot peeling using concentrated trichloroacetic acid, which kills melanocytes (cells responsible for pigmentation). Corrected by several superficial peelings with fruit acids.
• Scars may appear in places where the crust was forcibly removed or an extra layer of acid was used to treat a deep defect.
• As a result of increased individual sensitivity to acid, dry skin may persist for a long time with the formation of creases in the form of pseudowrinkles. In this case, a course of biorevitalization or mesotherapy will help.
• The return of acne a short time after peeling may not be related to the condition of the skin and sebaceous glands. In this case, it is worth looking for internal reasons.
• In patients with a tendency to rosacea, redness may persist for a long time (up to a year) due to dilated blood vessels. To reduce it, you need to give up any thermal procedures (sauna, steam bath), increased physical activity, and eliminate spicy foods and alcohol.

After TCA peeling, do not lose touch with your cosmetologist; contact him for advice in any unusual situation during the rehabilitation period. A timely solution to the problem will protect you from the adverse consequences of the procedure.

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TCA peel or trichloroacetic acid peel for face

TCA peeling is a type of chemical peeling that affects the middle layers of the epidermis. At the same time, the skin is cleansed at sufficiently deep levels. This peeling is carried out using trichloroacetic acid (Trichloroacetic acid) or trichloroethanoic acid - a highly toxic, absorbed through the skin, which has a pronounced bactericidal, anti-inflammatory and cauterizing effect, an analogue of acetic acid.

The mechanism of action of TCA peeling consists of coagulation of protein structures of the epidermis, destruction and removal of damaged skin cells, stimulation of increased division of cells in the basal layer, and the formation of young cells with an even distribution of the natural pigment melanin. The effect of TCA peeling depends on its depth.

Exposing the skin to 15% trichloroacetic acid provides a superficial peel. A solution of 20-35 percent acid is used for medium peeling. Trichloroacetic acid in a concentration of more than 40% is not used for peeling due to the high risk of complications. Such a solution can be used strictly locally to remove pinpoint (no more than 1 cm in diameter) benign formations.

The diffusion of this acid into the epidermal tissue, as well as the effectiveness of its effect, depend on the number of layers of the applied solution, its type (gel or hydroalcoholic), the connection during one procedure with other substances (resorcinol, acetone, glycolic and salicylic acids), the presence of mechanical damage in the treated areas, the nature of the pre-peeling preparation.

TCA peeling is considered much more painful than, for example, exposure of the epidermis to hydroxy acids.

Peeling with trichloroacetic acid is a serious cosmetic procedure related to medical, and not at all aesthetic, cosmetology. For this reason, it should be performed exclusively by a cosmetologist.

Indications for TCA peeling

TCA peeling is prescribed if:

Uneven skin
hyperkeratosis
fine-mesh and medium-depth wrinkles caused by photoaging
acne scars
hyperpigmentation
solar and senile lentigo (freckles)
flat birthmarks
melasma
oily skin prone to acne
congestive spots after acne
dull complexion
inelastic skin
stretch marks (striae)
enlarged pores

Contraindications for TCA peeling

This peeling is not performed if you have:

Any chronic diseases in the acute stage
ARVI
fever
need to take Roaccutane
any fresh injuries and skin lesions in the treated area
pronounced rosacea
pregnancy
lactation
need for radiotherapy
fresh tan
IV–VI skin phototype determined according to Fitzpatrick
patient's age is less than 18 years
acute inflammatory processes on the skin, exacerbation of dermatoses, herpes infection, acne
tendency to form hypertrophic and keloid scars
recently (less than 8 weeks ago) traumatic procedures (deep cleaning, mesotherapy, laser resurfacing)
mental illness
recent (less than 6 months ago) completed use of various aromatic retinoids
hypertension
tendency to papillomas and warts
photodermatitis

There are also relative contraindications for performing TCA peeling, they are associated with the presence of:

Sensitive skin
multiple nevi
hypertrichosis, hirsutism (since trichloroacetic acid is a strong hair growth stimulator)
menses

Properties of trichloroacetic acid

Trichloroethanoic acid or trichloroethanoic acid is an analogue of acetic acid halogenated at the methyl group, in which three hydrogen atoms of the methyl group are completely replaced by chlorine atoms. Trichloroacetic acid is obtained by the synthesis of chlorine with acetic acid in the presence of a catalyst.

This acid has the following effects:

keratolytic(stronger than retinoic and glycolic acids), which ensures loosening and removal of the upper layers of the epidermis

lifting caused by increased synthesis of collagen and elastin

antioxidant, which involves binding heavy metals and blocking free radicals, which helps protect skin cells from harmful environmental influences

comedolytic, ensuring the elimination of blockage of the sebaceous gland ducts and smoothing of pores

whitening, which occurs due to exfoliation of keratinized layers and smoothing of the skin

antiseptic, affecting skin microbes both bacteriostatically and bactericidally

remodeling on dermal structures

Benefits of TCA peels

Relative safety. The main difference between trichloroacetic acid and other peeling agents, like phenol, is the absence of severe toxic effects;

The presence of clear criteria for the depth of penetration of trichloroacetic acid, which is determined by the nature of the “frost” (the effect of instant skin lightening due to protein denaturation);

Good distribution of trichloroacetic acid over the skin;

Significant visible results;

Minimal preparation;

Fast completion of the procedure;

Minimal rehabilitation period and absence of social restrictions in the case of using a 15% TCA solution.

Before and after photos

Disadvantages of TCA peels

A significant list of contraindications;
high rates of penetration of trichloroacetic acid into the skin, which can make it difficult to accurately determine the depth of its effect during the procedure;
presence of pain in patients during procedures;
the presence of active large-plate peeling in the post-peeling period when using 20-35% solutions of trichloroacetic acid, which leads to longer rehabilitation periods.

Stages of TCA peeling

Performing a TCA peel involves the following:

1. pre-peeling preparation;
2. make-up removal and cleansing;
3. applying trichloroacetic acid to the skin;
4. neutralization;
5. applying an anti-inflammatory mask;
6. home post-peeling care.

Pre-peeling preparation

The optimal period for performing a median TCA peel is considered to be from October to March. Pre-peeling preparation consists of superficial glycolic peeling. After its completion, the patient is asked to use creams with fruit acids, as well as moisturizing sunscreens, for 14-20 days.

During pre-peeling preparation, experts recommend taking medications that help strengthen blood vessels, which ensures more successful tissue regeneration.
In addition, a month before the procedure, you should exclude the use of scrubs, washcloths, sponges, as well as hair removal, shaving, eyebrow correction, visiting the bathhouse and solarium. For 3-4 days before the procedure, it is recommended to use antiviral drugs to prevent herpes.

Performing TCA peeling

make-up removal and cleansing, for which special gel-like preparations are used, since when using traditional milk, including lipids, there is a decrease in acid penetration;

applying acid to skin using a brush, it is applied evenly at a fast pace. During the application of the drug, patients feel a burning sensation, to eliminate which a fan is used. Due to severe pain, peeling using trichloroacetic acid, which has a concentration of more than 30%, is carried out under anesthesia. The exhibition continues for several minutes. The key condition for proper TCA peeling is to ensure uniform and controlled penetration of the acid into the epidermis. The main feature that determines the depth of penetration is the appearance of frost. Externally, frost appears as white zones. Thus, the presence of pink frost indicates superficial penetration of acid, milky white indicates superficial-medium penetration, and dull white frost indicates median penetration (at the level of the basement membrane).

There is also an assessment of the depth of skin damage when using TCA peeling based on a technique developed by the American dermatologist and scientist Dr. Zein Obagi, MD. He developed a modified 30% TCA peel (Blue Peel), where he mixed the composition with a special blue base and substances that slow down the penetration of trichloroacetic acid into the skin to create a 15% solution. The cosmetologist performing the procedure should apply the peeling composition evenly and ensure that the skin is evenly colored blue. If the coloring is uneven, the acid will penetrate the skin unevenly and cause complications. Depending on the thickness of the epidermis, in order to obtain the desired depth of penetration, it is necessary to apply from 1 to 4 layers of peeling.

Obagi grades of skin damage:

1. Epidermolysis- mobility of the epidermis, which can be determined by palpation (the skin feels like soft cheese)

2. Pink spots- the acid has reached the epidermal and dermal junction (skin color is pink)

3. Even blue color - the beginning of acid penetration into the dermis (skin color is light blue)

4. Frost(from the English frost - frost) or dull white color - penetration of acid into the upper layer of the reticular dermis (skin as if covered with frost);

neutralization, which in the case of TCA peeling is carried out by washing off the acid with water, although some companies have a special alkaline neutralizing preparation. In this case, the burning sensation should gradually go away;

applying an anti-inflammatory, moisturizing mask.

Stages of post-peeling skin care

Post-peeling care is recognized as one of the most important stages of the peeling procedure. The final results and the quality of prevention of possible complications depend on the thoroughness of its implementation. The key goal of post-peeling care is to ensure the protection of the skin from a variety of damaging factors such as dehydration, UV radiation, damage by microorganisms, as well as to help stimulate regeneration processes.

For these purposes, a whole range of means is used:

Preparations that form semi-permeable films (protein hydrolysates, aloe extract, hyaluronic acid), retain moisture and ensure the creation of effective conditions for regeneration

Sunscreens (SPF 50+) and melanogenesis inhibitors to prevent the appearance of hyperpigmentation

Antioxidant agents like green tea extract

Preparations with vasoprotective and anti-inflammatory effects (witch hazel, calendula extracts), reducing inflammation, swelling and hyperemia

Products that stimulate regeneration processes (zinc, vitamin complexes), which provide skin remodeling and scar prevention

Ceramides that help restore the epidermal barrier and reduce skin sensitivity

Antiviral drugs, which are recommended for use within 3-4 days after the procedure to prevent herpes

Mesotherapy biorevitalization using hyaluronic acid, ensuring restoration of skin moisture and elasticity

Post-peel care is performed daily for 14 days after the TCA peel procedure.

Possible complications after TCA peeling

Expected complications

Expected problems include those that occur to some extent in the majority of patients. Traditionally, their occurrence is observed in the first days after the procedure, and they pass without consequences quite quickly. Thus, the expected complications are a predictable reaction of the skin to the presence of trichloroacetic acid. You need to be prepared for the following reactions:

erythema, representing redness of the treated areas. The severity of this complication depends on the concentration of the trichloroacetic acid solution used during the procedure. So, for example, when the skin is exposed to alpha hydroxy acids, erythema persists for up to 4 hours, and when performing a medium TCA peel - up to 5 days;

peeling, which is a common post-peeling phenomenon. If it is almost unnoticeable after fruit peelings, then TCA causes large-scale peeling of the treated areas for almost a week;

swelling, signaling the presence of a local inflammatory reaction of the skin in response to aggressive influence. The mechanism for the occurrence of edema is determined by the fact that after the peeling procedure, the permeability of capillaries increases, while capillary fluid can accumulate in the tissues, causing edema. Thus, the use of fruit acids in the peeling process does not have such side effects, but TCA, the concentration of which is less than 15%, may well cause them. Swelling, as a rule, occurs 1-2 days after completion of the procedure and can persist for several days;

darkening of the skin in treated areas, which resolves after complete exfoliation in approximately 10 days;

skin sensitivity, which is expressed in the fact that the treated areas react to external stimuli such as sunlight, mechanical and temperature influences. Usually this condition goes away within 10 days.

Unexpected complications after TCA peel

Unexpected complications can appear either immediately upon completion of the procedure or after a very long period of time. They are not a normal reaction to peelings and have an extremely negative impact on the health and aesthetic results of the procedure. Such reactions include:

herpetic infection, which usually occurs when using a 20-35% solution of trichloroacetic acid. The risk group consists of patients with recurrent herpes, as well as reduced immunity. Acyclovir can be used as a preventative measure; treatment of herpes may require a full course of special medications

infectious complications, the impetus for which arises from violations of hygiene standards by specialists when performing procedures or by patients during rehabilitation measures. The most common infections include, for example, streptostaphyloderma, the treatment of which involves the use of antibiotics

allergies, which is rare when using trichloroacetic acid. In this case, the reaction in the post-peeling period to other external stimuli may be unexpectedly strong. To avoid allergies, it is advisable to take care of testing for sensitivity to peeling ingredients before the procedure and completely eliminate exposure to other allergens during the rehabilitation period

marbling of the skin, which is a consequence of the death of a huge number of melanocytes as a result of too deep chemical exposure. This situation is very difficult to correct; it is only possible to slightly even out the tone using a series of superficial peels

persistent persistent erythema, to which patients with dilated superficial skin vessels are prone. This reaction lasts up to 12 months and goes away on its own. In order to speed up the elimination of this reaction, insolation, saunas, physical activity, alcohol, and spicy foods should be excluded.

hyperpigmentation, which occurs especially often during TCA peeling. This complication is recognized as a direct consequence of poorly performed pre-peel diagnostics. The causes of hyperpigmentation include improper functioning of skin cells. This trouble can be eliminated only with a thorough preliminary examination, determining the presence of a predisposition to pigmentation, and treating existing inflammations. If this complication occurs, the use of additional phenol or retinoic peels and mesotherapy based on 15 percent ascorbic acid is indicated.

exacerbation of seborrhea, as well as acne, the provoking factors of which are inflammatory reactions that encourage sebocyte cells to work intensively. The risk group in this case includes patients with oily skin and acne. Taking the drug "Aevit" is considered an effective preventive measure.

demarcation line, which occurs between the treated skin areas and the untouched areas of the skin. This type of complication most often occurs in those with porous dark skin. This problem is eliminated through additional Jesner peeling.

the appearance of rough keloid or hypertrophic scars due to the use of an increased (50%) concentration of trichloroacetic acid or a violation of the procedure when using a 30% solution.

As a rule, the presence of active large-plate peeling in the post-peeling period when using 20-35% solutions of trichloroacetic acid causes longer rehabilitation periods (up to 2 weeks). You should be prepared for the need to give up an active social life during this period.

If we are talking about repeated peeling, then the next procedure using a 15% trichloroacetic acid solution can be performed no earlier than after 2 months. Medium TCA peel procedures can be performed multiple times, but no more than one procedure per year.

It should be remembered that with age, the regenerative potential of the skin decreases, so this type of peeling is not always recommended for aging skin. The appearance of complications in the form of persistent erythema and post-traumatic hyperpigmentation is more common in older people. Only a responsible doctor who can carefully assess the body’s available resources can make a qualified decision on the need for a median TCA peel.

What is a TCA peel? This is the name of the procedure, which is carried out under the influence of trichloroacetic acid. This organic substance dissolves well in ordinary water, so it has excellent cauterizing properties.

Numerous reviews from those who have experienced the effects of TCA peeling, as well as “before” and “after” photos confirm the effectiveness of this procedure. But is this manipulation really that good?

Features of TCA peeling

The first studies of the amazing properties of trichloroacetic acid began in the middle of the last century, when it was found that this substance can reduce the appearance of keloid scars by 25%.

Today, the title of leader in the market of cosmetic products based on trichloroacetic acid is assigned to the Spanish company Skin Rebirth.

In general, peelings are superficial, medium and deep. All of them differ in the depth of exposure to the acid composition.

TCA peeling has an effect on the middle layers of the skin. The abbreviation comes from the English term trichloroacetic acid, which means trichloroacetic (or trichloroethanoic) acid.

The substance is obtained through a laboratory synthesis process - one molecule of acid is combined with three chlorine atoms. The chemical reaction is further stimulated using various catalysts.

Many people are scared by the very phrase acid peeling. But you need to understand that trichloroethanoic acid is absolutely non-toxic. The depth of its penetration into the skin depends on 2 factors:

1. Concentration of the active substance in the cosmetic composition (there are different brands of TCA peeling, which contain this acid).
2. The number of layers applied during the procedure.

If the procedure is carried out in the summer, a person risks experiencing a burn (since the skin is very delicate) or pigmentation.

Types of procedure

Name	Depth	Trichloroethanolic acid concentration	Excipients	Action on the epidermis
"Easy TCA Peel"	Surface impact	15%	Ascorbic and citric acids, saponin complex	Auxiliary components significantly enhance the effect of the acid, increase the depth of its penetration into the epidermis, and improve skin microcirculation
"TCA Peel solution"	Medium impact (used exclusively on the body, not applied to the face)	20%	Lactokines, amino acids	Auxiliary components combined with acid stimulate immune defense, relieve inflammation and irritation on the skin
"Only Touch Peel"	Deep effects (applied only to certain areas of the epidermis)	40%	Saponin complex, phytic acid	Additional substances in the cocktail neutralize the overly abrasive effects of acid and improve skin regeneration

Mechanism of action of trichloroethanol acid

TCA peeling has a complex effect on the epidermis. Among the main properties of trichloroethanol acid are the following:

1. Deep cleansing. The top layer of epithelium will look cleansed, smooth and rejuvenated.
2. Active regeneration. Trichloroacetic acid has a direct effect on the deep layers of the skin. This starts the process of proliferation - the formation of new, young skin cells. As a result, the renewed epithelial structures become more resistant to various inflammations, diseases, and age-related changes.
3. Reducing inflammatory processes. Trichloroethanoic acid upon exposure to human skin. As a result, the secretion of sebum, which is an ideal environment for bacteria to live and multiply, is reduced.
4. Constant stimulation. When the epidermis is exposed to the constituent components of the cocktail, natural metabolic processes in the skin are enhanced and accelerated. Thanks to this, accelerated synthesis of collagen and elastin fibers begins, which are responsible for elasticity, absence of wrinkles and healthy appearance of the skin.

To eliminate scars, scars, the minimum concentration of the active substance should be 30%.

Indications and contraindications for use

Before making an appointment with a cosmetologist for a procedure, you must definitely go for a consultation with a dermatologist, who can objectively assess the condition of the skin and give related recommendations.

In addition, you need to familiarize yourself with the list of contraindications for this type of peeling.

INDICATIONS

• if the patient, as a result of natural age-related changes, has facial wrinkles in the area of ​​the eyes, mouth, cheeks, forehead;
• to reduce excessive and narrow enlarged pores;
• to remove the consequences of acne - keloids, scars, uneven skin;
• to eliminate stretch marks that appeared on the body after rapid weight loss or pregnancy;
• to reduce noticeable photoaging;
• to reduce visible age-related changes and restore the skin to its former youthful appearance.

CONTRAINDICATIONS

1. Inflammatory processes in the area of ​​skin to be treated. Violation of the integrity of this area of ​​​​the epidermis.
2. The presence of herpes infection in the body.
3. Increased tendency to form keloid scars.
4. Hyperpigmentation.
5. Allergy or individual intolerance to any of the components of the cosmetic peeling composition.
6. Pregnancy and lactation process.
7. The presence of diseases of the endocrine system in the patient, any cancer, dermatological diseases.
8. Taking vitamin A in large doses over the past six months.
9. Recent tanning of the skin.
10. A large number of moles.
11. Excessive hair growth.
12. Critical days.
13. Carrying out procedures that injure the skin during the last 2 months (for example,).

The effect of peeling with trichloroacetic acid depends on the depth of exposure of the active substance in the cocktail, the patient’s age, his level of health, the presence of bad habits and other factors.

Complications

TCA peeling is a traumatic and painful procedure. If you ignore contraindications and do not properly care for your skin, the following complications may occur:

• if the patient had diseases of a herpetic nature, they may worsen;
• in some cases, keloid scars appear on the treated areas of the skin;
• hyperpigmentation of the epidermis begins;
• A noticeable boundary between skin structures (demarcation line) appears on the treated area.

5 procedures for results (preparation)

The TCA procedure is carried out in stages. This is done to achieve optimal results after skin treatment. The number of stages directly depends on the level of peeling depth. The average session duration is approximately 20–40 minutes.

TCA peeling is considered one of the most traumatic, but at the same time the most effective procedures. When carrying out superficial peeling (15%), a recovery period is not required at all.

At an average rate (from 20 to 30%), the patient will experience peeling and redness of the epidermis, which goes away after a few days.

At this time, you need to remember some rules:

1. Under no circumstances should the treated area of ​​the epidermis be exposed to water for 48 hours after the session. A cosmetologist will prescribe you special soft products (creams, foams, lotions), which will be selected depending on your skin type. To enhance the effect of these cosmetics, a small percentage of fruit acids is often added to their composition, as well as all the vitamins, caring and moisturizing substances necessary for the epidermis.
2. Under no circumstances should you go outside for the first time without first treating your skin with sunscreen. The minimum protection factor is SPF 30.

Possible side effects (5 troubles)

After this manipulation, in any case, you should expect redness of the skin, swelling, and you also need to be prepared for the skin to begin to peel off.

There have been cases where patients experienced pigmentation, scarring, and allergies. Basically, this happens if contraindications were not taken into account, or the person ignored the doctor’s recommendations.

Thus, after the procedure you may encounter the following troubles:

1. Herpes. This problem appears for one simple reason: a person has a tendency to get frequent herpes, but he did not take a course of antiviral drugs at the preparation stage. In this case, you should consult a doctor who will prescribe the appropriate medications.
2. Dark spots. They form if the procedure was carried out during a period of increased sun activity, preparation for peeling was not carried out, and the crusts were torn off.
3. Acne. This often happens if the doctor chose the wrong session method. It is forbidden to lubricate acne with alcohol-containing products. Medicines against viruses and preparations containing zinc will come to the rescue.
4. Allergy. To avoid it, you need to do allergy tests before the manipulation.
5. Scars. They often form in those patients who have peeled off the crusts themselves.