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TCA CHEMICAL PEEL

This procedure is performed at our Gheringhap St., Geelong Clinic

ABOUT TCA CHEMICAL PEEL

The TCA peel (Trichloroacetic Acid) is a reticular dermal (medium depth) skin peel. It is a very popular and powerful skin resurfacing treatment that we use at Body Recon. We provide TCA peels both in clinic and in conjunction with surgical procedures.

TCA peels can vary in concentration. Determining the depth of peel that is most suitable for you will depend on your skin tone, depth of damage, severity of photodamage and the result you are seeking.

Deeper peeling is achieved by using a higher concentration of TCA, multiple applications of TCA or both. We have formulated our own peels which combine a high concentration TCA, glycolic acid and phenol. These have a mild anaesthetic affect which allows deeper resurfacing with less discomfort. Our TCA peels create the ultimate resurfacing and rejuvenating chemical peel. Traditionally, TCA was performed as a very deep one-off treatment. We now recommend integration of other modalities such as laser, skin care, and/or multiple TCA treatments dependant on your skin.

TCA is unique because of its penetration- it continues to penetrate until it reaches water within the layers of the skin and is therefore easier to control and determine the depth of penetration.

TCA CHEMICAL PEEL

FREQUENTLY ASKED QUESTIONS

TCA will address many extreme cases of photoageing such as pigmentation, fine lines and wrinkles, texture, tone, scarring and visible pores and thickening of the skin. TCA is a form of collagen induction therapy; therefore results continue to improve over a 6-12 month period.

TCA is commonly used to treat benign skin lesions and to ward off pre-cancerous lesions that may cause disfigurement such as BCC’s and seborrhoeic keratosis that are increasingly common amongst Australians.

Dr Rahdon uses TCA in almost all of his facial rejuvenation surgeries as this helps to improve the texture and appearance of the skin, complimenting any facial surgery which may include a facelift, fat transfer, eye surgery or nose surgery. The peel is usually performed as the first step once the patient is asleep.

 

Peels during surgery aren’t limited to facial procedures- they are a great addition for anyone undergoing body or breast surgery who is also wanting to improve their complexion. The added bonus is patients recovering from their procedure are already having downtime, so the hibernation associated with flaking and peeling post treatment isn’t an issue.

To improve the appearance of wrinkles, texture, smoker’s complexion and pigment disorders.

  • Skin is visibly younger-looking
  • Reduces signs of skin ageing
  • Improves skin texture and smoothness
  • Stimulates collagen and elastin production
  • Reduces appearance of acne and pigment spots

Your specialist will recommend the most appropriate peel and home-care regimen after conducting a professional diagnosis and analysing your skin type.

 

When TCA is applied to the skin, a controlled wounding of the skin takes place. This allows the skin to regenerate and stimulates cellular turnover. TCA peels can improve wrinkles by stimulating fibroblast activity thus stimulating the production of collagen and elastin fibres in the skin. This strengthens the skin and improves elasticity. The peel will penetrate down to the dermal/epidermal junction where the entire epidermal layers will separate causing the skin to scab, flake and peel resulting in new fresh skin. TCA peels can also improve the appearance of acne scars, fine lines around the eyes and mouth, hyperpigmentation, photodamage, as well as extrinsic and intrinsic signs of ageing.

The points we take into consideration when deciding if you would be a suitable candidate for TCA are…

EXPECTATION: TCA is, as a rule of thumb, the most powerful modality we can offer for those seeking the biggest and most dramatic change in their skin.

RECOVERY: More recovery is required after TCA. 7-10 days downtime is standard for most patients. During this time you will not be able to leave the house, as your will skin will form a large scab and flake considerably.

COST: TCA may be a cost effective solution because generally, fewer treatments are required to receive desired results. In comparison, laser resurfacing for rejuvenation tends to require more treatments to receive equivalent results to TCA.

SKIN CONDITION: TCA is generally reserved for those that require moderate to severe improvement for their skin. It is not suitable for anyone who only has mild imperfections of their skin- laser or clinic peels may be a better option in these cases.

SKIN TYPE: Caucasians or lighter European skins are generally the only suitable candidates for TCA. Darker skins pose a much higher risk of complications such as hypo or hyperpigmentation and even scarring. Laser resurfacing or skin needling is a better option for darker skin types.

People who are not sun-compliant are not suited for TCA. Following a TCA you MUST refrain from excess UV exposure to prevent reoccurrence of pigmentation lesions. The skin will be more photosensitized and much more prone to sunburn or developing pigmented lesions, should you have excessive exposure. This is why TCA is only performed during the cooler months when UV is lower, and if a tropical holiday is planned for the near future, the TCA is best postponed. A topical tyrosinaise inhibitor should be used indefinitely following TCA to prevent rebound pigmentation.

 

People who cannot afford to have 7-10 days of not leaving the house.  If downtime is not an option, laser or lighter chemical peels may be better option.

Poor health or poor healing can cause difficulty and a prolonged healing time.

 

TCA is not suitable for darker or Asian skin types.

 

Intensive peeling is not suitable for patients that have anxiety disorders or low pain thresholds. The treatment does create some discomfort and downtime and it is imperative that you don’t pick or touch the skin during recovery.

 

  • Day 1: slightly red
  • Day 2: red, tight and possibly some swelling
  • Day 3: begin to scab, the skin will develop a dark crust all over
  • Day 3 – 6: flaking will occur and will come away in sheets. Dry and itchy.
  • Day 7 – 10: flaking will still be visible but lessened. Skin underneath with be red.
  • Day 10 – 30: Skin will still be red but will look clear. The pigmentation will look clearer and texture and tone of the skin will be visible. It is normal to sometimes have blind pimples occur.
  • Day 30 – 180+: the skins elasticity will continue to improve, as larger wrinkles appear less obvious. TCA is a collagen induction treatment therefore will continue to improve in time as we are attempting to grow new collagen in the skin.

We perform TCA both in clinic and in conjunction with surgical procedures.

In clinic: The skin is thoroughly cleansed and degreased with an appropriate cleanser first. A Zimmer cooler device will be used to blow very cold air onto the skin during the procedure, as the main sensation during the peel is intense heat. The application proceeds by areas- starting on the forehead and working downwards area by area.

Once the TCA is applied to the skin, we look for an “end point” of frosting of the skin. Sometimes multiple layers may be required in sections for adequate penetration. The peel does not need to be neutralised as TCA has a unique ability to only penetrate until it reaches water stores in the skin. The period of discomfort and heat lasts for 10-20 minutes.

The peel is completed by applying post treatment ointment to the face. Following your peel, the skin will be slightly red and will feel hot.

Surgical: In a surgical setting the peel is applied once patients are under anaesthetic. The TCA application and recovery is the same as in clinic. You wake up very comfortable.

Experience is key with chemical peels. Plastic Surgeon Dr Rahdon is highly trained and has many years of hands-on experience with medical grade peels.

The skin is thoroughly cleansed and degreased with an appropriate cleanser first. A Zimmer cooler device will be used to blow very cold air onto the skin during the procedure, as the main sensation during the peel is intense heat. (Of course if your peel is being performed in conjunction with surgical procedures, such as a facial rejuvenation or even breast or body surgery, you will have no discomfort at all- the anaesthetic will take care of it!) Once the TCA is applied to the skin, we look for an “end point” of frosting of the skin. Sometimes multiple layers in sections may be required for adequate penetration. We do not need to neutralise the peel as TCA has a unique ability to only penetrate until it reaches water stores in the skin. The period of intense heat lasts for 10-20 minutes, after which there is no discomfort at all.

The peel is completed by applying antibiotic ointment on the face. Following your peel, the skin will be slightly red as if you have been for a jog around the block. You will be in no discomfort.

SUN EXPOSURE: You will require absolute sun protection during the entire time pre and post peel to prevent rebound hyper- or hypo-pigmentation.

TOPICAL OINTMENTS: As part of your treatment you will be required to follow pre and post care advice from your therapist.

COLD SORES – TCA peeling may cause an individual to develop a cold sore if they are prone to getting them. This may require the use of antiviral ointment (Zovirax) and/or tablets to prevent these following your peel. Application before and then as soon as you feel a tingle should be undertaken. If a cold sore is starting to develop during the week post your peel you should contact the rooms immediately so appropriate treatment can be undertaken.

You will be required to complete a confidential consultation form to outline your general health and suitability for this procedure. Please inform us of any medications you are taking or if you are affected by any of the following conditions prior to your TCA peel:

  • Recurring facial warts
  • Prior history of any cosmetic surgery, botox, fillers, peels, dermabrasion, etc.
  • History of cold sores
  • History of keloid formation
  • Pregnant or breast feeding
  • Use of retinoids over the last 12 months
  • Previous use of Roacutane
  • Recent sunburn or significant sun exposure within the last month
  • Cryosurgery or liquid nitrogen treatments
  • Skin cancer history
  • Current skin cancer treatments
  • History of pigmentation problems- hyper/hypopigmentation

 

As a rule, the deeper the peel, the higher the rate of complications and the longer the recovery. This is why TCA is performed as a specialised medical peel. TCA is performed by Dr Rahdon, Plastic and Reconstructive Surgeon or by one of our senior therapists under the guidance of Dr Rahdon. It requires more experience from the operator and more careful pre-peel preparation and post-peel care.

The deeper the peel, the longer it will take to recover generally 7-10 days for a 35% TCA peel. Some people will heal more quickly than others- age, skin type, intensity of the peel and how well the skin is prepped all impact on your recovery time.

TCA peel solution application will cause a stinging, burning sensation that will resolve within a few minutes. The peel will initially have a “whitening” effect (known as frosting) which is due to protein denaturation. The skin will then turn red and you may experience heat and swelling in the treatment area. This is a normal tissue response.

Upon completion of your peel, you will be required to wear a UV protective hat or clothing over the areas treated to avoid any UV exposure to your freshly peeled skin. In addition it is advisable to wear UV protective sunglasses.

Your skin will be covered with a thick ointment, so make sure your hair can be put back from the face.

Do NOT use abrasive scrubs, active skin care/ cleansers or cloths on your skin for the next 10 days.

Do NOT apply any retinoids, benzoyl peroxides, AHA’s or BHA’s to your skin until you have been reviewed.

Do NOT colour or dye hair for two weeks post TCA.

Do NOT undergo any laser treatments, waxing, microdermabrasion or facial treatments for one month after your TCA peel.

It is important for you to increase water intake and maintain a healthy diet.

Do NOT peel, scratch or rub the treated skin even if you feel that it itches – use a mild over the counter hydrocortisone cream if necessary for the itching. The itching is a normal part of the healing process, and it will resolve on its own.

AVOID UV exposure at all costs. This includes tanning beds. Do NOT use any tanning solutions for at least two weeks post treatment to ensure the area is healed. It is best not to expose the peeled areas at all, by wearing a hat or protective clothing that can shield the newly peeled skin from the sun.

Please follow these steps unless instructed otherwise by your dermal clinician or Dr Rahdon himself.

AM

  1. Cleanse: Benefit Cleanser- Gently use your fingertips ONLY, not a washcloth to cleanse your skin. GENTLY pat your face dry with a clean cloth.
  2. Panthenol: apply with a patting motion over the peeled skin
  3. K-ceutic SPF: apply a pea size amount, warm up in palms, pat into skin.

**** During the day you are able to use Panthenol Ointment a few times to alleviate dryness and discomfort.

 

PM

  1. Cleanse: Benefit Cleanser- Gently use your fingertips ONLY, not a washcloth to cleanse your skin. GENTLY pat your face dry with a clean cloth.
  2. Panthenol: apply with a patting motion over the peeled skin

You must continue to use a daily sunscreen for six months after your TCA peel to ensure the highest level of improvement and lowest incidence of any sun exposure resulting in hyper- or hypogipmentation. At Body Recon we encourage daily sunscreen use for all of our clients.

You will be reviewed at seven days post your peel and then again in two weeks when you will be provided with post care products to ensure the best results from your peel.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

INTERESTED IN LEARNING MORE? BOOK A CONSULTATION TODAY.



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