Lidlift Kenneth D. Steinsapir, M.D.
Cosmetic, Facial & Eye Plastic Surgery

Trichloroacetic (TCA) Acid

Light to medium depth peeling agent depending on the concentration of the agent. The lower, clinically useful concentrations are 10 and 15% TCA. These provide a freshening and firming of the face. At this strength there is generally improvement in superficial sun related brown spots. These peels don’t tighten the skin sufficiently to improve fine lines. These peels are considerable more effective than the glycolic peels administered by estheticians. Although not considered to need downtime, the skin may mildly discolor and the face will flake and peel for about a week revealing the fresh new complexion. It will look like you are recovering from a sun burn. These types of peels are effective for two or three months. Stepping up to 20 and 25% TCA increases the firming of the skin and the skin looks pretty beat up for about a week but is never raw. Overall, these strength peels remove more sun spots and provide some mild overall facial tightening. TCA 35% is considered to be a medium depth peel in that it will create facial tightening and improve fine lines. The treatment is sufficiently irritating that local anesthesia is needed in the form of topical numbing cream, injected local anesthetic, and post-procedure icing. Generally the old skin stays on like a bandage and peels off in about 5-7 days. Care involves icing the face for the first two days, frequent showers beginning 2 days after the peel and close monitoring by the surgeon. By day 7 the old skin is usually off revealing the fresh, intact skin. At first the skin is too dry to hold make up but by the tenth day, make up can be used to hide the mild redness that persists 3 to 6 weeks. Stronger concentrations of TCA are generally to be avoided due to the risk of scaring. However, 95% TCA is used for ice pick type acne scars.