Medium Depth TCA Chemical Peel Post Op Instructions

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TCA or trichloroacetic acid is a very effective peeling agent for wrinkled or sun damaged skin. 35% strength is typically used and applied by a physician. The goal of the procedure is to treat the epidermis and the upper layer of the dermis. A full face TCA peel can be done in the office with topical numbing cream and nerve blocks while small areas like lower eyelids are done with no numbing required. It is important that your skin be in the right condition prior to the peel. Issues regarding tanning, herpes cold sores, Acutane medication, and others will be sorted out prior to the procedure.

What to expect.

Stinging - TCA produces an intense stinging sensation when in contact with the skin. After several seconds it is then neutralized with water. Because of the stinging only small areas are done at a time if you are awake. The next area is then treated until the procedure is complete. Lower eyelids take just a few minutes whereas whole face peels take about a half hour. A mild stinging sensation can be present for a day or two after the peel. This is treated with cold or ice packs, or over the counter pain medications.

Swelling - Your swelling will probably peak on the second or third day then diminish. Try to sleep on your back with your head elevated on a couple of pillows. Cold or periodic ice application for a few days is soothing and is also helpful for swelling. Full face peels can produce much more swelling than small segmental areas. Don't be overly concerned. It won't be permanent!

Peeling Skin - Your skin will appear red and swollen for about two days. Usually on the third day a light brown layer of skin forms. This will gradually slough off over the next few days to reveal the new pink smooth skin. Do not pick or pull this skin since that will only increase the healing time.

Redness - How long the new skin stays red is quite variable. It can last just a week or for several weeks. Make up is fine to help conceal it once the skin is fully healed and no longer crusting.

Topical Care - Aquafor ointment is best for full face procedures but Vaseline is fine for lower eyelids. The ointment should be applied four times per day beginning the next day. You should wash the old layer of ointment off with mild soap prior to applying the next layer. It is very important to keep the skin glistening with as little crust as possible. Sometimes very tiny superficial pimples can form on the skin. These will usually resolve in a week or two. Once the skin is healed ointment is no longer necessary and your usual moisturizer is preferred. It is very important to avoid sun exposure during the healing process and for several months after the peel. If you develop a cold sore or feel one coming on call the office if you do not have anti herpes medication. If you do it should be taken as soon as possible.

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