TCA Peels: Side Effects and Precautions

Safety, side effects, and precautions to keep in mind |

Before you get a TCA peel, it's very important to understand what you're getting your skin into. Some skin types are not suitable for TCA peels (i.e. darker skin). Other people find that TCA peels make their skin worse instead of better.

This section will provide information about the risks and side effects associated with TCA peels, so keep reading to learn how to make TCA peels both safe and effective!

Who should not get TCA peels?

Unfortunately, TCA peels do not work for everyone. If you fall into the below categories, do not get a TCA peel done:

  • If you are using Roaccutane (Accutane) or have used it in the last 24 months
  • If you are pregnant or lactating
  • If your skin is prone to keloids (or raised scars)
  • If you have dark skin
  • If you have herpes simplex and/or are prone to cold sores
  • If you are undergoing chemotherapy or radiation treatments
  • If you are HIV positive or have AIDS

Roaccutane (Accutane) makes your skin more sensitive and can even slow wound healing. With a TCA peel, where the top layer of your skin is burned away with an acid, you need proper skin healing function to prevent infection and permanent damage. That is why those who have been on Roaccutane or oral isotretinoin are not good candidates for TCA peels.

Those who are pregnant or lactating may want to avoid TCA peels as well. It is unknown how much trichloroacetic acid would be absorbed by the skin during the peel. Many doctors tell their pregnant patients to avoid using AHAs and BHAs, so it is understandable that TCAs would be a concern, especially since not much is understood about its internal effects.

If your skin is prone to keloiding (or getting raised scars after a wound is healed), you should definitely avoid TCA peels because by "damaging" the skin on your face with the peel, you risk getting keloids anywhere you peel.

Darker skin tones should also avoid getting TCA peels. Light to olive colored skin tones are good candidates for TCA peels, but dark skin tones need to be wary because TCA peels can cause uneven pigmentation (either through hyperpigmentation or hypopigmentation).

Keep in mind that these are general guidelines. For more information about whether you are suitable for TCA peels, talk with your dermatologist, plastic surgeon, or aesthetician.

Side Effects and Precautions of TCA Peels

When you're getting a TCA peel, the main side effects you have to worry about include:

  1. Burning your skin
  2. Persistent facial redness (erythema)
  3. Skin pigmentation changes
  4. Scarring or infection
  5. Post-peel breakouts
  6. Sun sensitivity

These side effects sound scary, but they are generally avoidable if you properly care for your skin before and after a TCA peel. To what degree the above side effects will affect you also depends on your skin type and the strength of the peel.

Using too strong of a TCA solution and leaving it on your skin for too long contributes to skin damage and persistent redness. Therefore, it's always good to start slow and build your way up. Never use a strong TCA peel before you have acclimated your skin to weaker ones.

It's also best to get TCA peels performed by qualified and experienced professionals instead of doing them yourself at home. Getting these types of chemical peels from someone who knows what he/she is doing means you will have someone to monitor the progress of your skin in case anything goes wrong.

If you haven't taken good care of your skin during the peeling process, redness or pink skin can linger around long after you've finished peeling. Taking good care means: not picking at any skin flakes, not using AHAs or retinoids until your skin has completely healed, not exfoliating right away, not using harsh scrubs, avoiding swimming (chlorine pools and oceans), avoiding tanning beds, etc.

Staying out of the sun is very important if you want to avoid any pigmentation changes. I personally know one person who ran grocery errands in the middle of the day (after getting a peel and not wearing sunscreen or any protective clothing) and she ended up getting dark brown splotches on her cheeks. TCA peels remove the outer layer of your skin and if you want your skin to heal properly, you have to protect it from UV rays.

Many people also experience breakouts after a TCA peel. There are three possible reasons for this: 1) your skin was too dry during the peel, 2) the antibiotic or anti-itch cream was too heavy for your skin, or 3) you did the peel while you had active acne or clogged pores.

If you do not apply an ample amount of moisturizer to your skin during the peeling process, you could cause your skin to become overly dry and clog your pores. A TCA peel is already a big shock to your skin and you want to keep it moisturized to reduce irritation so it can function at its best.

Although antibiotic or anti-itch creams can cause pimples for some people, an emollient antibiotic is absolutely necessary unless you want your skin to be vulnerable to infections. The pimples caused by antibiotic creams usually go away quickly on their own.

Using TCA peels with active acne causes breakouts because the peel exfoliates the top layer of your skin, allowing it to push plugs it has on the inside to the surface. Some people even say that you break out because the TCA peel causes a dead layer of skin to sit on your face, trapping all the bacteria underneath. Although such "purging" tends to subside after a fourth TCA peel, it is generally best to avoid getting a TCA peel while you have active acne because you could get scarring and some really bad ensuing breakouts.

Last Minute TCA Peel Tips

If your skin is suitable for TCA peels, keep the following points in mind before getting a peel done:

  • If you are using prescription skin care products, stop using them three days before the peel and 14 days after the peel.

  • Don't pick at any skin that is peeling. You will cause your skin in that area to scar and heal improperly.

  • Avoid the sun like crazy! The TCA peel will make your skin more sensitive to the sun. If you do get unnecessary sun exposure, parts of your skin could permanently brown.

  • While you are peeling, don't use any scrubs, medicated cleansers, or treatment products. Only use a good, plain moisturizer and/or antibiotic cream.

  • Even if you are breaking out from the peel, don't apply any spot treatments because you could burn or permanently damage your skin (which is why you shouldn't get TCA peels when you have active acne).

  • Exercising post-peel is okay but don't go swimming. Chlorine in swimming pools and salt in ocean water can irritate your skin even more.

  • You don't have to increase the TCA peel percentage for each subsequent peel. If you are doing fine at a certain strength, it's perfectly okay to continue using the same concentration.

  • If your skin starts getting used to the peel, you don't have to buy a stronger peel solution. Instead, you can start applying the TCA peel in layers. To do a layered TCA peel, apply the layers in 5 minute intervals before neutralizing.

TCA peels can do wonderful things for your skin, but make sure your skin is suitable for such an intensive treatment in the first place. TCA peels work best on non-irritated and non-broken out skin. Before you get the peel, make sure you know all of the potential side effects and are prepared for the required downtime. That way you can safely and effectively peel your skin for extra youth and vitality.

Last updated: September 22, 2012

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