Trichloroacetic acid (TCA) peels are a type of chemical peel applied to the skin to smooth the surface and remove the top layer of dead skin. It uses acids to remove damaged skin cells to exfoliate the skin.

A TCA peel is one of many types of chemical peel and is a cosmetic procedure.

Various practitioners can apply chemical peels in an outpatient procedure. These include dermatologists, physicians, physician assistants, and nurses. Chemical peels may help:

  • minimize blemishes
  • reduce the appearance of wrinkles
  • even skin color
  • help with removal of precancerous growths
  • soften acne scars
  • help prevent and control acne

TCA peels are typically medium-depth. This means they remove the top layer of skin and only a small amount of the underlying layer.

TCA peels are available in medium to high concentrations. Stronger formulas create a deep peel, which removes more of the underlying layer of skin.

Which peel will work best for a person can vary. A person should talk with their practitioner about the best peel for them.

This article examines the safety and effectiveness of TCA peels, how TCA peels work, costs, who is a good candidate, what to expect during the procedure, risks, side effects, results, and recovery.

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According to a 2018 study, TCA peels come in medium- to deep-depth solutions that people generally tolerate well at lower concentrations.

The authors of the study noted that higher concentrations of TCA solution can increase a person’s risk of complications, such as:

  • reactivation of herpes
  • bacterial infection
  • scarring
  • change in the skin color

Following the application of a medium-depth peel, a person can expect about 7–14 days of healing time. Their skin may also:

  • become red
  • swell for 24–48 hours
  • blister and break open

If a practitioner uses a higher concentration, the recovery time can last for 14–21 days. They will also need to take steps to care for their skin for the first week following the peel.

TCA peels remove a uniform layer of skin cells from the epidermis and, in the case of higher concentrations, the dermis layer. The epidermis is the top layer of skin, and the dermis is the layer immediately below it.

A practitioner applies the peel to the skin and removes it at the appropriate time. Proper application and removal will help minimize scarring and side effects.

Following the procedure, a person will need some downtime.

For a medium depth peel, a person will typically need between 7–14 days for medium concentrations or 14–21 days for higher concentrations to heal. They may also need to take extra precautions in the sun for several months.

In 2020, the average cost of a chemical peel was about $519. The cost typically includes:

  • facility costs
  • cost of prescription medications
  • anesthesia fees, if required

Insurance typically does not cover the costs of the procedure since people typically use them for cosmetic reasons.

Several factors can affect price, including:

  • office location
  • time procedure requires
  • area procedure covers
  • practitioner’s expertise and qualifications

People and doctors generally consider TCA peels effective in smoothing the skin and:

  • reducing wrinkles
  • evening skin tone
  • reducing the number of blemishes on the skin

However, the results do not typically last as long as other chemical peels.

A person will also likely need more than one application to gain and maintain the desired effects.

A person should talk with their practitioner about the best peel for them.

An experienced practitioner can recommend the best type of peel based on the person’s targeted area, skin condition, and other factors that may affect the best type of peel to use.

In general, TCA peels are effective in treating wrinkles, blemishes, and pigment differences.

A person should consult their treating practitioner about what to expect and any special instructions they recommend prior to the procedure.

If a person plans to have a deep TCA peel, they should arrange to have someone drive them home and help them with daily activities for 1–2 days following the procedure.

On the day of the peel, a medical team will clean the skin and apply local anesthesia if needed.

Once prepared, the practitioner will work quickly to apply an even layer of peel and leave in place until it is ready to remove.

Next, the practitioner will remove the peel and apply cool compresses or other treatments to help the skin recover.

The procedure should take about 10–15 minutes.

A person will likely need a few repeat peels over several months to maintain results.

A practitioner may recommend a person use a TCA peel for their neck or other areas of their body.

People can use a medium-strength peel over small or large areas. If the TCA peel has a higher concentration, the practitioner will need to work in small areas of skin.

Chemical peels, such as TCA peels, can cause side effects in some people.

A person should aim to have their peel done with a certified practitioner to potentially reduce their risk of developing serious side effects.

Some common side effects that can occur include:

  • temporary darkening of the skin
  • persistent discoloration
  • scarring, though this risk reduces when a certified practitioner performs the peel
  • lighter skin color

In some people, more serious side effects can occur, such as infection.

Some steps a person can take to avoid more serious side effects include:

  • following all instructions from the practitioner
  • avoiding picking or scratching at the treated skin
  • wearing sunblock and limiting sun exposure
  • avoiding tanning beds
  • not applying makeup before the skin is ready

The results of any chemical peel, including TCA peels, are temporary.

A person may also need several repeat treatments for the desired results. They may also use the peel in conjunction with other therapies.

In the case of TCA peels, a person can expect about 1–2 weeks of recovery time.

A person should ask their practitioner about any special instructions they have for before the peel.

Before a peel, they may advise that a person takes special care of their skin. For example, a doctor may prescribe topical tretinoin to help prepare the skin prior to the procedure.

They may also recommend a pre-peel routine for 1–2 weeks prior to the peel. A pre-peel routine may help improve the results of the peel.

TCA peels are one type of chemical peel. People often use them as a medium-depth peel.

Other types of chemical peels include:

  • BHAs such as salicylic acid (30%)
  • AHAs such as glycolic acid (30–50%, or 70% with or without pretreatment primer such as Jessner’s solution), lactic acid (10–30%), or mandelic acid (40%)
  • AKAs such as pyruvic acid (50%)
  • Baker-Gordon phenol peel (50–55% phenol)

A person should talk with their doctor about the best peel to fit their needs and goals.

A person could start by asking a doctor about specialists in their area.

A person can also check with local dermatologists to check if they can perform the peel or recommend a healthcare team that can.

A person should avoid using nonmedical providers for a peel. While certain states allow for nonmedical providers to perform a peel, the risk of potential side effects is higher.

TCA peels are a type of chemical peel used to help even skin tone and reduce the appearance of wrinkles and blemishes.

A practitioner applies the peel in an office or surgical setting, depending on the peel’s concentration and the need for anesthesia.

Following the treatment, a person can expect 1–2 weeks of recovery. They will also likely need repeat treatments to get and maintain the desired results.