Recovery
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The science of TCA peels for melasma
- TCA peels are awesome to treat non-melasma pigmentation
- Treating melasma with high concentrations of TCA often results in hyperpigmentation
- Lower concentrations of TCA can be marginally effective in some cases of melasma
- TCA peels work by chemical exfoliation of pigment
- Low concentrations of TCA take 4 weeks or more to work
- High concentrations of TCA can give faster results, albeit a long recovery time
- Picosecond lasers work better than peels, with less risks & no downtime
TCA peels were once used to treat melasma pigmentation, however results are slow with multiple treatments required. Cosmelan & Dermamelan peels are better, whilst Picosure lasers provide fast results with no downtime.
What are TCA peels?
TCA peels are classed as superficial or medium depth peels depending on the concentration of TCA. Superficial peels use concentrations of less than 10-15%, whilst deep peels use conventions upward of 25 to 30%
TCA high concentration vs low concentration- what is the difference?
Higher concentration TCA peels are used to treat non-melasma pigmentation including sun damage, freckles & age warts. Results are fast with a recovery time of up to two weeks.
Low concentration TCA peels are used to treat some cases of resistant melasma. Results are slow, but side effects are less with little to no downtime.
Low concentration
High concentration
What results can I expect from a chemical peel?
TCA peels for non-melasma pigment is still an awesome treatment, clearing up to 95% of pigment in one session. They also improve skin texture, reduce wrinkling as well as improve skin laxity.
In contrast, TCA peels for melasma pigment is a dismal treatment (as compared with new age lasers), with clearance rates of 20 to 60%. With melasma pigment, the peeling process must be slow, as high concentrations will often result in post peeling pigmentation & rebound of melasma.
How many sessions will I require to clear my melasma?
4-8 sessions, spaced 2-4 weeks apart. Peels work by gentle exfoliation of the skin’s surface, in turn clearing superficial pigmentation. Results can be seen at the 4 week mark, maximal results in 2-4 months.
What is the treatment like?
Low concentrations of TCA peels are comfortable with mild stinging for a minute or two. This form of TCA peeling does not require analgesia (pain relief), in contrast to high strength Jesser-TCA peels.
Recovery following TCA peels for melasma is superquick- redness for several hours.
How does Cosmelan peel compare with TCA peels for melasma?
Cosmelan & Dermamelan peels are much more effective than TCA peels for melasma as they address the primary cause of melasma.
TCA Peels |
Cosmelan Peels | Dermamelan Peels |
---|---|---|
Works in 20% of melasma cases |
Works in 55% of cases | Works in 60% of melasma cases |
1-2 hour recovery |
7 day recovery | 8+ day recovery |
4-8 peels required |
1 peel session | 1 peel session |
What is Jessner TCA & is it good for melasma?
Jessner TCA is a historical treatment for melasma, outdated since 2007. The primary reason that this peel is associated with high rates of rebound pigmentation & post inflammatory hyperpigmentation.
Lasers have replaced medium depth peels for melasma as they provide better results with less risks & no downtime.
*Our dermatologists still employ Jessner TCA peels to address non-melasma pigmentation including sun damage, skin laxity & wrinkles. It is still an awesome peel for these indications.
What is the fastest & safest solution for melasma?
Picosecond lasers employ ultrashort pulses of light to safely shatter unwanted pigment without heating the skin. They provide the fastest & most effective way of improving skin quality, including clearing of melasma pigment.
As compared to chemical peels, Picosecond lasers have no downtime & are 20-25% more effective as compared to Cosmelan or Dermamelan peels.
Our Gallery of Results
When do we use TCA peels over lasers?
TCA peels are used to address non-melasma pigment, however we occasionally use low concentration TCA for resistant melasma (can work in less than 10% of resistant cases). We also employ this peel for patients who have a history of response to chemical peels.
The Melasma Clinic difference
Our specialist clinic is overseen by dermatologists who provide a comprehensive & bespoke approach to skin care. We take into account the complexity and individuality of your skin. Our pigment solutions include preventing future recurrences of melasma. Our ethos is to improve & maintain your skin’s health & vitality as an ongoing commitment to our patients.
Dr Davin Lim
645K subscribersHow to treat PIGMENTATION
If I can identify the cause of pigmentation, chances are I can treat it. This can only be achieved with careful real time examination…
More of our mostFrequently asked questions
What is the cost of TCA peeling for melasma?
What aftercare is required post peels?
What are the side effects of TCA peels?
Who performs the procedure?
How does TCA compare with AHA peels such as glycolic acid?
How does TCA compare with Jessner?
A SummaryDavin’s tip on TCA peeling for pigmentation & melasma
Dr Davin Lim | Dermatologist
TCA for melasma is historical. The last time I did this procedure for melasma was in 2007. Back then we knew very little on the pathogenesis of melasma & focused on quick removal of pigmentation with aggressive procedures such as ablative erbium, CO2 lasers & high concentrations of TCA. The post peel results were awesome, especially at week 2 to 3 as pigmentation removal in the upper layers of skin was, in many cases complete. The flipside? Super high rates of rebound pigmentation & post inflammatory hyperpigmentation.
Today I still love TCA peeling- especially Jessner TCA. This peel has a very narrow window of application, namely fair skin patients (skin type 1- 2) with no melasma, but pigment due to photodamage, age spots, freckles & sunspots. Jessner TCA requires only one session, with a recovery period beyond one week.
Picosecond lasers provide much better outcomes than chemical peels for melasma pigment. This includes Cosmelan & Dermamelan peels as lasers have no recovery with less rebound rates (providing the correct laser is used, in the correct settings).