Deep Chemical Peels / TCA Peels

Deep Peels At A Glance

  • Best Results1 session
  • Treatment Recovery5-10 Days
  • Procedure Time40 min
  • Skin SpecialistDermatologist only
  • Duration of Results4-10+ years
  • Anaestheticgas
  • Back to Work6-10 days
  • Cost$$$

Deep Chemical Peels / TCA Peels

Deep chemical peels can remodel collagen, improving scars, wrinkles, sun damage & resistant pigmentation. Downtime following deep peels range from 7 to 14+ days. My favourite peeling agents include phenol croton oil & modified TCA. Recent scientific papers show that deep peels outperform lasers when it comes to collagen stimulation.

FactsFact on Deep Chemical Peels

  • Deep peels reach the mid layer of the dermis
  • At this depth peels can address wrinkles, elastosis, pre-cancer skin cells & scars
  • I frequent combine peels with laser resurfacing as a compromise between downtime & best results
  • This peel is conducted under partial sedation
  • For extensive areas cardiac monitoring is required for phenol croton oil peels
  • Recovery from this peel is prolonged, sometimes reaching 4 weeks or more

What is a deep chemical peel?

Chemical peels can be classed according to the depth of skin penetration.

  • Very superficial peels: include retinoic acid- retinoid peels, enzyme peels, & majority of skin clinic peels
  • Superficial peels: include AHA peels such as glycolic acid peels, lactic, mandelic, citric acid & BHA peels such as salicylic acid peels. Stand alone Jessner peels.
  • Medium depth peels: These peels remove the entire top part of skin, known as the epidermis. TCA 20-35% peels are classic medium depth peels that penetrate to the papillary dermis.
  • Deep chemical peels: These peels penetrate into the deeper dermal layers. Jessner – high strength TCA as well as Phenol-Croton Oil peels are examples of deep peels.

What conditions can deep peels/ TCA peels / Phenol Croton oil treat?

Medium to deep chemical peels can treat-

  • Sun damage including pre-cancer solar keratosis & sunspots
  • Skin pigmentation including age spots, freckles & age warts
  • Fine lines, & wrinkles
  • Sagging skin & decreased elasticity
  • Crow’s feet & under eye skin laxity
  • Dark circles
  • Enlarged pores
  • Superficial acne scars (ice pick, box car)
  • Dull skin 

How is this peel performed?

In some cases, I prepare the skin weeks before peeling. Twice daily use of sunscreen is a must. Pre-peel prep is not mandatory for deep peels, I will guide you according to your skin type & concerns.

Day of Peel: Numbing cream is applied 1 hour prior to the procedure, at the same time anaesthesia consisting of a sedative & pain medication will be given by a nurse. Medium to deep peels are always conducted under partial sedation.

*Cardiac monitoring is mandatory during deep phenol croton oil peels exceeding 25cm2. *Not required for focal deep peels, such as Phenol Paint for acne scars. 

Peel itself: Skin prepped with degreasing, then disinfected. The chemical of choice will then be applied with either a gauze applicator & or cotton tips. This process will take between 20 to 40 minutes to perform.

After care: There will be no pain post procedure. My nurses will go through the post-peel after care & an instruction sheet given after the event. All patients who undergo medium to deep peels are followed up within 24-48 hours post procedure.

Depending on the depth of peel, skin healing will take between 8 to 14 days to fully heal.

How long does it take to recover from deep chemical peels?

7-14 days, depending on the strength & depth of the peel. TCA / Jessner TCA peels are medium to deep peels, whilst Phenol-Croton Oil peels are deep peels. An accurate down time will be predicted based on the clinical examination & planned peeling agent.

Davin’s viewpoint on deep chemical peels

Recent scientific studies have shown that deep peels, performed correctly, can generate more neocollagenesis (a term to describe new collagen formation) compared to CO2 & or erbium ablative laser resurfacing. My favourite deep peels include modified Jessner TCA, as well as phenol croton oil.

Combination treatments that I frequently employ include segmental peels, coupled with laser resurfacing. Treating the upper lip is one example. Segmental or focal peels can be performed on acne scars. 100% TCA or 88% phenol peels can safely & effectively treat ice pick & boxcar scars in skin types 1-5.

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