TCA Chemical Peels: what they are and what they can treat

Trichloroacetic acid (TCA) chemical peels have been used in dermatology for many years and remain an important option for improving skin tone, texture and certain pigmentary conditions. When used appropriately, TCA peels offer controlled skin renewal with predictable results.

Unlike superficial exfoliating treatments, TCA peels are medical procedures and should only be performed following proper assessment and by trained clinicians.

What is a TCA chemical peel?

A TCA peel works by creating a controlled exfoliation of the outer layers of the skin. This process stimulates epidermal renewal and leads to gradual improvement in colour, texture and clarity as new skin forms.

TCA peels are commonly described by depth:

• Superficial peels, which affect the upper skin layers

• Medium-depth peels, which penetrate deeper and require greater caution

The depth achieved depends on multiple factors, including skin type and clinical technique.

What skin concerns can TCA peels help with?

TCA peels are used in dermatology for a range of concerns, including:

Pigmentation and melasma

TCA peels can be helpful when excess pigment is located mainly in the epidermis. In melasma, peels are usually part of a broader management plan rather than a standalone treatment, as melasma is a chronic and recurrent condition. Careful technique and strict sun protection are essential to reduce the risk of post-inflammatory hyperpigmentation.

Acne

Chemical peels can support acne management in selected patients, particularly where there is a combination of active breakouts and post-acne discolouration. They are usually used alongside an appropriate skincare or medical acne plan rather than on their own.

Acne scarring

TCA has a recognised role in the treatment of certain acne scars. Medium-depth peels may improve overall skin texture, while specific focal techniques using TCA have been shown to improve deeper, narrow scars such as ice-pick scars. Results are typically gradual and often form part of a combination approach.

Uneven texture and dull skin

By encouraging controlled skin renewal, TCA peels can improve rough texture, dullness and uneven tone, leading to a clearer and more even appearance over time.

What results should you expect?

Results from TCA peels are progressive rather than instant. Most patients notice:

• Brighter, more even skin tone

• Improvement in texture

• Gradual softening of pigmentation or scarring

Multiple sessions may be needed depending on the concern being treated. Maintenance and aftercare play a major role in how long results last.

Downtime and safety

After a TCA peel, it is normal to experience redness, tightness and visible peeling for several days. These effects are temporary and part of the skin renewal process.

As with any medical peel, there are risks. These include post-inflammatory hyperpigmentation, prolonged redness and, rarely, scarring. The risk is higher in darker skin types and when aftercare instructions are not followed. Careful patient selection and conservative treatment planning are essential.

The importance of sun protection

Sun exposure is one of the main triggers for pigment recurrence after a peel. Consistent, high-level sun protection and sun avoidance are critical, particularly when treating pigmentation or melasma. Without this, results may be short-lived or reversed.

Is a TCA peel right for everyone?

TCA peels are not suitable for all skin types or all situations. A full consultation is essential to assess:

• Skin type and history

• Pigmentation risk

• Healing capacity

• Ability to follow aftercare and sun protection advice

In some cases, alternative treatments may be safer or more appropriate.

Final thoughts

TCA chemical peels remain a valuable and well-established treatment in dermatology. When used carefully and as part of a considered treatment plan, they can improve pigmentation, acne-related concerns and overall skin quality. The key to safe and effective results lies in proper assessment, conservative technique and long-term skin care.

References

1. Sarkar R, Arora P, Garg VK.Chemical peels in melasma: a review with consensus recommendations.Journal of Cutaneous and Aesthetic Surgery. 2017;10(2):57–65.

2. Rendon MI, Gaviria JI.Review of melasma pathogenesis and management.Journal of the American Academy of Dermatology. 2005;54(5 Suppl):S272–S281.

3. Chen X, Wang S, Yang M, et al.Chemical peels for acne vulgaris: a systematic review.BMJ Open. 2018;8:e019607.

4. Bhardwaj D, Garg VK.CROSS technique with trichloroacetic acid for ice-pick acne scars.Journal of Cutaneous and Aesthetic Surgery. 2010;3(2):93–96.

5. Goodman GJ, Baron JA.Postacne scarring: a quantitative global scarring grading system.Journal of Cosmetic Dermatology. 2006;5(1):48–52.