Are TCA peels good for Pigmentation? | Dr Davin Lim

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.

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.