TCA Peel Research Articles

A Randomised Open Label Trial to Evaluate the Efficacy of TCA Peel with Oral Metformin vs TCA Peel with Oral Alpha Lipoic Acid in Acanthosis Nigricans

A Randomised Open Label Trial to Evaluate the Efficacy of TCA Peel with Oral Metformin vs TCA Peel with Oral Alpha Lipoic Acid in Acanthosis Nigricans

Comparative evaluation of therapeutic efficacy and safety of black peel versus 25% trichloroacetic acid peel in mild to moderate acne vulgaris: a split face study.

Peeling has withstood the test of time as a simple, minimally invasive method to renew the skin, despite the introduction of more advanced procedures like lasers. Thirty patients (or 60 sites) with age ranging from 15 to 45 years with mild-to-moderate acne vulgaris were included in the study. Assessment at baseline was done by the global acne grading system score for including mild and moderate acne patients. On grading the improvement according to the 5-point Global Assessment Scale (GAS), it was found that in area A (black peel), 6.7% of patients showed excellent improvement, 86.7% of patients showed good improvement, and 6.7% of patients showed fair improvement. In area B (25%TCA peel), 6.7% of patients showed excellent improvement, 80% of patients showed good improvement, and 13.3% of patients showed fair improvement. None of the patients showed poor or worse outcomes in any of the areas. The difference between the groups was not significant (P = 0.688). There is a paucity of data in the literature regarding the comparison of black peel with other conventional peels in the treatment of acne vulgaris. To the best of our knowledge, this is the first study comparing black peel with TCA peel in the treatment of acne vulgaris.

Localized TCA peel for static facial wrinkle: case series

Localized TCA peel for static facial wrinkle: case series

A comparative study of 30% Trichloroacetic acid chemical peel with Q switched Nd-YAG laser 1064nm in the treatment of Macular amyloidosis

Macular amyloidosis (MA) is the subtlest of the cutaneous varieties of amyloidosis. In general, the treatment of MA is disappointing. Hence, this study was aimed at comparing the two treatment modalities for the same. To compare the efficacy of 30% TCA chemical peel with Q switched Nd-YAG laser 1064nm in the treatment of macular amyloidosis. 50 patients of MA attending our Dermatology outpatient department were enrolled in the study. The study involved application of 30% TCA in 25 patients at an interval of 2 weeks for 10 sittings and Q switched Nd-YAG laser 1064 in 25 patients at an interval of 1 month for 5 sittings. Digital photographs were taken before treatment and then periodically. The response was graded percentage of reduction in pigmentation both by the patient and the observer. The patients were followed up for 5 months post treatment for recurrence. Both TCA peel and Q switched Nd-Yag laser 1064nm were effective in the treatment of macular amyloidosis. switched Nd-Yag laser 1064nm showed better response compared to TCA peel at the end of the treatment, both by subjective and objective methods and in terms of less number of sittings and fewer side effects. The difference was statistically significant (P <0.05).No permanent side effects were seen in any of the treated patients and the improvement was sustained without any relapse at 5 months except in one patient in the peel group. Both these treatment modalities are effective and safe in the treatment of MA. Q switched Nd-Yag laser 1064nm was found to be marginally superior to TCA peel.

Comments on sequential Jessner's + 35% TCA peel for the treatment of facial field cancerization

Comments on sequential Jessner's + 35% TCA peel for the treatment of facial field cancerization

Treatment of lateral canthal rhytides with a medium depth chemical peel with or without pretreatment with onabotulinum toxin type A: a randomized control trial.

BackgroundCombination therapies used to treat the photoaged skin have become more popular as studies demonstrate greater efficacy and improved clinical outcomes compared to single treatment modalities.ObjectivesTo evaluate the safety and effectiveness of treating the lateral canthal rhytide complex with a Jessner’s and 35% TCA peel with and without pretreatment with BTX-A.MethodsTwenty-six subjects with Fitzpatrick skin types I -III were randomized to receive treatment of their lateral canthal rhytide complex with a Jessner’s and 35% TCA peel with or without pretreatment with BTX-A. A single blinded dermatologist assigned a lateral canthal wrinkle score of subjects’ at baseline and week 8-10.ResultsComparison between the two treatment groups demonstrated that the group receiving combination treatment had significantly greater improvement in wrinkle reduction as compared to the group only receiving the chemical peel (P =0.002). In addition, there was no significant association between skin type and treatment groups (P = 0.11).ConclusionsThese findings suggest that treating the lateral canthal rhytide complex with a combination of BTX-A followed by Jessner’s and 35% TCA peel is more effective than chemical peel alone. These results are independent of skin type and demonstrate an additional treatment strategy for lateral canthal rhytides.

Melasma: A Commentary

Copyright: © 2015 Khatri KA. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. One of my patients, a about 50 year old Hispanic female, with skin type IV, came to discuss treatment options of Melasma. After her skin evaluation, I recommended a TCA peel. She understood the risks and benefits and agreed to proceed with the peel. A 35% TCA peel was performed. She was also using bleaching creams and sunblock. When I saw her for a one month follow up, I was surprised to see that her Melasma was gone and she was very pleased. She came back three years later with Melasma again. She insisted that she wants the “same” treatment as three years ago. I performed another 35% TCA peel. This time when she came back for one month follow up, her melasma was worse than before the peel. I advised her to use TriLuma cream. Her one month follow up showed no improvement. I advised her to continue TriLuma for few more weeks. When she came back for her follow up this time, her Melasma has cleared 90%. I was very pleased but she told me that TriLuma didn’t work and she has been using a Chinese bleaching cream that she found at a Flea market. She showed be the box of the cream but everything was written in Chinese and I could not figure out the ingredients. Few months later while I was on a flight, I asked a fellow passenger sitting next to me who was reading a Chinese newspaper, to read the writings on the box. She told me that there are no ingredients listed but it only shows where this cream was produced. I did some more research to find out the ingredients but failed. I assume it had Mercury.

Evaluation of 70% glycolic peels versus 15% trichloroacetic peels for the treatment of photodamaged facial skin in aging women.

Chronic solar irradiation results in both morphological and functional changes in affected skin. Superficial peels have been shown to improve all symptoms of photodamaged skin. This study was designed to compare the efficacy and tolerability of glycolic acid (GA, 70%) with trichloroacetic acid (TCA, 15%) for the treatment of photoaging. Twenty female patients affected by photodamage were treated with graded concentrations of 70% GA and 15% TCA peel. Each patient was submitted to 5 sessions of these peels, with an interval of 14 days between each session. Four clinical parameters of surface evaluation of the living skin (hydration, elasticity, melanin, and erythema) were measured. The records were made before each treatment and 3 months after the last application. The statistical significance in each group of patients was observed with elasticity and hydration. Decrease in melanin content in the skin occurred significantly after the application of a series of treatments with GA. Increase in severity of erythema showed statistical significance after the treatment with TCA. Superficial peels, such as 70% GA and 15% TCA, proved to be an effective treatment modality for photodamaged facial skin. Both acids contribute to improvement of the photodamaged skin's parameters. Glycolic acid increases skin's hydration faster.

Plane xanthomas in a child treated successfully with focal 35% TCA peel

Plane xanthomas in a child treated successfully with focal 35% TCA peel

Overview on Melasma and other Hyperpigmentations Using TCA PEEL with Moderator System

Melanoma remains a major cause of morbidity and mortality worldwide, however tremendous advances have been made in its treatment over the past several years. The discovery of genomic alterations that contribute to oncogenicity has ushered in a new era of molecularly-targeted therapy. Importantly, over half of melanomas harbor a mutation in the BRAF gene that leads to constitutive signaling down the MAPK pathway and multiple subsequent deleterious effects. Pharmacologic agents targeting this mutation have been developed and several are now FDA-approved, having yielded high response rates to therapy although these are tempered by a short duration of response. Multiple molecular mechanisms of resistance have been identified; however until recently few studies had delved into the immune effects of BRAF inhibitors. The effect of BRAF inhibition on anti-tumor immunity will be discussed herein, as will potential implications of these findings in the treatment of melanoma.

Comparative study of 15% TCA peel versus 35% glycolic acid peel for the treatment of melasma

Background:Chemical peels are the mainstay of a cosmetic practitioner's armamentarium because they can be used to treat some skin disorders and can provide aesthetic benefit.Objectives:To compare 15% TCA peel and 35% glycolic acid peel for the treatment of melasma.Material and Methods:We selected 30 participants of melasma aged between 20 and 50 years from the dermatology outpatient department and treated equal numbers with 15% TCA and 35% glycolic acid.Results:Subjective response as graded by the patient showed good or very good response in 70% participants in the glycolic acid group and 64% in the TCA group.Conclusions:There was statistically insignificant difference in the efficacy between the two groups for the treatment of melasma.

The effect of chemexfoliation and anti‐aging regiments on fibroblast expression of IGF‐1: A pilot Study

The normalized IGF-1 levels for subjects 1,2 and 3 at baseline were 0.85, 0.59 and 0.87 respectively. When looking at the antioxidant creams the effect of the weaker antioxidant cream regiment of Effulgere and Effulgere P.M. demonstrated a decrease in IGF-1 levels in subject 1 while that of subjects 2 and 3 were virtually unchanged. The stronger antioxidant cream, Effulgere ultra, showed a decrease in IG F-1 levels of subject 1 while demonstrating a significant increase of IGF-1 levels of subjects 2 and 3. (Tables 1,2 and 3) When looking at the post-auricular sites, medium depth chemexfoliation via Jessner’s and 35% TCA peel, showed significant decrease in IGF-1 levels for subjects 1 and 3 and a slight decrease in levels for subject 2. The deeper chemexfoliation utilizing Baker’s solution, showed significant decrease in subjects 1 and 3 while it demonstrated an increase in subject 2. (Tables 1,2 and 3) Profilometry When evaluating the profilometry results the median depth of the wrinkles impression on the silicone cast were evaluated. Evaluating the effects of weaker antioxidant cream showed in subject 1 the median depth changed from 0.52 mm to 0.80 mm while, in subject 2 it changed from 1.15 mm to 0.71 mm and in subject 3 it changed from 0.68 mm to 0.62 mm. Looking at the stronger antioxidant cream, the values in subject 1 changed from 0.57 mm to 0.77 mm, in subject 2 these values changed from 1.07 mm to 0.70 mm and in subject 3 this valued changed from 0.74 mm to 0.50 mm. The specimens from the areas treated with medium depth chemexfoliation method showed change from 0.50 mm to 135 μ m in subject 1, while in subject 2 it increased from 0.64 mm to 1.05 mm and in subject 3 it increased from 0.87 mm to 1.44 mm. The sites treated with deeper chemexfoliation method showed a change from 0.89 mm to 0.52 mm in subject 1, change from 0.47 mm to 0.91 mm in subject 2 and a change from 1.0 mm to 0.41 mm. (Figure 1)

Combined Resurfacing Techniques: A Systematic Approach

Many resurfacing techniques are available to the modern facial aesthetic surgeon, and may be broadly grouped as mechanical, chemical, and laser abrasion. Each resurfacing modality has its own inherent strengths and weaknesses that make it suitable for certain defined goals. Understanding the characteristics of each type of resurfacing tool permits the surgeon to combine them effectively to achieve the desired cosmetic outcome. This paper represents the 10-year experience and personal philosophy of the senior author (EFW) and reviews how he has implemented combined resurfacing techniques using the CO2 laser, TCA peel, and wire-brush dermabrasion. Three important guidelines will determine which resurfacing modality is best suited to a particular situation: the facial subunit principle, the depth of the facial pathology (e.g., scar, rhytid, or actinic damage), and the Fitzpatrick classification of the patient's skin. Different resurfacing modalities are discussed, and three clinical scenarios for combined resurfacing are presented: acne scarring, rhinophyma, and facial rejuvenation (rhytids and actinic damage).

Combination medium-depth peeling: the Jessner's + TCA peel.

The Jessner's + TCA peel is an enhanced medium-depth peel that is a combination of two acidic compounds. It has been found to be effective as a peeling procedure for moderately photoaging skin, actinic keratoses, and superficial acne scars.

The Jessner's + TCA peel: a medium-depth chemical peel.

The Jessner's + TCA peel, a method of chemexfoliation, is a combination of two acidic compounds. It has been found to be an effective peeling procedure that produces a medium-depth peel for photoaging skin, actinic keratoses, and rhytides.