A middle age woman presented to Porcaro Cosmetic Surgery for evaluation of multiple dark areas on her face- hyperpigmentation-that was noticeable from 20 feet away! She purchased Tricloracetic Acid (TCA) on line (without a prescription) & performed a facial peel on herself, resulting in a horrible disaster!
Chemical peels vary in their concentration and thus their dept of skin penetration. TCA at a low strength can be used as a light peel like what you might experience at a spa. More concentrated TCA can result in penetration through the entire outside layer of the skin, the epidermis, and possibly through the deeper layer, the dermis. Now your talking about placing yourself at a high risk for permanent skin darkening or lightening and even life long scarring, like this patient!
At Porcaro Cosmetic Surgery we perform the Obagi Blue Peel for certain benign skin abnormalities including wrinkles. We obtain our TCA by submitting a prescription to a reputable compounding pharmacy. Only after the skin has been properly “prepped”, which takes several weeks, and we are certain the patient will be compliant with the post peel instructions do we perform the Obagi TCA Blue Peel. This is a physician administered peel, sometimes requiring pain medicine. The blue dye that is used along with the TCA enable the physician to precisely determine the depth of TCA penetration. If the TCA is removed before it has penetrated to the proper depth it may only result in redness of the skin but no peeling and therefore no change. On the other end, to affect a change in the appearance and quality of the skin, the TCA needs to penetrate down to the mid-dermis. Once this occurs, we can be confident that the desired changes will ensue.
Obviously, just because you can purchase TCA on line doesn’t mean you can safely perform a TCA peel on yourself!