Trichloracetic acid peels work by coagulating protein. Typical strengths used vary from 15% up to 35% (higher strengths can be used when treating specific, isolated acne scars). If a patient desires less downtime, lower strengths are used in a series of treatments generally 4 weeks apart to achieve desired results. Common treatment areas are the face, neck, backs of hands and chest. However, lower strengths should be used when treating areas other than the face. TCA peels are self neutralizing and create a "frosting" effect that indicates a proper clinical endpoint.

• 3 day prior to your first peel, stop using exfoliating creams or sponges.
• If you have a history of cold sores, you must start taking Valtrex 2 days prior to your treatment and 2 days after treatment.
• Avoid shaving the treatment area the day of your peel.
• Avoid waxing in the treatment area 5 days prior to your peel.

• First your skin will be cleansed thoroughly and degreased with acetone.
• The solution will then be applied to one area of the face at a time. The solution will be left on the skin for several minutes during which time the skin will begin to tingle and burn. The strength of the peel will determine the intensity of the burning sensation. Patients often describe it as mild to moderate.
• Cool compresses will then be applied for comfort and the skin will quickly begin to feel better.
• Sunscreen will be applied before you leave the office.

• Your skin may be slightly red immediately following your peel. This usually subsides within minutes or hours.
• The peeling process usually begins 3-4 days following your treatment. During this time your skin will begin to dry and tighten. This is normal as the skin is preparing for the shedding process.
• Once the peeling process begins it is extremely important not to pick or force skin that is not ready to shed. This can result in minor scabbing or discoloration of the skin. While this is usually correctable, you do not want to go through the extra days it will take for your skin to heal.
• The degree of peeling will be based on the strength of the solution and your skin type. If you tend to have a naturally dry skin type, you may peel more than someone with naturally oily skin. Oily skin types naturally hydrate their skin during the peeling process.
• The amount of peeling does not determine the effectiveness of the treatment.
• You may moisturize as often as you like.
• Wearing a physical SPF of 30 or higher is mandatory to protect your skin during this process and to protect your new skin once it has healed.