TRICHLOROACETIC ACID PEEL INSTRUCTIONS

The Trichloroacetic Acid (TCA) Peel, a medium peel, is one of the gold standards for treatment of fine wrinkling of the skin. Trichloroacetic acid treatments can be used in varying concentrations from as low as 10% to as high as 50% -- The higher the concentration, the deeper the peel. When used in a controlled fashion, TCA peels produce improvement in collagen and elastin in the skin and reduction of fine wrinkling, acne scars and dark spots. It will lighten or even diminish tattoos (depending on darkness and depth of tattoo). Medium peels produce a deeper penetration than light peels such as glycolic. The draw back is that a medium peel causes the skin to appear to have a severe sunburn for about one week. A person having a medium peel must stay in for one week (maybe longer) to recover.

Warning to Client/Patient: Skin condition and overall health are factors in determining whether you are a good candidate for a TCA Peel. Whether pretreatment medications may be needed, the strength of solution to be used, and duration and depth of the peel should be determined by a qualified skincare practitioner. Applying this product without proper medical consultation constitutes using it at your own risk. (The seller of this product is not familiar with buyer’s skin type, condition, skin history, or sensitivity and does not make personal recommendations of any kind to any buyer. Seller is not liable for negative or damaging results that may be obtained by proper or improper use of this product on any person.)

Side Effects:

The first week after the peel the skin will be red and perhaps swollen. The skin may also burn and may weep slightly.

Peels can sometimes cause persistent redness of the skin and ultimate de-pigmentation.

The most common side effect after a peel is brown discoloration of the skin. This is usually reversible but can rarely be permanent. This side effect usually occurs only in those who have had sun exposure after the peel and who are not using sunscreen SPF 25 or higher.

If the client gets cold sores, a peel can cause them to flare. Client should begin taking Lysine 1-2 weeks prior to a peel (or consult their doctor).

Precautions to Clients:

If the client has any of the following problems (contraindications), a doctor’s advice is recommended so that precautions can be taken:

Facial Warts
Prior bad reaction to a peel or dermabrasion
Past herpes simplex (cold sores)
History of sun allergies
Recent radiation treatment for cancer
Keloid or hypertrophic scars (thick scars)
Pregnant or breast-feeding
Accutane use within the past six (6) months. Accutane should not be taken for at least six months after the peel either. There are reports of scarring in people who have taken Accutane after a peel.
Sunburn or significant sun exposure in the last two days
Surgery or cryosurgery within the last six weeks to the area that is to be treated.

What to Do Before The Peel:

At least three to four weeks before the peel client should stop using exfoliating sponges or buff pads. All forms of hair removal should be discontinued at least three to four weeks before the peel. Client should avoid shaving the day of the peel.

Each night before client goes to bed, starting at least two weeks before the peel, client needs to begin applying a mild AHA (Alpha Hydroxy Acid 3-8%) cream or lotion to the entire face and to any other areas that will be treated. This conditions the skin and begins the exfoliation process. It enhances the TCA treatment, resulting in a more even peel.

>>>>> REMEMBER TO DILUTE & DO A PATCH TEST <<<<<

How the Peel is Done:

ALWAYS do a patch test close to the area you wish to peel to determine the skin’s reaction to the solution. Treat it as you would the complete peel... keep it moist with ointment and out of the sun for a week. Then determine whether to use the full 25% TCA or to dilute it to a weaker solution for your full treatment. Not everyone’s skin reacts the same to skin peel solutions….some peel more than others and some less. Also, using too strong of a solution could result in darkening of the skin and scarring. A number of factors come into play, such as allergies, previous peels, etc. Always do the patch test before undergoing a complete peel. You are responsible for it's usage.

To Dilute:

For a 12% Solution: Mix 1 part 25% TCA with 1 part water (equal amounts).

For variations between 25% and 12% just add a little more or less water.)

A 25% solution will result in a medium peel, whereas the 12% will give you a lighter "lunchtime" peel, comparable to a 30% glycolic treatment.

Procedure: First cleanse the skin with a mild cleanser and remove oils from the skin with an alcohol prep pad. For extra protection, you may want to apply a small amount of ointment around the eyes to protect that area. A 25% TCA solution is the average strength used for normal skin and gives good results without a prolonged recovery period. - Using too strong a solution may result in scarring or discoloration. Skin around the eye area is thinner; a weaker solution should be used there. Avoid getting the solution too close to the eyes. After completing the patch test and determining what strength to use, apply an even coat of the TCA solution using a cotton swab or cotton pad. Do not scrub any areas that may need more exfoliation than others. The skin will burn. The treated skin should frost (turn white) after just a minute or so. Apply a second coat of TCA to problem areas or if the skin is not frosting. The frost indicates that the TCA is penetrating and working as it should. (This is normal and will subside. The frost will fade within 20-30 minutes after the treatment). The solution will be left on the skin for several minutes (3-4), depending on the skin type, condition, and results desired. You will want to fan the treated area at this time since the burning will be intense. Rinse the treated area with cool water and apply cool compresses (water dampened cotton or cloths) after the 3-4 minute application, gently blotting the skin to remove excess solution and to cool the skin. Do not rub the area, as it is now somewhat sensitive. A neutralizer is not necessary, but if you prefer to use one, you may make your own by mixing one cup water with one teaspoon baking soda; simply apply it with cotton pads on the treated area. The treated area will soon begin to take on a pink/brownish color. Next apply a thin coat of protective triple-antibacterial ointment. During this time the skin will begin to feel better, although a very slight burning sensation may continue for a while.

Note: If you are only applying a 12.5% solution for a "lunchtime peel," there is no need to apply ointment. DO apply a sunblock for a week or so following the "lunchtime peel" treatment. Lunchtime peels lightly flake... they do not peel the same as the 25% TCA treatment.

Post Treatment Care:

For 7-12 days after the peel, clean the skin with warm water using the mild liquid cleanser. Use fingertips (not a wash cloth) since the skin is very sensitive at this time. Avoid the use of abrasive or exfoliating sponges. After cleansing, pat dry with a clean towel, and then apply ointment to keep the exfoliating skin soft and the new skin protected.

The skin will turn brown, wrinkle up, and crust, much like a bad sunburn. It is this browned outer layer of skin that is in the process of exfoliating. Keep it moist each day with ointment. Do not peel, pick, or scratch the exfoliating skin. Advil, Nuprin, or Ibuprofen (200 mg) may be taken 3-4 times daily with food to reduce swelling and discomfort, if needed.

Avoid sun exposure -- this includes tanning beds. Sunlight on the skin after a peel can cause brown discoloration of the new skin. A sunscreen of SPF 25 or higher should be applied every morning before going outdoors. With trichloroacetic acid peels, scarring and brown discoloration of the skin is unlikely unless the client goes to a tanning salon after having the treatment or lies out in the sun. Daily sunscreen use should continue indefinitely to prevent new photo damage from occurring. The new skin will have a pinkish color for several days, perhaps weeks after the peel (depending on solution strength and skin condition). If there is persistent redness in an area that doesn’t seem to be fading after the first few weeks, let the doctor know. Persistent redness of the skin can lead to brown discoloration of the red area and a scar if it is not treated right away.

For a minimum of one month after the peel, do not have hair removed by any technique. It can cause severe irritation of the skin. Make-up application may be resumed one week after the peel, provided there is no crusting or tenderness.

Touch-ups or a second peel may be needed after the initial peel. Wait at least 4-6 weeks before reapplying the TCA.