Experience With 25% TCA Chemical Peel to Treat Hyperpigmentation
Procedure specific satisfaction rating
I have had horrible hyperpigmentation since my late 20’s, when I went on Yasmin birth control for the treatment of acne. It was so bad that it looked like someone had splattered mud across my fair cheeks. All of my pigmentation is on the sides of my face on my cheek areas, down slightly onto my neck. I have tried laser treatments, topical prescriptions and over the counter treatments for years and although the pigmentation would fade, it was still very present. It is also very difficult to keep out of the sun, what triggers hyperpigmentation. Even though I would wear sunscreen every day, I am a runner and it was nearly impossible to keep my face covered 100% of the time. I had eventually faded my hyperpigmentation pretty well over the years to the point where a full coverage makeup made it only slightly noticeable, but I wanted to be able to go makeup free and was looking for something to completely get rid of it. I visited my local Dermatologist and she recommended another Dermatologist in other town that specialized in treating melasma. I visited her and she recommended a TCA (trichloroacetic acid) peel at 25% to start with. I agreed and paid $250 for the peel. It was scheduled for a few days later and she informed me that my skin would be pretty red and crusty and advised me to do it over a weekend. Since I work in retail management and I worked on weekends, I arranged to take a few days off from work.
When I arrived for the peel the doc brought in a nurse to assist. They had me wash my face even though I was makeup free and then vigorously rubbed down my skin with acetone (yes the same thing in fingernail polish remover) it was quite unpleasant. Then they both proceeded to rub TCA soaked cotton onto either side of my face and forehead. The Dermatologist was on one side, the nurse assistant on the other. I felt no pain at first and then it felt as if my face was literally on fire. The Doc told me to tolerate it as long as I possibly could. It was extremely painful and frightening. Soon thereafter, the pain diminished. It was only really intense for a few LONG seconds. Then the doctor proceeded to put ice packs on my face, which was amazingly soothing. I held them there for a few minutes and then she asked me to wash my face with cetaphil. She then put a thick layer of petroleum jelly all over my face and let me take a look at it. My face looked white where the peel had been applied. It is called “frosting”. I was sent home and told to take it easy for the rest of the day and to keep my skin protected with the petroleum jelly until it healed. Over the next few days my skin felt very tender, hot and it was red. The pigmentation darkened. The 3rd day my skin was extremely tight and began to crack and peel. the 4th and 5th day my skin was trying to slough itself off and sheets of skin were just kind of hanging there. It was hard not to peel it but I did peel a few that were barely hanging on. The new skin underneath was slightly red and less pigmented.
Although my melasma did not completely disappear, I saw a significant difference it its appearance. I subsequently followed up with the same dermatologist for another peel. We did a 30% peel. It was a very similar experience. In pictures with makeup it’s not very visible but it’s still there. I am planning on doing a few more to completely get rid of the pigmentation.