Rediscovering TCA Peels

Chemical peels have been a mainstay of dermatology practice for decades. They seem rarely to garner the credit they deserve for influencing the birth of cosmetic dermatology or for their ongoing essential status in the field of aesthetics. As noted by Dr. Lain, even with the large-scale adoption of energy-based devices, neurotoxins, and fillers over the last two decades, chemical peels have remained popular in aesthetic practice.

At SkinCeuticals, we have never taken for granted the important benefits of chemical peels, and we have focused on optimizing these tools for patient care. We are pleased that our latest innovation, the Smart TCA Peel, is expanding the safe and effective use of TCA for a range of patients and skin concerns, including the appearance of fine lines, wrinkles, pore size, laxity, and discoloration. Our novel formulation is self-neutralizing, reducing the risk for unwanted effects, and making it possible for properly trained medical staff members to administer treatment under the physician’s supervision. The product comes as a system, alongside a Restorative Masque formulated specifically to support post-peel recovery and soothe the skin.

Of course, the best outcomes in aesthetics seem to rely on a comprehensive approach, and peels are no exception. Certainly sunscreen is foundational to any aesthetic regimen to protect the skin from future photodamage and pigmentary change; SkinCeuticals offers formulations that feature physical sun blocks to enhance both safety and efficacy. Many of our topical skincare products designed for at-home use have been formulated specifically to target the same types of concerns that the Smart TCA Peel can address. Using these products in advance of and/or after a peel procedure will help to enhance outcomes and support long-term maintenance. Consider the additive benefit of SkinCeuticals Retinol Creams, SkinCeuticals Discoloration Defense, or our market leading antioxidant blends.

No doubt the past few weeks have brought significant challenges for aesthetics practices. As patients are able to refocus attention on their skin care needs in the weeks and months ahead, SkinCeuticals is pleased to support them with innovative and affordable interventions that are scientifically effective and safe. We are pleased to be part of this dynamic and evolving specialty, and we stand with you as you return to practice.

What are some of your preferred uses for chemical peels in your practice?

Ted Lain, MD: I certainly use peels to treat the skin signs and symptoms of photodamage, including pigmentation, laxity, fine lines and wrinkles, redness, and textural changes. In addition, I use peels for certain medical purposes, as well. For example, in acne, peels can both decrease the severity of acne as well as help minimize acne scars.

For conditions like acne or pigmentary changes, a peel can be used to “kickstart” the regimen in the office. The patient can use at-home prescriptions or skincare and receive additional in-office peels at appropriate intervals to bolster the effects of treatment.

Peels are diverse and can be used on so many different skin types and in different conditions, climates, and times of year. The flexibility in their application means peels are useful throughout the year in a practice. It can be like the Swiss army knife of aesthetic procedures.

With multiple energy-based devices, do peels remain relevant?

Dr. Lain: Peels have a price point appeal. They tend to be offered at a lower price point than some of the light-based devices, making them more accessible for people, especially during an economic downturn.

Clinically, peels can have advantages. Certain peels can be more targeted in their effects than some of the light-based treatments. Thinking again about acne, peels can really target the hair follicles or pores where acne forms.

Importantly, peels should not be thought of only as a replacement for energy-based devices. They can often be thought of as a complement to light-based devices; there are paradigms that include the combination of chemical peels with light-based devices either at the same time or spread apart to optimize treatment outcomes.

Injectable fillers are also popular, as we know. There is no concern about peels affecting any underlying filler, especially when the filler is placed in the deep layers, where the peel will not reach.

What distinguishes the SkinCeuticals line of peels from some of the others that are available on the market?

Dr. Lain: The SkinCeuticals line of peels addresses the breadth of the epidermal layer; you can start off with a very superficial peel limited to the stratum corneum—often termed a “lunchtime peel.” This type of peel is suitable for those who just want a quick brightening of their skin for an event, for example, or who don’t have the downtime for some of the deeper peels and are happy with frequent light peels.

You can go deeper into the skin with the variety of peels offered by SkinCeuticals; these have different effects on the skin and also come with different downtime. With the SkinCeuticals portfolio, you really can tailor these peels to the needs of the patient balanced with the downtime the patient has the ability to undergo.

With the introduction of the Smart TCA Peel, SkinCeuticals has now developed a peel that not only targets the deepest layer of the epidermis; this means that the peel targets pigmentation as well as fine lines and wrinkles and other signs of photodamage. They have developed the peel in a way that delivers a consistent formulation and a consistent method of application, so that the physician or provider in the practice can be assured that the peel is being applied appropriately for the patient with the definitive end points associated with each layer. This advancement has made the TCA peel more amenable to use by a wider range or providers, including aestheticians, because there are end points that are known and accessible for each layer.

How do you set patient expectations? Do you use skincare in combination with peels?

Dr. Lain: It is important to set expectations at the outset of the treatment regimen. If I plan to use peels only, I discuss expected outcomes and patients tend to be satisfied. If I believe that energy-based devices will help achieve the outcome desired by the patients, then I set that expectation at the start of the regimen.

SkinCeuticals has demonstrated a devotion to the science behind their peels and integrated skincare. As a result, not only do we have great peels that target the different layers of the epidermis, but we have trials and other data to prove the effectiveness of integrating skincare regimens with these procedures to achieve the best outcome.

Skincare recommendations depend on the peel being used. Prior to a Smart TCA Peel, for example, I’ll often ask my patients to prepare the skin with a regimen that involves a retinoid, brightening serum, and antioxidant serum, because there’s good data to show that skin that’s been prepped in this way for at least three to four weeks has better, more consistent results after the peel.

For post-peel care, we really emphasize the use of sunscreens. We also very quickly introduce the use of antioxidants because of their wound healing properties. Once healing is complete, we resume the previous skincare regimen to continue to lighten, brighten, and grow collagen.

PRODUCT SPOTLIGHT

Smart TCA Peel

• Features a blend of 15% Trichloroacetic Acid with 3% Glycolic Acid
• In-office, self-neutralizing treatment
• Significantly improves the appearance of fine lines, wrinkles, pore size, laxity, and stubborn discoloration
• Patented post-peel Restorative Masque to soothe and reduce skin temperature immediately following peel application.
• Clinically tested on a variety of skin tones, from Fitzpatrick I-IV.