TCA and the Skin Therapist

Trichloroacetic acid (TCA) is a great acid that any skin therapist can incorporate into her or his treatment arsenal to focus on pigmentation and aging. If combined with other chemical agents (like salicylic acid), it can also show marked changes on acneic breakouts and the common side effects that acne leaves behind, such as post-inflammatory pigmentation.

While similar to alpha hydroxy acids (AHAs), TCA is a much stronger acid that causes a denaturing of skin proteins. According to Claudia Aguirre, Ph.D., the effect will produce a white “frost” on the skin or cause the tissue to turn white. This characteristic of TCA is a great tool for skin therapists as it helps us to monitor the progress of the peel. If frosting has occurred during the treatment, it is a signal that the peeling step of the treatment is done; progressing further will only inflict serious damage to the skin as frosting is a sign of cell death. Achieving a frost on the skin will give great results, however frosting may not always occur and should not be forced. Remember: peeling is about controlled inflammation—triggering excess inflammation would encourage premature skin aging, and that defeats the whole purpose of a peel!

Another unique characteristic of TCA is that it has the ability to self-neutralize. Therefore, TCA does not depend on timing to trigger a frost or change, unlike AHAs. This feature makes the ingredient an especially unfailing chemical agent for skin therapists to use. Though, be sure to double-check your manufacturer’s directions when using a formulation with TCA, as some may require a neutralizer of some sort.

Sometimes a manufacturer may offer TCA as a stand-alone formulation. While it is effective when used alone, research has shown that when combined with other ingredients like lactic acid or salicylic acid, it will enhance the effects of these ingredients and provide a more effective skin resurfacing result. Look for concentrations under 20 percent as it is an excellent acid for use in superficial chemical peels. Note that higher concentrations lead to medium depth peeling, which should only be done by a medical professional.

About the Author: Whitney Johnson, global education developer for The International Dermal Institute, has more than seven years of industry experience and an extensive background in training and development. Not only has she worked as a director of education, with other product lines, Johnson was also the clinical educator for a multi-door chain of medical spas; Whitney worked directly with the medical director in creating protocols for the medical skincare services and laser procedures. In addition to her licenses as a Skin Therapist and Massage Therapist, Whitney holds numerous continuing education certificates in chemical peels, laser and light therapies, is an NCEA candidate and has served on the editorial board for the PCI journal.