TCA peels = safe, cheap, predictable, a good alternative for brown spots and mild rhytides (It won't net the same results as advanced laser resurfacing but it remains a very important niche in the skin care regiment. Tried, tested and true...

yet TCA peels have, for all intensive purposes, been replaced by lasers, a medium that has a high tech appeal that clearly excites consumers and they we have to invest the big bucks in.... but uh... how shall I put this? .......Oh this way here:

- Lets not forget where we came from -

Still has a place in the arsenal. Some lasers have better efficacy on certain modalities as well as more revenue. I think if you offer it and you know where it works - keep it on the menu.

I like TCA peels. They work well. I still perform them.
But, the recovery really seems to be longer than with my fractional CO2 laser.
It's going to take some comparison studies to figure out the details of this.

I would ask you to mention a link on a peer-reviewed medical journal where any TCA peels have shown clinical wrinkle reduction that lasts longer than the period of swelling does

I agree that TCA peels can be beneficial but they do not last. Patients will need to repeat the peels every 12 to 24 months. So then we have to ask ourselves if we are causing long term problems due to the repetition.

I do some TCA's but not a lot. They are good for the person with a lot of epidermal pigmentation. These patients see a lot of improvement but as far as deeper wrinkles there are better choices.

Agreed that TCA doesnt have much in the way of long term results, but it definately gives patients more instant gratification where they have to wait months to see results with many of todays most popular modalities and are often initially disapointed. Patients generally like to see what they paid for right after they pay for it for them to deem it worthy.

Which will get me better short term results for fine lines, brown spots and smile lines and forehead creases, TCA, or 20 micron MLP with 150 micron profractional? Which will get me better long term results?

Amelia

I would surmise that the TCA peel will look better in the short term, esp around the eyes. It would have to be at least a 25-35% peel though, but in the long run the mlp + pfx will do much better for you.

I have no personal experience with the pfx whatsoever though, so I can't really be sure about the benefits of combining it with an mlp but I'd ask any doctor here who is more expereinced in this to give you a better answer to your question as I am pretty much just guessing.

I would imagine Dr. Harold Brody (if you do not recognize his name, google it) would beg to differ with you that chemical peels in the hands of an experienced, talented dermatologist can give nearly equal results that are as long lasting as most laser modalities with less downtime and possible bad side effects/outcome

I've had laser resurfacing and a TCA peel (medium depth).

I had TCA (35% TCA w/Jessners) back in the early 1990s for melasma and acne scarring (rolling acne) my improvement was about 75% for the scarring and 100% for the melasma. The melasma NEVER returned. I stayed out of the sun and have worn high SPF sunscreen every since. My peel was performed by Dr. Brody.

I had an Erbium Yag laser resurfacing under my eyes 22 months ago-can't remember the microns or passes-but my PS said fairly deep--deeper than the peel for sure.. It's less than two years later and every wrinkle, and more, that I had post-resurfacing has returned. My downtime was MONTHS for the laser (extended swelling, redness, textural changes). When what little collagen showed up, it was minimal and certainly not worth the problems it caused. I'm left with a small scar under one eye, my eyes have a slightly sunken appearance, and a malar bag appeared under one eye within three weeks of the resurfacing and only gets worse with time. My laser was done by a PS ( double board certified).

I would NEVER have another ablative laser put to my face but I'm having another TCA peel in December.

So, hope that helps for those of you that wonder which is best for a patient. Oh, the cost of the TCA was $350 back in the 90's and now it is $500. The cost of the lower lid resurfacing: $2500--not counting the surgi-center.

I said this: It's less than two years later and every wrinkle, and more, that I had post-resurfacing has returned.

I meant to say PRE-RESURFACING.

I said:

I would imagine Dr. Harold Brody (if you do not recognize his name, google it) would beg to differ with you that chemical peels in the hands of an experienced, talented dermatologist can give nearly equal results that are as long lasting as most laser modalities with less downtime and possible bad side effects/outcome

Again, I should have said, he would differ with you AND say that PEELS CAN GIVE equal or better results than lasers.....

Sorry for my typos or lack of clarity.

In March 2007,I had a 35% TCA and a 20% 2 months later with a slight positive change in skin texture and an INCREASE in hyperpigmentation, which is still there 1 year later.
Had IPL to reduce bruising around eyes and cheeks after eye and cheek lift. IPL again 1 month later, total face, for brown spots.TCAs done by double board certified ps, IPL done "under ps supervision" by licensed tech.
RESULT: Major fat loss( lumpiness, irregular contours, sunken under eye area) and red streaks around eyes . Large indentations on my forehead and cheeks.
I"m out a lot of money and gained a loss of self esteem!