A medium peel is a cosmetic non-surgical procedure using Trichloroacetic acid (TCA) to

• revitalize lifeless skin
• brighten complexion
• eliminate fine wrinkles
• fade brown spots and other discoloration
• make pores appear smaller and
• smoothen the skin surface.

by peeling away the skin’s top layers.
It can be performed on the neck, chest, hands, back, arms and legs using the same technique as for the face

A medium peel is done when the following are present

• lifeless skin
• dim complexion
• fine wrinkles
• brown spots
• large pores
• superficial blemishes and pigment problems

• Candidates who want a fast procedure with dramatic results
• Candidates with darker skin are preferred
• Candidates who are physically healthy, psychologically healthy and have realistic expectations from the procedure
• Candidates who wish to enhance their appearance
• Candidates who seek improvement rather than perfection

• Scarring, infection or abnormal pigmentation.
• Creates bleaching effect and patient may need to wear make-up to match treated and untreated areas.
• Can activate latent cold sore infections.

• During the initial consultation, a thorough gathering of the expectations of the patient as well as the complete medical history of the patient is done
• Photographs are taken for further comparison after procedure.
• A careful history and physical exam of the face will be done to determine the skin type, skin thickness and degree of wrinkling and whether the treatment is the right decision.
• The doctor discusses and advises on options of anaesthesia, type of facilities, various techniques and cost with the patient.
• A small “test spot” may be peeled to get a better idea of the results, especially for people with darker skin.
• Two to three weeks before the peel, the patient will need to begin preparing the skin by cleansing it twice a day, applying a special moisturizer or cream once or twice a day, and using sunscreen every day.
• The doctor provides guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications
• The patient must be free of skin infections, including acne and any type cold sore, especially herpes simplex sores.
• The patient may be given a short course of medication (such as acyclovir) a few days before the peel to prevent viral infection.
• The patient requires pre-treatment with AHA(alpha hydroxy acids) or Retin-A creams from a month prior to the treatment
• The patient must not take Acutance for twelve to 18 months before treatment, depending on the doctor’s specifications.
• The patient must limit exposure to the sun for at least a month before undergoing the peel.
• The patient must arrange for transportation and assistance.

• The patient may be given a pain reliever and an oral sedative to reduce pain and anxiety during the procedure.
• The skin is thoroughly cleaned by rubbing alcohol or acetone to remove any traces of grease.
• The TCA solution is applied to the area to be treated (avoiding the eyes, brows and lips) using sponge, cotton pad, swab or brush.
• After the peel solution has worked on the skin, it is neutralised with water
• Cool compresses and fans can be used to cool the stinging and burning caused by the chemical.

The procedure takes 15-20 minutes to complete

The treatment is done as an outpatient procedure.

• There may be puffiness and swelling in the face which subsides after several days.
• The doctor may prescribe a mild pain medication to relieve any tingling or throbbing experienced.
• There is no discomfort after the peel solution is removed.
• In about a week to ten days, the new skin will be apparent

• The patient may return to work and resume some of the normal activities in 7-10 days
• Two or more treatments must be performed to achieve the desired correction
• Make-up is not recommended for the first 7 to 10 days or until the skin has completely peeled.
• Flaking and peeling begin 4-5 days after the peel and finish within 7-9 days.
• The patient may engage in normal activities that do not include sun exposure, immediately following the peel
• Sunblock must be used for several months
• The results of a TCA peel are usually not as long-lasting as those of phenol peel but the skin will be noticeably smoother and fresher-looking.