Treating Acne Scarring with the TCA Localized Peeling Method

A common result of teenage and persistent adult acne is scarring. Acne scarring can be separated into three different classifications: rolling scars, boxcar and ice-pick scars. To treat these scars dermatologists have developed many treatments including subcision, chemical peels and punch elevation or excision.

A chemical peel is a simple process that forces the skin to peel away from the treated areas. As skin ages and is exposed to sunlight and acne it results in the fracturing of the elastic-collagen matrix. The elastic-collagen matrix is responsible for maintaining tight, healthy looking skin.

A chemical peel results in the rejuvenation of the skin and a stronger production of collagen in the affected areas. The TCA Localized Peel is the focal application a peeling solution called trichloroacetic acid. TCA is available in many different concentrations and depending on the level of acne scarring can be increased. The end result of a localized TCA peel is that there is a complete dermal reorganization. There is an increase in glycosaminoglycan, elsatin and collagen.

Most dermatologists begin by washing the face completely with a mild antiseptic soap or alcohol. The trichloroacetic acid is applied to the affected area with a needle and the dermatologist begins applying pressure to the depressed areas on acne scarring. After a short period of time the area begins to appear ‘frosted’. This ‘frost’ is the coagulation of dermal proteins and epidermal proteins. Dermatologists use this as a method of measuring how deep the trichloroacetic acid peel has penetrated into the epidermis.

Once treatment is concluded the treated are is covered with an antibiotic based moisturizing cream father than a bandage. The antibiotic cream is applied until scabs or crusts begin to form in treated areas. In order to prevent the patient from inadvertently detaching these scabs, medication is either taken orally or discontinued until the treated areas are blemish free.

There are some side effects associated with using trichloroacetic acid to treat acne scarring. Some of the more common complications are increased acne breakouts and additional acne scarring. In addition, some patients have suffered from either hyper-pigmentation or hypo-pigmentation. Hyper-pigmentation is a condition that increasing the production of melanin in the skin. This can result in a color change of the skin in the affected areas. Conversely, hypo-pigmentation reduces or even halts the production of melanin in the treated areas. This can leave the patient with ‘white’ patches on or near the acne scarring. Using a TCA solution that is too strong can also result in the necrosis of nearby healthy skin cells.

With new research and medicines available every day, the best advice is to assess what type of acne scarring you suffer from and what are the goals of your treatment plan. In order to select the most effective treatment for your acne scarring you should always consult your family doctor or a dermatologist. No one treatment will permanently rid you of acne or the scarring is causes, but by combining different treatment modalities the results can be incredible.