Medium peel : TCA peel (trichloacetic acid)

Senior woman pulling cheeks to feel softness and looking at camera. Beauty portrait of happy mature woman smiling with hands on cheek isolated over grey background. Aging process and perfect skin concept.

A medium peel is a peel that acts on the papillary dermis where it causes necrosis and inflammation.
The TCA peel (trichloacetic acid) is a medium peel if used at effective concentrations.
There are several concentrations of TCA, to increase the concentration the penetration depth increases.
The 15% TCA is equivalent to a superficial peel, so I prefer to use fruit acid peels.
TCA 20-25-30% is a medium peel.
TCA 40% is a deep peel, I prefer to use phenol in this indication.


peau lumineuse

The indications of the TCA peel are as follows :
- Acne scars.
- Brilliance.
- Skin aging: elastosis, lines and wrinkles.
- Keratoses.
Actinic keratoses, I prefer to leave the treatment of these precancerous lesions to dermatologists.
-Stains of old age, redness, melasma.
The face, neck, decolletage  and hands can be treated.
Only ligth skin can be treated.


The skin is prepared using three weeks before the peel a cream based on glycolic acid.
The previous three weeks the peeling should not make masks in clay, scrubs or undergo aggressive techniques like laser hair removal.
Do not use self-tanners, additional exfoliating agents (including creams based on fruit acids), essential oils, any cream without medical advice.
The day of the peel it is necessary to come without make-up (even the eyes must not be made up), without earrings, without contact lenses, without having applied cream on the face the same day.
The men will shave the night before.

Local anesthesia is performed.
The area to be treated is disinfected and the peeling session begins.
The number of passages and the exposure time depend on the skin and the indication.
The peeling has immediate action, intense redness and whitening of the skin (frost) appear.
After the peeling the skin is red and swelling begins.
At the end of the session the area is covered with a healing cream.
Antibiotics and aciclovir are prescribed, the total screen should be used for 3 months.

beauty salon, facial peeling mask with retinol and fruit acids


The contraindications are:
- Pregnancy.
- Pacemaker or cardiac defibrillator port.
- Chronic diseases such as diabetes, severe deficiencies (eg renal insufficiency, heart ...).
- Isotretinoin treatment stopped for less than a year.
- Anti-acne treatment in progress.
- Recent aesthetic intervention (surgery, laser, dermabrasion).
- Skin infection or herpes.
- dark Phototypes
-Contact allergies.


Redness and swelling last for about 48 hours. From the 3rd day the skin becomes brown to desquamate under 7 days (look at the picture) and leave room for a new pink and toned epidermis.
This pinkish color lasts one month.
You have to plan a week of down time.

Possibles complications are :

Swelling, persistent redness, sloughing off of skin or overly significant exfoliation.
Bacterial infection ( impetigo ) or viral infection ( herpes ).
An outbreak of acne could justify specific treatment.
Hyperpigmentation ( dark marks ) or depigmentation (white marks ).
Accentuation of limits of treated zone ( scalp, jaw ).
Small scabs which should not be picked.
Scarring after untimely handling of the skin.


I had a dull skin, irregular tone and a tired look! The mid peeling ameliorated the quality of my skin which is now radiant, sweet and beautiful! Thank you Doctor Romano.


I’m a 35 year-old woman (smoker), the mid peeling gave me a baby’s skin! I’m more than satisfied with Doctor Romano’s service.


I really recommend the mid peeling to all people who wish to recover their youth’s skin. This act was done by Doctor Romano and I’m very pleased with it.


I did a mid peeling with Doctor Romano. The result is perfect : the tone is illuminated, the pores have tightened and the small scars have disappeared.


Written by Valeria Romano

Former intern at the Hospitals of Paris Graduate of the Faculty of Medicine, University of Paris 7 – Paris Diderot Registered with the medical board of Paris, n° 75/80452 More informations

Contact us