TRICHLOROACETIC ACID (TCA)

TRICHLOROACETIC ACID (TCA) has a particularly long history as an effective agent for rendering histo­logic and clinical improvement to the skin and is par­ticularly safe when used as a superficial peel or in "combination peels" of medium depth for acne scars.Application of TCA to the skin causes precipitation of proteins and coagulative necrosis of cells in the epider­mis and necrosis of collagen in the papillary to upper reticular dermis.

1. Over several days the necrotic layers slough and the skin reepithelializes from the adnexal structures that were spared from chemical damage.
2. Dermal collagen remodeling after chemical peel may continue for several months.
3. Many investigators have observed that the clinical effects of TCA were due to both a reorganization in dermal structural elements and an increase in dermal volume as a result of an increase in collagen content, glycosaminoglycan, and elastin.