TCA Peel treatment program

Hi, I have a client on Skinscript TCA peel program. I did glycolic and lactic peel a week apart following the protocol. Client came in couple days after lactic peel saying that around her mouth got dry and slightly red. When she applied Vitamin C serum and Glycol wipe it tingled and the red area now turned lightly brown like a scab. I looked at it and it was few small area with what looks like a scab.

I am thinking the mouth area got sensitive/red and when she used Vitamin C serum and Glycolic/retinol wipe it tingled and now turned slightly brown. It looks like a scab and it seems like it's healing. She had no reaction to the treatment during and after. Other area of her face looks fine. I told her to put extra moisturizer and I will take a look at it next week before we proceed with TCA peel (I did a spot test on her arm and she is fine).

I have done TCA peel treatment program before and never had this happen.

Did anyone have this happen to one of your client?

Replies to This Discussion

Permalink Reply by coldsalineplexus on July 19, 2013 at 6:49pm

Sounds like a normal peeling process to me. Just make sure she is not picking those scabs!

The reality with peeling is that the entire face becomes a very very thin scab, so it's important for us as estheticians to know that and not to freak out when we see visible signs that one area has processed a bit more.

There are many reasons her mouth area would have processed more than the rest of her face. The two big ones are: 1) subclinical sensitivity (allergies, perioral dermatitis, etc. can all induce mild irritation that may not be immediately visible with your skin analysis, and would thin the skin, increase blood flow to the area, and increase peel absorption - this is why it's a good idea to wood's lamp before peels); 2) the fact that the lower face just naturally gets more blood flow and movement can make it LOOK like that part of the face processed further.

Of course, ideally you would have all parts of her face process evenly. This becomes easier as you get more familiar with the peels you are using, and learn to read the skin for clues of how far different areas of the face have processed. We're talking even, controlled all-over erythema, and even-depth, all-over frosting where appropriate. Normally I will do self-neutralizing peels with one layer fewer than I plan to do, and then spend some time spot-treating areas that have not processed as far. This ensures an even peel for me.

When you work more on this client, I would keep a close eye on her mouth area. If you see it processing more quickly (getting red faster, frosting faster), then she may have some ongoing sensitivity and you might consider occluding that area for the first couple passes.

Good luck!

Permalink Reply by Lisa Fulton on July 19, 2013 at 11:16pm

Thank you so much for detailed information Christine. I really really appreciate it.
Lisa. :)

Permalink Reply by Lisa VanBockern on July 22, 2013 at 4:10pm

Hi Lisa: Christine did a thorough job answering your question. Yes, this can happen. You should adjust the usage of the Vit C and the Glycolic/Retinol pads based on how your client is reacting. I write protocols as a "guideline", but keep in mind that you need to adjust it based on how each client responds. If you need to space your peels out, please do so. If you need to back off on the homecare, please do that also. I like the idea of spot treating or working around sensitive areas.