For years, I have been treating many conditions with TCA, some of them uncommon, with excellent results.

Conditions wherein I use TCA peel.

1 Hyper pigmentation darkening of skin. For bringing out the natural color and texture of the skin

2 Hypertrophy, thickening of skin.

3 Scaly skins

   **The above three constitute what is known as Lichanification of skin, found in chronic dermatitis, lichen planus. Keratotis palmaris

   ET plantaris

4 Milia, Tiny keratin filled cysts found in young adults on their face arms and back.

5 Small warts, flat warts, pedunculated warts.

6 Small sebaceous cysts.

7 Balanitis incognito, herpes genitals.

8 Vulval itching, krorosis vulva

9 Submucus fibrosis.

1. Procedure  - Method of application.

concentration of acid to be used depends upon the size – extant- area of individual lesions

   For small lesions like milia, warts, and cysts 100 % acid is used. I use a bamboo stick made pencil sharp with a knife, wrap around a piece of cotton dip the tip in the acid, and touch the lesion to be treated. Wipe immediately with a piece of cotton to remove the excess. Within seconds frosting is seen. If necessary the procedure is repeated once a week. (Minimum amount of cotton is taken –one single fibre 1cm long). Cyst is punctured with sharp stick and the inner surface is treated with acid.

  Dilute acid, 10 to 30 % strength, is used for larger surface, so that the acid is uniformly applied to the whole surface

2. Mechanism of action

The treated lesion desiccates, and as the under lying tissue heals the sloughed tissue peels off, almost invisibly. Cure is achieved.

3. Safety profile. 

It is important to be careful not to apply in excess and in larger quantity. More tissue damage may be caused, but always heals up. Other wise no serious damage is done. On application of more than required concentration/quantity, to large surface hyper pigmentation may result. Experience is the only way to learn the correct technique.

If the air is humid, frosting may occur after a few more seconds.

4. Final remarks

In experienced hands chemical peel with TCA is a safe and effective treatment for a number of conditions; perhaps better than other peeling agents

When required, other therapeutic agents like Mayaderm Herbal cream and Anti Pruritic Paint, etc were used with TCA peel

Please refer to photo album for pictures of patients treated with TCA