How can I lighten dark scars that were caused from a TCA Peel burn?

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What is a TCA burn?

TCA, or trichloroacetic acid, is an agent used in chemical peels on the face. Demarkation, lesions, and dark spots indicate that the chemical has likely burned the skin or at the very least caused clinically unacceptable outcomes. This could happen if you are experimenting with TCA chemical peels at home.

How do I treat a TCA burn?

Please seek an evaluation from your physician or dermatologist.

How do i prevent Tca burn scars?

There are several modalities to consider when treating dark spots after a TCA burn:

  • Regular use of sunblock.
  • Hydroquinone, if tolerated.
  • Retin-A, if possible.
  • Broadband light or intense pulse light in conjuction with above skincare routine.

These are due to postinflammatory hyperpigmentation and this type of pigmentation can be very difficult to completely eradicate; however, with multimodality treatment, we can very successfully improve the appearance of these types of lesions. Treatment includes regular and judicious use of sunblock. Do not confuse sunblock with sunscreens.  Sunblock would have titanium dioxide and/or zinc oxide in the ingredients and this would be a sunblock preventing any significant UV from damaging or causing further pigmentation to the skin. This is by far and away the most important step in a treatment regimen for postinflammatory hyperpigmentation.

Other additional treatment options would include hydroquinone applied at least daily if the skin is able to tolerate it. If hydroquinone tends to irritate the skin, this can further produce postinflammatory hyperpigmentation and I would therefore place the patient on Tri-Luma, which has hydroquinone and Retin-A as well as a steroid to reduce the inflammatory reaction.  Broadband light or intense pulse light can also be used on postinflammatory hyperpigmentation, but must be used in combination with the aforementioned treatments to prevent further pigmentation from the injury.

Ultimately these areas will greatly improve over time, but there really is no quick fix for postinflammatory hyperpigmentation and most patients will take at least several months to show significant improvement and possibly six months or even longer for resolution of these lesions.

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