The Nova Clinic

Instructions

TCA Chemical Peel Application Instructions:
(This applies to TCA, Chemical At-Home Peels. For stretch mark removal, tattoo removal, face peels etc you will be supplied with the appropriate detailed instructions with your order.)

General TCA peel application instructions & after care
Chemical face peel after care
Post Treatment Care
Identifying Your Skin Type
Directions to dilute TCA
Legal Disclaimer & possible side affects

 

General TCA peel application instructions & after care:
Two weeks before you have your peel clean areas to be treated and apply retin A, mild alpha hydroxy acid cream or similar. This OPTIONAL.
Never, never exfoliate, use a skin mask, or remove hair from the area to be treated for at least 1 week prior to your treatment. If you do this opens the pores, can often break the skin, and irritates the skin, especially if you use a loafer. Then, the TCA will penetrate too quickly and deeply, this will lead to a VERY painful application, you also would run the risk of leaving burn type marks on the skin. Do not shave the face 1 day before treatment.

1) For full face peel - Set up your sterile environment:
Have a chair in front of a mirror and a table beside you. Wipe the table with disinfectant. Lay out your gloves, applicators, cotton balls, and bottle of peel solution (in amber poison bottle). Alcohol swabs (or you can use witch hazel or rubbing alcohol). Vaseline, 2 aspirin or other analgesic and glass of water. Tube or jar of antibacterial cream. A bowl of water with ice cubes in it. Have a clean towel & wash cloth beside you, and one in the bathroom. Have a fan set up close, to blow on your face. A timer. Hair band or shower cap.

2) Patch Test:
Put gloves on. Wipe patch test area with alcohol swab. Next take a cotton swab and wet sparingly with TCA solution. Wipe solution on the side of your face beside your nose. An area about as big as a 10c piece. Throw swab in bin. Put lid back on bottle. Set timer for 2 minutes .Treated area will sting/burn for a couple of minutes (depending on strength used). Let fan blow down on your face during this time. The area will frost over - turn white (this is good). The frost indicates that the peel is penetrating and working as it should. However some people don't frost over and the peel works perfectly. After 2 minutes wash area gently with iced water and wash cloth. Any burning sensations should have stopped by now. You can wet a cotton pad with iced water and leave it on the patch area for a few minutes.

Note: All reactions, and finished result, at all stages of the peel, will depend on the strength of peel you are using, your skin type and condition, and general overall health. Eg: 25% mild reaction. 50% mild-stronger reaction. 80%-100% very strong reaction.

3) Cleanse whole face, neck and hands with soap and water, rinse very well. Dry.
Now rub face with alcohol swab, this removes face oils.

4) Before you do your full peel:
Take 2 aspirin (or other analgesic). For possible pain and swelling if using a deep 80% - 100% strength. Most people get neither. Put hair-band, or shower cap on to keep hair well away from face. With cotton bud (q-tip) lightly rub Vaseline on your eyelids and around the outline of your eyes (don't get it in your eyes). Also around your nostrils, creases beside nose, and over lips. This creates a barrier. Put on your gloves. (If you don't wear gloves your fingertips will peel). Turn fan on.

Note: With the fan - have it blowing down on your face, not up, otherwise it can make your eyes water and this may dilute the peel solution on the cheek area.

5) Full Peel:
Looking in the mirror, use a cotton swab to treat the whole face and other areas you want treated with solution right out of the amber poison bottle. Use sparingly. Don't have the swab dripping, wetter is not better. If you let the TCA pool due to swab being too wet it can leave a red mark, or milia, as that area will be over-treated. Wipe over thoroughly and firmly. Don't retreat patch area. Start at top of forehead at hair line. Feather into hair line all around face or you may have an obvious line later on. At the chin go over into neck area (under chin) so you don't create an obvious line. You can treat your neck and hands as well if you need to.  Go over whole face. Stretch the skin where there are wrinkles so the whole area of the inside of the wrinkle is treated. Use the same pressure over the whole face and neck. Quickly cover all of the areas to be treated. Put the timer on for 3-4 minutes.

DO NOT treat eyelids. DO NOT get into eyes. DO NOT treat lips or ears.
POISON DO NOT SWALLOW or get into mouth.
POISON If swallowed do not induce vomiting. Dilute by drinking large amounts of water. Seek medical attention.

Have the fan on full blowing down on your face, as the burning sensation will be intense for 2-4 minutes. (Burning sensations depend on the strength of TCA used) The face will frost over/turn white. Note: Some people frost lightly and it is hardly evident, other's skin turns completely white. Either way the peel is still working. The frost will fade after 5-45 minutes. When your timer goes off after your 3-4 minutes - Rinse whole face & other treated areas with cold running water. Keep rinsing to cool face. Do not rub the face, be gentle. Pat dry with clean towel. The water does not take the TCA off, it just cools the skin. The small amount of TCA used comes off the skin when it peels/flakes. TCA naturalizes itself after approximately 20 minutes. It does not need a cream or neutralizer paste applied as fruit acids peels do.

Note: If you are treating a large area like a back or shoulders for acne treatments or tattoos, you can wash the area in the shower to take the heat out. Pat dry with a clean towel.

Note:TCA does not need to be neutralized to stop it working as fruit acid peels do. TCA will stop working after about 20 minutes. So if the burning sensation (only with a deep peel) is too much for you just splash the area with cold water to take the heat out of the skin. You do not have to wait the full time that is indicated on your instruction sheet you will still peel.

Put a cold compress on your treated area….wash cloth rinsed in your ice water….to soothe the treated area. Relax. If using a stronger strength peel the skin will turn a pink/brown colour and feel tight. If using a mild peel your skin may just tingle. Rinse face, and pat dry again and apply a coating of your antibacterial cream. Your skin will begin to feel better, though tight, a slight burning sensation may/may not continue for a short while.

Note: All reactions, and finished result, at all stages of the peel, will depend on strength of peel you are using - 25% mild reaction. 50% mild-stronger reaction. 80%-100% strong reaction. Twice a day after peel wash face using a mild non-soap liquid cleaner, and pat dry with a clean towel. Apply any good moisturizer you have, when skin breaks and starts to peel apply anti bacterial cream to prevent infection.

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Chemical face peel after care:
How severe the reactions are, depends on strength of peel you use (15%-100%). It can take 1-4 days before you have skin changes, every skin reacts differently. The first week after the peel the skin will tighten and be red or possibly slightly swollen. The skin may feel irritated, dry and may/may not weep slightly. However, these conditions will disappear as the skin adjusts and peels. Peels can sometimes cause persistent redness of the skin and ultimate de-pigmentation. The most common side effect after a peel is brown discoloration of the skin. This is usually reversible but can be permanent. This side effect usually occurs only in those who have had sun exposure after the peel and who are not using sunscreen SPF 25 or higher.

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Post Treatment Care:
It can take up to 6 weeks to see the full affect of the peel. Following the peel, clean the skin with warm water using a mild (non-soap) liquid cleanser from the supermarket. Use fingertips (not a wash cloth) since the skin is very sensitive at this time. Avoid the use of abrasive or exfoliating sponges. After cleansing, pat dry with a clean towel, and then apply any good moisturizer that you have. It is very important to keep the exfoliating skin soft, moist, and the new skin protected from infection. Once skin breaks and peels/flakes apply antibacterial ointment/cream to keep moist and protected from infection. If itching is severe use a mild, cortisone based cream, like hydrocortisone, from the chemist. The skin will turn brown, wrinkle up, and crust, much like bad sunburn, often like leather, and then it will peel/flake. It is this browned outer layer of skin that is in the process of exfoliating. You may/may not have small weepy blisters. Keep skin moist each day. Do not peel, pick, or scratch the exfoliating skin. Your face/skin will scar if you pull the peeling skin off, let it peel naturally. Paracetamol, Aspirin or similar may be taken 3-4 times daily with food to reduce swelling and discomfort, if needed. All reactions depend on peel strength used.

Do not touch your face/skin without washing your hands.
Keep skin moist with moisturizer and antibacterial cream.
Do not put cosmetics on your face/skin for the first 1-2 weeks, or until healed. You can use tinted moisturizer, eye make up and lipstick.
For 2 weeks after the peel application, do not have hair removed by any technique on treated areas. It can cause severe irritation.
Stay away from heavy, sweaty exercise, dust, hot tubs, steam rooms, saunas and chlorinated water for at least 3 weeks. Keep treated area clean.

Avoid sun exposure: for 4-6 weeks following application. This includes tanning beds. Sunlight UV on the skin after a peel can cause permanent brown discoloration of the new skin. A sunscreen of SPF 25 or higher should be applied every morning before going outdoors from 2 weeks after treatment. Wear a hat.

With trichloroacetic acid peels, scarring and brown discoloration of the skin is unlikely unless you go to a tanning salon after having the treatment or lie out in the sun before the new skin has healed. The new skin will have a pinkish colour for several days, perhaps weeks after the peel.

Take the above measures seriously for at least 4-6 weeks after your peel. Then continue to use sunscreen and wear a hat in the sun to keep your skin in good condition. After your peel you will still tan as usual. Some clients have acne breakouts during the healing process, it is called Milia, it is the pores being cleaned out which of course is good. This is common in all ages after a peel. If it happens do not scratch or pick, they will pass. Do not apply acne creams/treatments. Remember to hydrate inside and out drink plenty of water.

Peels do not thin the skin. Repeated peels will generate more collagen and elastin ensuring that the skin will remain rejuvenated and in optimal condition. Your bottle of solution has many peel treatments in it.

If you choose to do another peel there must be a sufficient between each treatment to allow the skin to heal.

80% deep peel: wait 3-6 months
50% peel: wait 2 months
15% - 25%: wait 2 weeks to 1 month

See the Peel Progress Page for daily progress of an 80% strength face peel in photos.

Legal Disclaimer & possible side affects

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Identifying Your Skin Type:
Always check your skin type and be well informed before you order a TCA peel.

Which skin type below best describes you?

Type 1: Never tans, always burns, (extremely fair skin, blonde hair, blue/green eyes)
Type 2: Occasionally tans, usually burns (fair skin, sandy brown hair, green/brown eyes)
Type 3: Tans on average, some times burns (medium skin, brown hair, brown eyes)
Type 4: usually tans, rarely burns (olive skin, brown/black hair, dark brown/black eyes)
Type 5: Mostly tans, almost never burns (dark brown skin, black hair, black eyes)
Type 6: Never burns (black hair, skin and eyes)

Skin types 5 & 6 are not suitable candidates for deep 80% chemical peels, due to probable pigment irregularities and scaring.

Skin types 1-2 use 15% or 25%.
Skin types 3-4 use 50% or 80%.
Skin types 5-6 use 25% or 50%.

Tattoo is sold as 100% strength. This is for non sensitive skin and not suitable for sensitive skin (e.g. you burn easily in the sun or you are treating sensitive areas).
Be responsible for your own skin. Dilute the first peel to see how your skin copes with it. Best to be safe than sorry later. Dilution instructions come with the tattoo removal peel and are shown below.

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Directions to dilute TCA:
Generally you buy the strength you require and do not dilute it. But with a higher strength 100% you may want to dilute the 1st application. In a disposable bowl or container - add 1 teaspoon TCA and 1 teaspoon of bottled or purified water. This will make your peel half the strength that is written on the bottles label. If after your 1st peel is completed (6 weeks to see full result) you do not have the results you require you can either not dilute the next peel, or add less water. Apply TCA sparingly - over-treating (swab too wet) could leave burn-looking brown marks which may take many months to fade away.

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Legal Disclaimer & possible side affects:
One of the most important things with having a peel in the privacy of your own home is to create a sterile environment. You must always follow the instructions for applying the peel to the letter. Also religiously follow aftercare instructions. Medical grade Trichloroacetic acid is a great product but you use at your own risk. Seller is not responsible for negative or damaging results obtained by proper or improper use of this product by any person. Buyer of the product indicates that he/she agrees seller is held harmless when payment is made.

With buying a cosmetic peel off The Nova Clinic in this manner, you will be agreeing to be completely responsible for the above. As with any peeling product, some people are resistant to acids. If you think you fall into this category, please do not buy this product. Even though our customers (world wide) experience great success, we cannot guarantee results. You assume sole risk and responsibility when using this product.

Note: It can take up to 6 weeks to see the full result of your peel. Repeated medium to deep peels should have a time lapse of at least 6-8 weeks or you will get a superficial peel. The peeled skin needs to heal completely and toughen up before the next peel. Mild peels can be applied monthly.

Significant complications with TCA chemical peels are rare but potential complications may include: Scarring, infection and temporary changes in skin tone or uneven tone. These include hyper-pigmentation (a darkening of the skin, treatable in most cases with bleaching techniques). Hypo-pigmentation (a lightening of the skin, more difficult to treat).

A peel cannot reverse the aging process or completely remove very deep scars. Wrinkled skin that is loose and sagging cannot be improved with a peel. TCA face peels will not give results like a face lift.

Trichloroacetic acids (TCA) peels may cause swelling or blisters, depending on the potency/strength of the chemical solution that was used. These should diminish after the first week. Clients can contact the Nova Clinic for professional advice at any time.

If you have the following you may not be a suitable candidate for a peel:

• Prior bad reaction to a peel or dermabrasion
• History of sun allergies
• Recent radiation treatment for cancer
• Keloid or hypertrophic scars (thick scars)
• Pregnant or breast-feeding
• Accutane use within the past six (6) months. Accutane should not be taken for at least six months after the peel either. There are reports of scarring in people who have taken Accutane after a peel.
• Sunburn or significant sun exposure on area to be treated
• Surgery or cryosurgery within the last six weeks to the area to be treated
• Severe Psoriasis, Eczema, Dermatitis, Rosacea (mild is ok)
• Infection or disease - Cut or broken skin - obviously on area to be treated
• Have black or dark olive, ethnic or Asian skin tone (increased risk for developing blotchy skin and probable pigment irregularities after deep peel)

For Olive/Black skin tones we recommend a lighter peel over a longer period of time to obtain good yet safe results e.g. 25% & 50%.

If you ever get, or have had, cold sores: (herpes simplex) a peel may cause them to flare. So begin taking L-Lysine or similar at least three weeks prior to your peel. Obviously this is only if you use the TCA on your face. And you do apply Vaseline over the lips before application so you don't get TCA on the lips.

Reality check: While new skin is noticeably fresher and smoother following a TCA peel, anyone considering this procedure must be prepared for some possible discomfort and a few days of hibernation. Of course which strength peel you choose (15%-100%) will determine this. As with any acid or laser peel there is a risk of scarring and affecting the pigment, leaving the treated skin white, if the procedure is improperly performed, or the after care not adhered to.

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