Easy TCA®

Superficial Easy TCA or 10-15% m/m solutions, depending on number of coats and preparation, or in combination (e.g. Abrasion, Dry Ice, Jessner)... 

Deep Sandpaper abrasion + Easy TCA Unideep Only Touch (AHA + TCA > 40% m/m - localized deep)... 

With TCA-SAS, resorcinol, salicylic acid, azelaic acid or phenol peels, the skin needs to be thoroughly cleansed of make-up, degreased and disinfected. Easy TCA solution, on the other hand, contains saponins that make pre-peel make-up removal and degreasing unnecessary the skin s natural defenses are only very slightly diminished by this peel, and therefore there is no need for any particular prepeel preparation against infections. 

Prevention of the herpes simplex virus is essential for patients who have a history of the infection (a single incidence of herpes is enough). Herpes prevention is necessary with a peel to the papillary dermis. It is also worthwhile when a more superficial peel is usually accompanied by a severe inflammatory reaction, as is the case with resorcinol, classic AHAs and TCA-SAS. It is not necessary when using Easy TCA imder its basic protocol or Easy Phytic . General infection prevention measures should be taken, depending on the depth of the peel. For more information, see the discussion of infections in Chapter 37. 

Treatment of telangiectasias by (Ellman ) radiofrequency immediately before the application of Easy TCA . Scattered pinpoint frosting signals the penetration of the acid at each point treated by radiofrequency. This combination significantly reduces scabbing and includes a pixillized deeper peeling. 

For example Easy TCA and Easy Phytic need no pre-peel preparation. 

Easy TCA is an exception among TCA peels, and should be distinguished from TCA-SAS, as it does not require pre-... 

Combining Easy TCA with appropriate post-peel cosmeceuticals helps improve and maintain results. The cosmeceuticals should be applied the day after the first peel and continued between sessions and for at least 6 weeks after the last application. As with any peel, effective sun protection is necessary to make up for the temporary loss of the stratum corneum. Easy TCA causes the skin to flake, but not so much as to disrupt the patient s social life, although certain activities may be compromised television presenting, customer contact in the food industry, etc. Easy Phytic is recommended in these cases as there is almost no visible flaking of the skin (see Chapter 11). 

There are cosmetic products that have been specially created for application very soon after a peel. They can be used the morning after the first AHA peel, Easy Phytic or Easy TCA . With TCA-SAS, Only Touch or phenol peels, cosmetics usually are not applied until the 8th day after the peel. With Unideep , an anti-oxidant cream (Renutriv ACE Lipoic Complex ) can be applied two days after the peel. 

One Easy TCA peel per week for 4 weeks can restructure the skin and eliminate any abnormal sensitivity. In this indication, the cosmeceuticals that can be combined with it are restricted to Vit E Antioxidant cream in the morning and the more nourishing Renutriv ACE Lipoic Complex cream in the evening. 

Summary of Easy TCA basic protocol no pre-peel treatment, application of the solution until scattered pinpoint or cloudy white frosting appears, apphcation of the post-peel cream (tyrosinase inhihiting, anti-oxidant, stimulating). Repeat this process four times at weekly intervals. 

Patients often ask about make-up. The general principle is that it is possible to wear make-up, even when the skin is flaking, after an epidermal peel or a peel to the basal layer, but it is unlikely to look good. After a peel to the papillary or reticular dermis, make-up is usually allowed, and even recommended, on the 8th day. Patients who do not like wearing make-up should be warned of the likelihood of post-peel erythema, depending on the depth of the treatment. Some patients are thus ruled out, as their professional lives do not allow any visible erythema or they cannot stand the idea of wearing make-up. In these cases, it is recommended to repeat an Easy TCA peel four times rather than use Unideep . ... 

Unideep (Skin Tech) TCA peel to the papfllary dermis, with a qualitative formulation based on Easy TCA , hut with a more concentrated solution and post-peel cream. 

Peels on the backs of the hands are very easy and cause few complications with trichloroacetic acid in the form of Easy TCA . 

Another possibility would be one alpha-hydroxy acid (AHA) peel per week for 6-10 weeks or one Easy TCA (pinpoint frosting) per week for 4 weeks. The daily care routine should include DMAE to firm the skin, tyrosinase inhibitors and antioxidants to limit melanin production, ... 

It is essential to clean the skin beforehand with a come-done extractor to limit damage to the skin the skin should be cleaned in this way a week before an alpha-hydroxy acid (AHA) peep or immediately before each of four Easy TCA peels. Removing the comedones helps produce quicker results and prevents post-peel infections. 

Either the applicator provided with the product or the point of a 30G1/2 needle should be used to limit the action precisely to the head of the comedone. In 95% of cases, comedolysis is achieved. Very large macrocomedones (>2 mm in diameter) can benefit from careful infiltration of Easy TCA or Easy Phytic solution into the center of the comedone. Post-peel care, which is very important, consists in avoiding comedogenic cosmetics, having the skin cleansed professionally once a month, and applying an antiacne cream containing AHAs, tretinoin or precursors, disinfectants, anti-inflammatories, tea-tree oil, etc." once or twice a day. For details of this treatment, see Chapter 15. 

Differences between Easy TCA (ETCA) and TCA in simple aqueous solution (TCA-SAS)... 

With Easy TCA and Easy Phytic , papulopustular acne can be treated during its active phase. 

Either four Easy TCA peels to the basal layer or a Unideep peel to the papillary dermis. 

Effective neutralization as soon as erythema appears. Author s note The comparison was made using Only Touch peel combined with Easy TCA. ... 

Handling the skin during the peels and post-peel vasodilation" does not seem to have much effect on the outcome of the botulinum toxin injection. In 10 years of experience injecting botulinum toxin immediately before applying the trichloroacetic acid peel Easy TCA , I have seen no evidence of any direct interaction between these two procedures. 

It should be noted that EPS and Easy TCA are both used in conjunction with anti-free radicals that control the post-peel inflammatory reaction. This is not the case with the majority of other peels. My experience is only based on the combination of botulinum toxin and EPS or Easy TCA. Combinations with other peels have not been tested. 

Awareness of this problem led to the rapid development of new TCA peel formulas between 1990 and 2000. One of the first solutions put forward was the New Peel combination of TCA and Mikuda complex. The soft Peel formulation used asiaticosides and ginsenoids, glycerol, urea (carbamide), sorbitan monolaurate and methyldibromo-glutaronitrile, among other ingredients. Easy TCA , Unideep and Only Touch Peel (OTP) provided another answer to the problem these stabilized solutions consist of a base solution to which a determined quantity of 50% m/m TCA is added. There are no complicated calculations to be performed, the directions for use state precisely what volume of 50% m/m TCA solution should be added to the base solution to make up the Easy TCA , Unideep and OTP solutions, which provide peels to the basal layer, the papillary dermis and the reticular dermis, respectively. 

Easy TCA is a stabilized, homogeneous and adjuvanted solution with a final TCA concentration of 15% m/m, combined with alpha hydroxy acids (AHAs), antioxidants, vitamins and saponins. Unideep is a TCA peel based on the same principles as Easy TCA and reaches the papillary dermis readily and evenly it has a TCA concentration of 23% m/m. The application protocols for these two peels allow all depths to be reached. There is no point using higher concentrations that could cause complications (see Chapter 37). 

Easy TCA and Unideep consist of peel solutions as weU as a post-peel cream whose ingredients help achieve better results and avoid complications. Only Touch consists of a solution alone, but has to be combined with Easy TCA or Unideep , and thus benefits from the application of the post-peel cream of these peels as weU. 

Overall rejuvenation of the hands after four sessions of Easy TCA at a rate of one session every 2 weeks. 

Lentiginosis and photoaging, (a) Before treatment, there are about 40 lentigines and/or actinic keratoses, (b) After four sessions of Easy TCA peels to the Grenz zone, there are only about 10 lentigines/keratoses left. The signs of photoaging are visibly reduced fine lines, quality of the skin, improved eyelid tension, etc. 

Early photoaging treatment of rosacea on the cheeks with a radiofrequency device (Ellman) and four applications of Easy TCA (basic protocol). Daily care Vit E Antioxidant cream. 

Easy TCA , Unideep (TCA) and Lip Eyelid (phenol) can all be used as treatments for freckles, although phenol will generally not be used as the TCA can get rid of them by itself. Other treatments have been suggested. As freckles grow darker on exposure to UV rays, using a sunscreen helps to lighten them. Tyrosinase inhibitors, antioxidants, and tretinoin and its precursors can be used in conjunction with the peels to improve or prolong results. 

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