Easy TCA basic protocol and skin aging

In 1968, Paul Langerhans discovered the presence of a particular type of epidermal cell in humans, which is now named after him. The Langerhans cell (LC) is a mobile dendritic cell that has no desmosomes and is found in most multilayered malpighian epithelia. LCs make up 2-5% of epidermal cells. They come from the medulla and migrate towards and within the skin and stay within the epidermis for 2 weeks at the most. 

Superficial peels with alpha-hydroxy acids (AHAs), on the other hand, are known to cause very few bacterial or viral complications after peeling, as their direct action is limited to breaking up the spaces between corneocytes. Even if the peel penetrates too deeply in places, it is, quite logically, exceedingly rare for an AHA peel to cause complications in the form of infection, when the endpoint is focal or localized frosting. 

With AHAs, the stratum disjunctum (SD), the outermost layer of the epidermis that makes the skin feel rough, flakes immediately. The skin, having lost its topmost layer, immediately feels softer to the touch. 

The risk of bacterial or viral complications with medium or deep peels could lead doctors to think that, in order to avoid these problems, only superficial peels should be performed and patients with active acne or herpes should not be treated at all. With a medium or deep peel, herpes prevention - as far as it goes - consists in a sandwich treatment with aciclovir, which is not well tolerated by patients with sensitive stomachs. With acne, caution limits the range of treatment choice to careftjl superficial peels (which have limited effectiveness even after repeated sessions). We are forced to put off, sometimes indefinitely, performing medium-depth peels on patients with acne or herpes that have not responded to preliminary medical treatment. 

With the development of Easy TCA (ETCA), another possibility for treatment has opened up, however. In many indications, ETCA can produce the results of a medium peel with only the complication risks - usually non-existent - of a superficial peel. ETCA can be applied quite successfully to active acne lesions, and the presence of herpes lesions on the Hps is only a formal contraindication to the peel applied following the basic protocol. It is still advisable to avoid treating patients with active herpes, however. Then again, if herpes were to develop in the course of an 

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