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Hi, 

I am African American and have melasma. I have been looking around for ways to cure it other than just using a sun block, which is also recommended, and TCA peels seem to be a good permanent solution. My melasma is mainly on my forehead and it is really dark. Now my question is whether I should do a 35% TCA peel or a 15% TCA peel. What is the best for brown skin affected by melasma, and what else should I know before I do this? All tips are appreciated because I want to heal this not make it even worse. 

L

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Hi,

I just came across this study where they compared 15 % TCA peels vs 35 % glycolic acid peels for the treatment of melasma. It was interesting to see that the glycolic acid peel , which is a much gentler peel, had good results. Participants said that it took longer to recover from the TCA peel, with pain and discomfort after the peel, while the glycolic acid peels just caused burning during the treatment itself. There were pictures and the results were very similar, do you need to do glycolic acid peels more often to get the same results. Especially for darker skin, glycolic acid peels simply have a reduced risk of complications including hypopigmentation, which is basically the opposite problem to what you have now. If I were you, I would strongly consider going for glycolic acid peels instead of TCA. If you do use TCA, that is a no brainer. Start with the lesser strength first and make sure you prep properly.

Sunny
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Hiya,



Have you looked around these boards? There have been a few threads about TCA peels at home gone really wrong lately. If I would ever have considered doing a TCA peel myself before reading that, that insane idea is now cured forever, you know? I'd first say that you need to get it done by a pro, then, and that pro will know best whether you need 15 per cent or 35 per cent. If you are going to be crazy and do it at home anyway, that's really a no brainer: start with the weaker stuff, and for God's sake prep beforehand, and make sure you don't leave the peel on too long either. No, forget that. Just don't do it. Even the NHS says that peels are always meant to be done by dermatologists. Just get a pro in, and you'll be fine!



 

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Melasma is hard to treat anyway, and especially on darker skin. A peel alone may not be enough, and you absolutely do need to team up with someone who has lots of experience treating melasma in darker skin. Do not do the treatment at home because you risk damaging your skin if you do. Some people have luck with the MelaPeel treatment, but you may also need to use hydroquinone in addition. Also, if you are on the birth control by any chance, do you know that that can make melasma much worse? If you are, looking into another birth control method will help prevent your melasma from becoming worse.
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While everyone of any color can benefit from chemical peels, the right question to ask is... what strength do you want that peel to have? If you have a good derm on board, one who has experience, like lots of experience, with AA skin then you should be fine. If not, hahaha, well go look for one. Mine recommended a salicylic acid peel for my skin, and it worked out really well. Think it was 20 percent or something? Anyway I had a spot test before I went ahead with the first peel and that showed no problems so I went for the full peel. That's another very important thing to do before having any peel, just so you have a better idea of how your skin is going to react.
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Many beauticians simply aren't comfortable doing peels on brown skin, because of the increased risk of side effects. Keloid scar formation is a special risk for brown skin. I recently went for a Mandelic Acid peel, which is an excellent alternative to TCA especially for brown skin. The risk of side effects is greatly reduced. What's more, I was told that it is less painful to the skin with a shorter recovery time as well. I can't compare, never having had a TCA peel done, but the results were awesome, the peel did not cause too much discomfort, and I looked great on the fourth day after the peel. That compared to TCA, which people with light skin say can take like two weeks to peel completely. Just another thing to consider!
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For what it's worth, TCA has a much higher rate of complications on black skin. Some dermatologists will perform lower strength TCA peels on dark skinned individuals, while others won't. The good news is that there is always an alternative to a TCA peel, whether you have wrinkles, stretch marks, acne, or... melasma. Fraxel lasers, for instance, are used to achieve good results for melasma on dark skin. Some creams may have an effect as well, but because of the increased risk of complications (read: making your skin look bad!) I strongly advise you to see a dermatologist or a plastic surgeon about this, rather than applying any treatment at home without first consulting a doctor.

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