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Hi,

I had a TCA peel, 20%, 2 weeks ago. Since then the immediate after period has passed but I still have loose skin left over. Not at all what I was hoping for! What do I do now? I look much worse than I did before the peel and I am desperate, really, every time I look in the mirror. What caused this and most importantly what can I do to fix this problem?

If you have had loose skin after TCA as well or if you know anything about this, please let me know! I want to fix this ASAP.

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My question is simple — are you really sure that your loose skin was caused by your TCA peel? Though there is no doubt that TCA peels, when applied incorrectly or when patient aftercare was lax or inappropriate, can do real damage to the skin in the form of scarring and texture changes, I have never heard that someone's skin became loose after a TCA peel. I would return to your treating dermatologist and try to get to the bottom of the reason your skin has become loose. You may actually find that it has nothing to do with your chemical peel, and also that options are available to help you improve your skin's tightness. 

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Forgive me if I am wrong, but I don't think she meant "loose" as in "sagging", excess skin type loose, but loose as in flaking. That most certainly happens after a TCA peel. I have had several and yes, flaking is an integral part of the healing process. What you do about that, OP, is to keep on cleansing your skin with a very gentle cleanser and use a good moisturizer to keep everything hydrated, three, four times a day. This will immediately make you look better (just a little) and will help you ensure you don't have damage afterwards. This is really very important.
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Oh, yet ANOTHER person asking about damage after TCA peels! I swear, I'm never going to use this stuff, no matter how good it can be, because too many people seem to have problems after having TCA peels. It seems though, to be fair, that some of it is lack of patience. What a TCA peel does is renew the skin and the old skin flakes off and looks bad for a while. Of course, if you want this to happen properly, you have to be serious about moisturising as well as actually keeping your face out of the sun for a while. Do that and you will look fine afterwards, unless you were like allergic to the peel or something. 

One final tip though. I'm a tattoo collector myself, and of course that also comes with a fair share of peeling. People who go to doctors after tattoos look a bit odd when they are healing often end up with really detrimental advice. So well, it's probably the same here - you ought to go back to the person who did your peel and ask them for advice, rather than just seeing your GP because they may not know what your beautician or whoever did it knows.

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OK, time for an overview of what to do before and after a TCA peel.

BEFORE

Some derms will tell you to use AHA or retinol for a few weeks in advance of getting a TCA peel. This preps your skin for a more penetrating and even peel. You stop using exfoliators three days before. You will also be told which creams are not compatible with TCA. It is very important not to scrub your face immediately prior to the TCA peel. This will cause damage. You will also have a patch test to make sure your skin is fine with the TCA.

AFTER

You need to apply sunscreen liberally, and use the cream provided to you by your dermatologist, or recommended by them. This can include an antibacterial ointment, a very rich moisturizing cream, and anti-itch creams for the itchy period of recovery. You will flake like crazy and you will look unpresentable for a few days (like 7), so many people like to take time off work so they can avoid being seen by people. Do not actively remove peeling bits of skin with your hands. This has to happen naturally, or you will risk scarring. What you can do is have a lukewarm shower running over your face. This will get rid of some of the flakes without actually needing to pull them off.

Hope that helps.
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Post-care instructions for a TCA peel:

1. It may seem stupid, but is actually really helpful. Ask a friend to drive you home from the derm's office. Ask them to stay with you for 24 hours, or ask your partner. You'll feel a little weird after the peel.
2. Sleeping with your head elevated, so on several different pillows, will really help you reduce swelling you experience after the peel.
3. Feel free to use ice packs afterwards.
4. Use acetic acid on the skin as your derm advises.
5. Use nourishing moisturizers frequently as advised by your derm.
6. Don't pick at your skin.
7. Don't forget about your sunscreen!

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Be kind to your skin: it just suffered a form of trauma and though it will look better than before the treatment, with the right care, it needs to be given the right nourishment and time to recover now. Loose skin after a peel is quite normal. However, what you need to be doing is moisturizing it all the time, perhaps with something natural like jojoba oil, a few times a day. You also need to use a sunscreen and stay away from scratching your skin or peeling it. Use gloves at night or file your nails if you are prone to scratching and peeling in your sleep (which I am — not after a peel but in general I have dry skin). 

Rosie

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Yeah, I totally agree with this post. Chemical peels are wonderful tools that can do an awful lot to rejuvenate your skin and liberate it from issues such as acne scars, pigmentation and a tired and dull look, but the key lies in following the instructions to a T. If you're not sure what to do, ask, ask, and ask your provider, then ask some more. If you have silly questions afterward, don't hesitate to call them and explain what you're dealing with, then ask for advice some more. They don't mind. It's in your provider's interest that your peel goes well too, after all.
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