What is a medium depth peel?
A medium-depth peel involves complete destruction of the epidermis with penetration into and destruction of the upper layers of the dermis. Medium depth peels require sequential use of either Jessner solution, or frozen CO2 followed by 20% to 35% trichloroacetic acid (TCA). This type of chemical peeling is designed to improve acne scarring, uneven skin texture, and discoloration by stimulating controlled skin renewal and collagen remodeling.
What types of acne scars improve?
This peel is most effective for shallow to moderate rolling scars, shallow boxcar scars, and post- acne discoloration. Deep ice-pick scars require alternative treatments such as TCA CROSS or punch excision.
Can medium depth peels be combined with TCA CROSS in the same session?
Yes. This is a very effective “one-two punch” to address all acne scar types in the same session.
How is a medium depth peel applied to the skin?
Jessner solution or CO2 primes and prepares the skin for the deeper wounding agent. TCA is then applied to create a controlled deeper injury, into the upper layers of the dermis.
What sort of preparation is necessary?
Strict sun avoidance for 1 month before and 1 month after, use of proper skin care routine including tretinoin and/or glycolic acid. Initiation of Valtrex 1 day prior and for 1 week afterwards. Avoidance of smoking is also necessary.
What to expect during treatment
You will experience burning or stinging during application. The stinging typically lasts 3 minutes but can be quite intense. The entire procedure typically lasts 30 minutes. Visible frosting and peeling for 1 week are expected.
Recovery and downtime
Expect 7–10 days of visible peeling and healing, followed by several weeks of pinkness. Strict sun avoidance and post-care instructions are critical. Most people stay inside for 1 week afterwards.
Risks
Risks include prolonged redness, pigment changes, infection, delayed healing, and scarring (rare). These risks increase if aftercare instructions are not followed.
Summary
This is a deeper medical-grade peel, not a superficial peel offered by med spas and aestheticians. Advanced training and experience are necessary to perform these chemical peels. Proper patient selection, downtime, and aftercare are essential for safe and effective results.