Trichloroacetic acid (TCA) is a time-honored peeling agent that has no known systemic toxicity. Recent interest in reversing the effects of actinic damage has led to the utilization of combination therapies. Retinoic acid, solid CO2, pyruvic acid, Jessner's formula, and other agents have been used to increase the effectiveness of TCA and enhance peeling results. Repetitive peels with low concentrations of TCA can be effective for areas prone to scarring.
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