SkinMed® EnerPeel® Trichloroacetic Acid (TCA) Anti-Ageing Protocol®

EnerPeel TCA 25% is a medium to deep acting remodelling solution, delivered within an EnerPeel® carrier solution; it is taken deep into the skin before being released to increase the dermal effect on promoting maximum fibre revision, stimulating processes causing old fibre matrix breakdown, while replacing it with a more elastic and fluid collagen elastin mix, all lubricated by higher levels of hyaluronic acid, which reduce the rate of collagen binding so wrinkle formation is slowed and minimised.

We also aim to better control epidermal trauma and erythema through reducing the TCAs activity at the surface utilising epidermal active ingredients to reduce post inflammatory issues.

Understanding Anti-Ageing

‘Ageing’ can mean many things. We focus on fibroblasts; cells in the dermis that produce fibres of collagen and elastin for structural integrity and elasticity, while also boosting hyaluronic acid levels in the dermis using a unique patented solution.

With anti-ageing, there is no such thing as one-size-fits-all, therefore a flexible protocol that can be tailored to each individual’s skin is needed for success in targeting the keys signs of ageing.

The Science and Know
How combine

Choosing the right acid or needling combination for different skin ethnicities, Fitzpatrick types, different skin histories, conditions and life stages is a skill Skinmed® have perfected with their SkinMed® Anti-ageing protocols.

We can combine Mandelic Acid with Dermal needling (tested and approved as a protocol). We can also extend mandelic acid exposure times in the skin but not on the skin to gently increase fibroblast stimulation over an extended period, without triggering epidermal adverse events.

We can ramp up the stimulation using Jessners or pyruvic acid, or even combining them to challenge dermal revision further.

We also have a range of TCA Strengths to go further still. We have creams to mitigate epidermal pigmentation events and erythema issues without reducing dermal fibre revision. the range of different SkinMed® Anti-ageing Protocols are carefully put together for every client, whatever their skin situation. All of the above is only possible through the unique patented delivery technology available only to SkinMed® in the UK and Ireland.

SkinMed® Protocols are driven by EnerPeel®: Patented Carrier Technology

EnerPeel® uses a patented carrier solution which restrains the activity of the acid until it is absorbed. This is not buffering the acid and thereby reducing its activity; it is restraining it and then releasing it to accelerate through the skin. EnerPeel®s carrier system enhances its activity for uniform and enhanced absorption of the active ingredients; with two to three times improved skin penetration.

Application details

EnerPeel TCA 25% is usually applied using the brush heads and drawing the EnerPeel solution evenly onto the skin a monolayer at a time whereby the skin looks visibly wet but the solution is not running and then left for 1 to 4 minutes on the skin or until the first sign of frosting/or the client gives discomfort scores of 7 to 8 out of 10.

Then the TCA is neutralised using an EnerPeel neutraliser wipe which will penetrate deeply into the skin and will neutralise the TCA. You are also able to wipe or wash the skin surface with cotton pads dampened with water a few minutes post neutralisation. Always use EnerPeel neutraliser as the 12% arginine neutraliser is also held in an EnerPeel carrier solution. This means it will go wherever the TCA has gone and neutralise it even deep in the skin.

This is different to other company procedures who don’t neutralise the TCA as they believe you cannot, and they don’t advocate wiping or cleansing the skin with pads dampened with water for fear of reactivating crystalised TCA on the skin. Our TCA is taken in using the EnerPeel carrier solution technology and our 12% arginine neutraliser is also held in an EnerPeel carrier and so wherever the TCA is, the neutraliser will reach it.

If a second layer is to be applied, (only do this for a greater response and ensure that the client’s skin is prepared and suitable for a double layer). It would be applied 1 minute after the first layer. It normally takes up to a minute to apply a layer to the whole face and so the second layer is usually applied immediately after completing the first, but always starting from the same point on the skin from where the application of the first layer began, and then to follow the same pattern of application as with the first layer to ensure uniform time exposure for all areas of the face.

Applying a second layer will significantly increase the impact and also post procedural erythema and desquamation. However, neutralisation should be carried out regardless of layers or timings as soon as frosting begins. Maximum exposure is 4 minutes whether it’s one layer or two layers.

The aim is to apply the full 2 ml of TCA solution and so may apply again to make sure you have a good covering. (It is useful to consider that 50% of the 2ml vial contains carrier molecules and 50% is TCA molecules, and so to get the required amount of TCA for the whole area would require the full 2ml of solution). Flaking and desquamation (peeling) with an EnerPeel TCA begins later than with a standard TCA and is less and normally begins around day 3 or 4, not 1 to 3 as with standard TCA’s.

The Result

Remodelling does not start until 5 to 7 days after the peel and can continue for up to 3 months. It is advised to repeat the peel to boost the process of remodelling 21 to 28 days later and results after 3 peels are considerable. Results are enhanced by utilising the Tebiskin regimens especially using Tebiskin EGF and Tebiskin HYAL. We strongly endorse and know that supplementing the skin with products that feed the skin, protect the skin and provide introduce more ingredients to make new skin fibres, like proline for collagen manufacture and growth factors to increase fibroblast density and glucuronic acid and acetyl glucosamine for HA development. This leads to a bigger response to the peels.

Anti-ageing TripleLock® Products to be used with Enerpeel® TCA/ TCA Strong

EnerPeel® TCA is recommended with the following protocols:

Anti-Ageing Protocol

EnerPeel® TCA targets deep lines and wrinkles and breaks up pigmentation. Our unique carrier solution takes the TCA deeply into the skin in an inactive format and then releases it at the depth where we want to stimulate skin remodelling. By bypassing epidermal inflammation then the incidence of post peel inflammatory pigmentation is much reduced. The TripleLock® products you use should not only boost this revision but also should ensure melanocytes are restrained especially in darker skin types. Enerpeel TCA 40% is excellent for targeting scars and deep lines but requires extended skin preparation to ensure results are not marred by complications.

Pigmentation Protocol

EnerPeel® TCA reduces fixed and trapped pigment and also slows down pigment production and is especially useful in lighter and moderate skin types. Caution should be observed in darker skin types as the power of EnerPeel® TCA could trigger increased pigment production. So, it is a balancing act, but combined with TripleLock® products on pigmentation completes the pigmentation protocol, and is based on removing the inflammatory stimulus, normalising melanin production, and creating a healthy skin environment.

Top Tip

Clinicians and clients should normally expect frosting with a TCA 25%, but it often comes on later due to the EnerPeel® system. Remember this delay is not an indication as to the degree of remodelling within the skin as these represent surface effects; but as EnerPeel® technology works in the skin and not on the skin then it is described as working from the ‘inside out’ then surface frosting is a good indication that there will already have been a significant dermal impact. Hence, we recommend that neutralisation begins as soon as surface frosting is observed and if no frosting, neutralise definitely after 3 minutes.

EnerPeel® Clinic Accreditation
Trichloroacetic Acid (TCA)

Complete and submit your EnerPeel® Accreditation Test answers and a member of the Clinical Team will be in touch regarding your results, good luck.

1. EnerPeel TCA is good for?
2. EnerPeel TCA contains the following?
3. EnerPeel is special because...
4. What is the exposure time for an EnerPeel TCA standard application?
5. What is EnerPeel TCA commonly combined with to treat more severe acne scarring or sun damage?
6. When should you ask the client how they are feeling when applying the EnerPeel?
7. What is the application process for an EnerPeel TCA?
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