Dermo-Epidermal bio-revitalisation is a broad term generally referring to aesthetic techniques such as mesotherapy, hyaluronic acid injecting and chemical peels, with the purpose of revitalising and rejuvenating the skin. The innovative TC Plus chemical peel from KSurgery falls squarely into this aesthetic treatment category.
What is TC Plus?
TC Plus is a chemical peel developed by the Italian based KSurgery Laboratories, which contains the cornerstone ingredient of Trichloroacetic Acid (TCA) which has been enhanced by the addition of two alpha-hydroxy acids namely, Mandelic acid and Kojic acid. The innovative gel formula stabilises TCA thanks to the combination of strong and weak acids mixed in such a way as to make the peel treatment Safe, Stable and Effective.
TC Plus exhibits the following key functions:
• Chemical peeling – treatment to visibly improve skin structure mostly by cell exfoliation
• Regeneration – the peel can reach the dermis and stimulate the organised regeneration of tissue matrix
• By so doing, becomes more of a bio-revitalisation and not just a surface peel
• Reactivates certain cell chemical pathways which promote overall skin physiological conditions leading to improved skin tone, firmness, pore size and fine lines.
In particular TC Plus is indicated to treat:
• Photoaging (Glogau type II to type III)
• Melasma
• Shallow acne scars
• Zones of deeper hyperpigmentation
What do the key ingredients in TC Plus do?
As mentioned earlier, Trichloroacetic acid is the cornerstone ingredient and forms the basis of the formulation. TCA is a carboxylic acid which has the primary function of peeling the skin through the action of chemical exfolition. During the exfolition process, the Skin Stress Response System (SSRS) is activated and pro-opiomelanocortin (POMC) is produced by keratinocytes. POMC is then split by an enzymatic reaction at an acid pH. The reaction produces a range of peptide hormones, including beta-endorphins. The beta-endorphins act as skin stimulators for the fibroblasts, and keratinocytes and thereby increase cell turnover.
TCA also assists skin growth and repair by promoting growth factors which are fundamental to proper epidermis cell functioning. The following growth factors are directly affected by the presence of TCA:
• Platelet-derived growth factor (PDGF)
• Transforming growth factor alpha (TGF-α), which plays a key role in the functioning of keratinocytes
• Transforming growth factor beta (TGF-β) which is vital for cell proliferation
• and Vascular endothelial growth factor (VEGF).
Kojic Acid is the second key ingredient and is best known for its ability to inhibit melanin formation. The mechanism is as follows: Kojic acid limits formation of tyrosine, an amino acid required for melanin production, by binding the copper in the active part of the tyrosinase (an enzyme which helps to produce tyrosine), thereby inhibiting the enzyme’s action.
Kojic acid is routinely used in the treatment of:
• Melasmas and chloasmas
• Senile lentigo and solar lentigo
• Dark circles under the eye
• Lightening of visible sun damage, age spots, or scars
• Skin-lightening / brightening effect
• Antimicrobial properties: reduces acne caused by bacteria in the skin.
The final key ingredient in TC Plus is Mandelic Acid. Mandelic acid is the largest of the alpha-hydroxy molecules and, because of its size, penetrates the skin slowly thus ensuring slow and safe absorption of TCA and other molecules. It also reduces proliferation of Propionibacterium acnes and is thus a great anti-bacterial and anti-inflammatory agent. The final important function it serves is to stimulate skin regeneration by reducing corneocyte adhesion.
What is the overall mechanism of TC Plus?
• TCA causes the coagulation of proteins which leads to the destruction of the living cells of the epidermis and possibly dermis (dependant on duration and concentration of treatment). The depth of the skin necrosis is directly proportional to the concentration of TCA.
• Abnormal keratinocytes are replaced by deep surviving islets of keratinocytes, pilosebaceous units and sweat glands.
• As the skin re-epithelialises, new collagen is formed which leads to a stimulated healing cascade. Dermal collagen starts forming within 2-3 weeks. Increased papillary dermal collagen and elastin fibre production continues for up to 6 months.
• Remodelling of elastic fibres takes place over time, resulting in a stronger dermis.
• Most importantly, a good TCA peel not only causes cell destruction, but stimulation as well resulting in a double aesthetic end point. In general, it is better to do less harsh peels but more often, as this eliminates complications of deeper TCA peels. One of the advantages of TC Plus is that one can easily manage the depth of peel.
TC Plus is available in two concentrations of TCA depending on the needs and end goals required for the patient: TC Plus Soft – 12% TCA and TC Plus Strong – 20% TCA.
Whereas TC Plus Soft is a milder peel focussed on the corneal and granular layer of the epidermis, TC Plus Strong targets the entire thickness of the epidermis. TC Plus Strong provides a much deeper exfoliation and can be used to treat medium-superficial scars, papules, pustules, nodules, cysts, deep acneic lesions and skin blemishes. It is ideally more suitable for middle aged patients, whilst Soft is recommended for younger patients and darker skin phototypes.
Should you wish to know more about TC Plus or would like to arrange for a demonstration, please contact Amo (0628481749) or Grant (0828098954) or visit the Regensys website: www.regensys.co.za
