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Fraxel vs TCA Peel

Fraxel: A laser that heats thousands of microscopic columns in the skin and leaves the skin between them untouched. Used for sun damage, acne scars, and rough texture. It takes a course of treatments and a few days of looking sunburned each time.

TCA Peel: A chemical peel using trichloroacetic acid. Depending on the strength it is either a light peel with a few days of flaking or a medium peel with a week of visible healing. It carries the highest pigment risk of the peels in common use.

Reviewed by Dr. Schwarz, Board-Certified Dermatologist
Last updated: 10/22/2026
Editorial illustration for Fraxel, based on the entry’s treatment or equipment reference.Editorial illustration for TCA Peel, based on the entry’s treatment or equipment reference.
Choose ifKey differencesWhat is it?What it treatsTreatment areasSkin tonesHow it worksBefore your treatmentDay of treatmentAfter your treatmentRisksCostQuestionsRelated

Choose Fraxel if…

Choose for acne scars or sun damage with a few days of downtime per session instead of the week-plus of ablative lasers.

  • Rolling or boxcar scars
  • Sun spots and rough texture
  • You can plan 3–5 sessions

Choose TCA Peel if…

Choose for ice pick scars (as TCA CROSS) or stronger sun-damage peeling — the highest pigment risk of the common peels.

  • Deep, narrow ice pick scars
  • Sun spots and fine lines on lighter skin
  • You can take a week of peeling
Fine together

Can you have both?

TCA CROSS for ice pick scars is often added to a Fraxel plan. Space them several weeks apart.

Key differences

● Fraxel
● TCA Peel
DowntimeNone → 2+ weeks
3–7 days
3–7 days
PainMinimal → Needs anesthesia or sedation
Moderate
Moderate
Results showImmediately → 3+ months
1–3 months
1–4 weeks
How long it lastsWeeks → Years or permanent
Years or permanent
1–2 years
Visits neededOne → Every few months
A longer series (4–6+)
A short series (2–3)
Cost per visit$ → $$$$$
$$$
$$
ReversibleYes, can be undone → No, permanent
No, permanent
No, permanent

What is it?

Fraxel

TCA Peel

What is it?

It is a nonablative fractional laser.

Fraxel heats microscopic zones while sparing skin in between.

Platforms differ.

Wavelength and device determine the treatment.

It is not CO2 resurfacing.

It is less intensive than ablative lasers.

It is not risk-free.

Burns, redness and pigment changes can occur.

It is a chemical peel.

Trichloroacetic acid removes selected layers of skin.

Depth varies.

Formulation, application and technique set the depth.

It is not a home treatment.

Online acid products should not be used to copy it.

History matters.

Pigment-prone skin, herpes and scarring history need assessment.

What it treats

Evidence level
Fraxel
TCA Peel
Strong evidenceMost established uses
Acne scarring on light skin. Small sharply cut pits and broad shallow dips across a cheek, several sitting inside faint flat pink marks, with no active spots.

Acne Scarring

Improves rolling and boxcar scars.

AI-generated educational illustration of Sun Spots: 1. Sun Spots Header — Light Skin; Lighter skin. Not a clinical photograph.

Sun Spots

Clears sun damage.

Ice Pick Scars on light skin.

Ice Pick Scars

TCA CROSS raises deep pits.

Moderate evidenceSome supportive research
A relaxed forehead with faint shallow horizontal fine lines.

Wrinkles and Fine Lines

Smooths texture.

AI-generated educational illustration of Sun Spots: 1. Sun Spots Header — Light Skin; Lighter skin. Not a clinical photograph.

Sun Spots

Clears spots.

A relaxed forehead with faint shallow horizontal fine lines.

Wrinkles and Fine Lines

Medium peels smooth lines.

Existing educational image of Actinic Keratosis

Actinic Keratosis

Removes sun damage.

Limited evidenceEarly or small studies
Flat tan patches with soft irregular edges across the forehead and upper cheek of an adult with light skin, the surface completely smooth.

Melasma

Low settings may help some.

—
Little evidence
Ice Pick Scars on light skin.

Ice Pick Scars

Too deep for most sessions.

—
Can make it worse
Redness and fine superficial vessels across a light-skinned cheek and nose.

Rosacea

Can worsen redness.

Flat tan patches with soft irregular edges across the forehead and upper cheek of an adult with light skin, the surface completely smooth.

Melasma

Deep peels can darken patches.

Redness and fine superficial vessels across a light-skinned cheek and nose.

Rosacea

Very irritating.

Treatment areas

Treatment areas

Face and hands.

Face; the selected area depends on the concern and treatment plan.

Skin tones

Skin tone
● Fraxel
● TCA Peel
Lighter skin
Low risk
Redness and swelling for days.
Low risk
A week of peeling for medium depth.
Medium skin
Some risk
Dark marks possible; lower settings help.
Some risk
Dark marks are common; pre-treatment helps.
Deeper skin
Some risk
Safer than ablative lasers at lower density with an experienced provider.
Higher risk
Highest pigment risk of common peels; spot TCA CROSS is safer than full-face.

How it works

Fraxel

TCA Peel

How it works
Fraxel DUAL diagram: 1927 nm reaches up to 0.3 mm and 1550 nm up to 1.6 mm, depending on settings.
TCA Peel mechanism diagram. TCA is applied to selected skin: A clinician chooses the formulation and treatment plan. A controlled injury forms: The acid coagulates proteins in the treated layers. Skin heals and renews: The response depends on peel depth, technique, and skin.
Diagram explanation

Fractional heat zones leave surrounding tissue untreated. Superficial 1927 nm treatment helps fade uneven pigmentation; deeper 1550 nm treatment triggers repair and collagen remodeling.

Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.

TCA is applied to selected skin: A clinician chooses the formulation and treatment plan. A controlled injury forms: The acid coagulates proteins in the treated layers. Skin heals and renews: The response depends on peel depth, technique, and skin.

Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.

Before your treatment

Fraxel
TCA Peel
2–4 weeks before

4 weeks before: Sun: Avoid tanning, self-tanner and sunburn.

Pigment preparation: For deeper skin tones, providers may prescribe a pigment-lowering cream for 2–4 weeks and test near the ear.

4 weeks before: Sun and pigment prep: No tanning or sunburn for a month, or the peel leaves blotchy pigment.

4 weeks before: Sun and pigment prep: On deeper skin tones and with melasma, providers pre-treat 2 to 4 weeks with a pigment-blocking cream.

2 weeks before: Actives and hair removal: Stop retinoids, benzoyl peroxide and exfoliating acids 5 to 7 days before.

2 weeks before: Actives and hair removal: Stop waxing, threading and hair removal creams for 2 weeks.

The week before

Cold sores: Tell your provider; preventive antiviral medicine often starts the day before.

Hair removal: Stop waxing, threading and hair-removal creams.

Actives: Stop retinoids, retinol and acids 3–7 days before.

1 to 2 days before: Antiviral: Antiviral medicine starts a day or two before a medium peel, whether or not you get cold sores.

Day of treatment

Fraxel
TCA Peel
Before you arrive

Arrive with clean skin and no makeup.

Arrange a ride if you will have strong settings or oral pain medicine.

Not specified
Arrival & prep

Skin is cleaned and photographed. Numbing cream stays on for 45–60 minutes.

Skin is checked and photographed, and antiviral medicine started if it has not been.

Treatment

The laser passes over the skin while cold air cools it.

Expect prickly heat that builds with each pass, often strongly uncomfortable—especially on the forehead and around the mouth.

Skin is cleaned and degreased, eyes and lips protected.

The acid goes on with gauze or a brush, section by section, each area watched for frosting before the next layer. No neutralizing step; cool compresses follow. A light peel takes about 20 minutes, a medium 30 to 45. Medium TCA is genuinely uncomfortable, worst early.

Before you leave

Skin feels hot, red and swollen. Ice packs and a bland ointment are usually applied.

Frosting fades within about 15 to 30 minutes, leaving skin bright red and swollen.

After your treatment

Fraxel
TCA Peel
First 24 hours

Days 1–2: Redness and swelling, especially around the eyes.

Days 1 to 3: Skin turns brown or bronze and feels stiff and leathery.

Days 2–7

Days 3–7: Rough, bronzed skin flakes away. Do not scrub or pick.

Days 3 to 10: Skin cracks and comes away in sheets, often starting at the mouth.

Weeks 2–4
Not specified

Weeks 2 to 6: Pinkness settles over several weeks and takes makeup once skin is intact.

Beyond 1 month

1–3 months: Time to results.

Scar improvement can last years; sun damage can return with sun exposure.

Not specified
Time to results
Not specified

1–2 weeks after peeling

How long results last
Not specified

Months to years

Risks

Risks
  • Dark patches
  • Worsening redness
  • Cold sores
  • Acne or white bumps
  • Lighter patches
  • A light TCA peel behaves like other superficial peels
  • Dark patches
  • Pale patches
  • Prolonged redness
  • A cold sore outbreak
  • Skin that will not close

Cost

Per session

About $900–1,500 for a full face in the US. Smaller areas cost less.

In the US a light TCA peel runs about $150 to $300 a session and a medium peel about $400 to $900, more for a full face with sedation.

Full course

Several thousand dollars. Packages may reduce the per-session price.

Not specified
Insurance

Cosmetic treatment is not covered. Coverage for surgical or injury scars is uncommon.

Insurance does not cover peels for pigment, texture or scarring.

Questions

Fraxel

TCA Peel

Individual Questions
How many Fraxel sessions will I need?

Three to five, two to four weeks apart. Sun damage sometimes needs fewer, acne scars usually need the full course, and deeper skin tones are treated at lower settings, which means more sessions.

Does Fraxel get rid of acne scars?

It improves them rather than removing them. Studies of nonablative fractional lasers show partial improvement in scar depth and appearance over a course. Deep icepick scars respond least and are often better treated by combining the laser with subcision or filler.

How much downtime is there really?

Plan for a week. Two days of redness and swelling, then a few days of rough, bronzed skin that flakes off. Most people cover it with makeup from day three and look normal by day seven.

Does it hurt?

With an hour of numbing cream and cold air, most people call it hot and strongly uncomfortable rather than unbearable, and it stops as soon as the laser does. The forehead and around the mouth are the worst.

Is it safe for deeper skin tones?

It can be done, but differently. The main risk is temporary dark patches. Lower settings, more sessions, pre-treatment creams and strict sun protection all lower that risk, and the provider experience with your skin tone matters more than the device.

Is Fraxel the same as CO2 laser?

No, though one device sold under the Fraxel brand is a carbon dioxide laser. The Fraxel most people mean is nonablative, heating the skin without removing the surface. A carbon dioxide laser removes tissue, does more per session, and brings one to two weeks of downtime and more pigment risk.

What is frosting?

The white film that appears as TCA coagulates protein. It is the intended endpoint and how the provider judges depth. Patchy frost means a superficial peel; a solid white sheet means the upper dermis.

How is TCA CROSS different from a TCA peel?

Same acid, different procedure. TCA CROSS places a high strength into the base of individual icepick scars and leaves the rest of the skin alone. A peel treats the whole area at much lower strength. If icepick scars are why you are going, ask for TCA CROSS by name.

How much downtime should I plan for?

About 3 to 5 days for a light peel, 7 to 10 for a medium one, plus several weeks of fading pinkness. Plan the week off before you book.

Is TCA safe on deeper skin tones?

Light TCA and TCA CROSS are used on all skin tones. Medium-depth TCA across the face risks lasting dark or pale patches on deeper skin tones, so many providers choose a course of lighter peels instead.

Why is there no neutralizer?

TCA is used up as it reacts, so it stops on its own. Water rinses the surface but does not undo the reaction underneath. That is why it goes on in slow layers and is judged by frosting.

Will it get rid of my acne scars?

A face peel improves discoloration and texture but does not lift indented scars. Icepick scars may respond to TCA CROSS; rolling and boxcar scars usually need subcision, needling or laser.

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