The Peel That’s Not a Peel

WiQo PRX-T33 (GPQ srl; Trieste, Italy) is one of the more recent European imports to the U.S., adding an innovative, clinical nonsurgical skin revitalization option for the medical spa menu.

An FDA-registered treatment as of September 2019, this patented peel penetrates the dermis, leaving the surface of the skin relatively unscathed. Call it a “biostimulator” or “clinical facial,” it’s a peel that’s not your typical peel, formulated with a proprietary combination of hydrogen peroxide and TCA for, what the company says are, instantly visible skin rejuvenating effects, with no downtime.

Decoding PRX-T33

“The names are odd to an American ear, but they do make sense,” says Mishail Shapiro, D.O., medical director for WiQo U.S.

The components “PRX” and “T33” stand for the ingredients in this unique formulation:

PRX = hydrogen peroxide

33 = the percentage of TCA in the compound

“So PRX-T33 is hydrogen peroxide plus TCA at 33%,” says Dr. Shapiro.

As for the WiQo name, that stands for World Italian Quality Output and is a GPQ brand.

The company holds an international chemical patent on their product. The combination of hydrogen peroxide and TCA, which moderate each other, create a unique compound. More than 2 million treatments have been performed in 40 countries worldwide, and it’s safe on all skin types and tones, says Dr. Shapiro.

Notably, “It’s not photosynthesizing so you don’t have to worry about going outside in the summer,” he says.

Dr. Shapiro was first introduced to PRX-T33 at the International Aesthetics Show in early 2019 before it was available in the U.S. His wife, an esthetician, proactively became the first stateside distributor of the product. The company then asked him to join the team as Medical Director for the U.S.

How It Works

Normal skin tissue includes hydrogen peroxide, which stimulates fibroblast receptors and leads to collagen formation, explains Dr. Shapiro. He points out that while high concentrations can destroy tissue, the peroxide concentration in PRX-T33 is low, noting that the exact concentration is patented and can’t be divulged.

According to Dr. Shapiro, TCA is modified when you combine it with low concentration hydrogen peroxide, the formulation of which disrupts cellular bonds to transport hydrogen peroxide into the papillary dermis. There’s no sloughing, no peeling and no crusting — none of the post treatment effects that are typically associated with TCA peels.

“Hydrogen peroxide stimulates collagen receptors. TCA acts as a vehicle to get the hydrogen peroxide where it needs to go. But also it has a beneficial effect. It causes the stress response to the tissue and also stimulates the collagen formation and cellular regeneration,” says Dr. Shapiro.

The Treatment Protocol

The product fills a specific niche in the aesthetic practice, according to Dr. Shapiro. It offers instant and longer-term results, with no downtime.

“PRX-T33 was initially designed for the European market where women were accustomed to getting a series of weekly [skin] treatments,” says Dr. Shapiro.

With PRX-T33, patients have a series of four treatments for 6 to 8 months of results.

Studies in the U.S. are currently underway looking specifically at a series of four treatments spaced one week apart.

Although the treatment is most often used on the face and neck, it can also be used on the chest, hands, stretch marks and scars, according to Dr. Shapiro.

Treating the face and neck takes about 30 minutes and can be combined with microneedling, PDO threads and more, he says.

Contraindications are few, including active acne and dry, flaky skin, and are discussed in product training, says Dr. Shapiro.

“In general, for most people, the treatment can be accomplished regardless of the time of year and sun exposure,” says Dr. Shapiro.