TCA Cross Treatment in Singapore

TCA Cross, which stands for Trichloroacetic Acid Chemical Reconstruction of Skin Scars, is a treatment designed to improve indented acne scars. It works by stimulating collagen production and helping to lift scar tissue, leading to a smoother skin surface.

Dr Gerard Ee
MBBS (UK), MRCS (Edinburgh), DP Dermatology (Cardiff)

About TCA Cross

TCA Cross is a technique used to address deep acne scars, particularly ice pick scars. The procedure involves applying a concentrated trichloroacetic acid solution directly to the scar, triggering a controlled inflammatory response. This response stimulates collagen production, which gradually raises the scar and improves skin texture. TCA Cross is often considered for scars that are difficult to treat with other methods, such as laser therapy.

What Types of Acne Scars Can Be Treated with TCA Cross?

TCA Cross is particularly effective for treating ice pick and boxcar scars, which are deep and narrow. These scars are often difficult to address with other treatments. For other types of scars, such as rolling scars, TCA Cross may not be the primary option but can be combined with treatments like subcision for better results.

How Does TCA Cross Work?

Here’s what you can expect during your TCA Cross treatment session with Dr Gerard:

  1. Application of TCA to the Scar: During the TCA Cross procedure with Dr Gerard, a high concentration of trichloroacetic acid (TCA), typically 70% to 100%, is carefully applied to the base of each acne scar. The concentration used depends on your skin type and the depth of the scar. The acid is applied directly into the scar tissue, targeting only the affected area while leaving the surrounding skin unharmed.
  2. Controlled Chemical Injury: The application of TCA causes a controlled chemical injury to the scar tissue, which triggers the body’s natural healing response. This process induces localised inflammation, prompting the skin to initiate a repair process. This reaction leads to the generation of new collagen, which is essential for improving the appearance of indented scars.
  3. Collagen Production and Scar Lifting: As collagen production is stimulated, the scar tissue gradually lifts, becoming more level with the surrounding skin. This process improves the appearance of deep acne scars, such as ice pick and boxcar scars. The treatment is precise, affecting only the targeted scar tissue.

Most patients notice a difference after just one session, though 2-3 treatments are often recommended for optimal results. Each session typically takes 5-15 minutes, depending on the extent of the scarring. TCA Cross can be combined with other treatments to further improve skin texture and tone.

Learn More About Dr Gerard Ee

MBBS (UK), MRCS (Edinburgh), DP Dermatology (Cardiff)

Dr Gerard Ee is a medical aesthetic doctor specialising in treating acne and acne scar removal in Singapore. He earned his medical degree (MBBS) from St George’s University of London. He pursued further training and became a member of the Royal College of Surgeons (MRCS) in Edinburgh.

  • Acne and Acne Scar Treatment
  • Medical Aesthetics
  • Skin Rejuvenation

Dr Gerard Ee believes in building strong relationships with individuals based on trust and open communication. He takes the time to understand their concerns and goals, creating personalised treatment plans tailored to their specific needs. He is committed to providing a comfortable and supportive environment where patients feel empowered to make informed decisions about their skin health.

Frequently Asked Questions About TCA Cross

Patients generally experience a 50-80% improvement in deep ice pick scars after a series of 2-3 TCA Cross treatments. The scars become shallower and less noticeable, particularly in different lighting and shadows. Scar improvement continues over several months following the procedure. Once deep acne scars are raised to a more shallow level, lasers such as Fraxel may be used to complete the acne scar revision process.

The procedure is minimally uncomfortable, with most patients reporting a mild, temporary stinging sensation as the TCA works on the scars. Local anaesthetic is typically not required.

Common side effects of TCA Cross include redness, peeling, and mild swelling, which typically resolve within a week. More rarely, there is a risk of hyperpigmentation (darkening of the skin), scarring, or infection. These risks can be minimised by following post-treatment care guidelines, such as avoiding sun exposure and applying prescribed creams to aid healing. Dr Gerard’s extensive experience performing TCA Cross helps ensure the treatment is applied precisely, reducing the likelihood of complications and optimising results.

The treated areas will appear “frosted” for several hours after the procedure, followed by redness that lasts for several days. The treated areas typically remain red for 3-4 days before shedding or peeling. Full recovery is expected within 5-7 days.

During recovery, the treated areas may initially appear white or “frosted” for a few hours post-procedure. Redness and swelling typically follow and last for 3-4 days. Scabbing or crusting may develop as the skin begins to peel and heal. By the end of the first week, most patients notice that peeling subsides, and the skin continues to recover, with final healing expected in 5-7 days. Full recovery depends on the depth of the scars and adherence to aftercare instructions.

Yes, TCA Cross is safe for all skin types, including Asian and darker skin tones. However, in darker skin patients, there is an increased risk of post-procedure darkening, where treated areas may appear darker than the surrounding skin for weeks to months. The use of sunscreen or fading creams can help reduce this risk. An extra 1 or 2 TCA Cross sessions may be needed for darker skin, as the concentration of TCA is modified to minimise the chances of prolonged post-inflammatory hyperpigmentation.

Yes, in cases of enlarged pores, 2-3 TCA Cross treatments may be required to achieve a noticeable reduction in pore size.

TCA Cross can be used as a stand-alone procedure to treat enlarged pores or as a preparatory step for laser resurfacing in the treatment of deep acne scars. Techniques such as subcision, lasers, and punch elevation can be combined to achieve optimal results, depending on the type of scars and the patient’s skin condition. Once the depth of scars is levelled, laser treatment can further refine the results.

Find out more about Fraxel Laser Skin Resurfacing.