TCA Cross for Acne Scars • Dr Gerard Ee

TCA CROSS for Acne Scars

As if acne itself weren’t annoying enough, pimples can leave their mark long after you thought they were gone. Whether they are raised, discoloured or depressed, there are multitudes of skin treatment options effective in reducing the appearances of these scars. TCA CROSS is the latest, highly successful targeted treatment for deep pitted and ice-pick acne scars when laser resurfacing is rendered ineffective. TCA CROSS, an ancronym for Trichloroacetic Acid Chemical Reconstruction of Skin Scars, helps to reorganise the dermal structure and stimulate new collagen production to help to lift the indented acne scars back to the normal skin level.

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TCA CROSS for Acne Scars

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TCA CROSS

TCA CROSS is superior to even the most advanced Fractional lasers for the treatment of ice pick and deep acne scarring, as well as pore size reduction. Deep acne scars and enlarge pores lie below the safety zone of lasers. Lasers including CO2 and Fraxel can all deliver the necessary power to reach deep scars, however this will be pushing the safety margin for skin resurfacing. TCA CROSS overcomes this problem by placing a known concentration of acid, causing a local inflammatory reaction leading to the formation of new collagen fibres and a resultant improvement in your acne scar appearance.

How Does TCA Cross Work?

The technique used is to place drops of high concentration TCA (from 70 to 100%, depending on your skin colour and depth of your scars) into the base of the affected acne scar. The acid actually ‘scars’ the scar, stimulating collagen and raising the level of the scar. After just 1 treatment, you will notice a difference, however most ice-pick acne scars will require 2-3 treatments before achieving optimal results. Treatment takes between 5-15 minutes, depending on the extent of scarring. TCA CROSS is usually coupled with other treatment modalities to improve facial skin texture and tone.

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How Effective Is TCA CROSS?

Generally, patients can see at least 50-80% improvement of deep ice pick scars after a series of 2-3 TCA CROSS acne scar treatments. Namely the scar should be shallower and less noticeable, especially in the light and shadows. Scar improvement will continue for several months following the procedure. TCA CROSS is well tolerated and the results are very predictable. Once deep acne scars are raised up to form a shallow scar, we then use lasers (e.g. Fraxel) to complete the acne scar revision process.

Is TCA CROSS For Acne Scars Painful?

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

What Is The Downtime For TCA CROSS for Acne Scars?

The treated areas will appear “frosted” for several hours post-procedure, there after turning red for several days. Each treated area will remain red for 3-4 days, then shed or peel. Full recovery is expected within 5-7 days.

Can TCA CROSS Work On All Skin Types?

Yes. All Asian and ethnic skin types including darker skin patients can be safely treated with TCA CROSS. However in darker skin patients, the risk of post-procedure darkening will increase. This means, treated areas maybe darker than the surrounding skin for weeks to months. The use of sunscreens or fading creams can reduce this incidence.

In darker skin types, an extra 1 or 2 TCA CROSS sessions may be needed as the concentration of TCA is modified to reduce the chances of prolonged post-inflammatory hyperpigmentation.

Can I Reduce Pore Size With TCA CROSS?

Yes. In cases where patients have enlarged pores, 2-3 TCA CROSS treatments may be needed to see a significant reduction in pore sizes.

Combining TCA CROSS & Lasers for Acne Scars?

TCA CROSS can be a stand-alone procedure to treat enlarged pores or it can be a stepping stone towards laser resurfacing for deep pitted acne scars. We often combine a number of techniques, such as subcision, lasers and punch elevation, to give the best possible results to patients, depending on the scar types and individual’s skin conditions. Once the depth of scars are in the same plane, laser treatment can finish off the treatment.

Find out more about Fraxel Laser Skin Resurfacing.