Cross out your deep acne scars
What is TCA (Trichloroacetic Acid Chemical Reconstruction of Skin Scars) Cross?
TCA CROSS (Trichloroacetic Acid Chemical Reconstruction of Skin Scars) is a specialized, non-invasive procedure used to treat deep acne scars, specifically ice pick and boxcar scars. The treatment involves the precise application of a highly concentrated solution of trichloroacetic acid (TCA) directly into the scar tissue. This causes a controlled chemical injury to the inner layers of the skin, stimulating the production of collagen and elastin. Over time, as the skin heals and regenerates, the depth of the scar reduces, and the skin’s texture improves.
The TCA solution promotes collagen remodeling, which helps "fill in" the scars and leads to smoother skin. It works particularly well for deep, narrow scars that are resistant to other treatments, such as microneedling or laser therapy.
What conditions can it treat?
TCA CROSS is primarily used to treat acne scars, particularly:
Ice pick scars: These are narrow, deep scars that look like small, deep holes.
Boxcar scars: These scars have broad, depressed areas with sharp edges. It can also treat other forms of atrophic scars, including some types of surgical or traumatic scars, though its use is primarily focused on acne-related scarring.
Why choose TCA Cross?
TCA CROSS offers a targeted, effective treatment for deep scars that are often difficult to address with traditional procedures. Unlike full-face chemical peels or laser treatments, TCA Cross is highly precise, meaning only the scar itself is treated, leaving the surrounding healthy tissue unaffected.
Patients choose this treatment because it provides a non-invasive option for significant scar reduction, with minimal discomfort and downtime and leads to long-term improvements in scar appearance.
Who is TCA Cross For?
TCA Cross is suitable for individuals who have:
- Deep, pitted acne scars (ice pick or boxcar scars)
- Scars that have not responded well to other treatments like microneedling or laser
- Skin that can tolerate medium to deep chemical peels (patients with darker skin types may require careful assessment to minimize risks of hyper or hypopigmentation)
- It's a treatment option for those who want a more focused, scar-specific approach without undergoing invasive procedures like laser resurfacing or surgery..
Treatment Duration
The actual procedure is relatively quick, usually taking between 10-15 minutes, depending on the number of scars being treated. Each session involves the direct application of TCA to each scar, which takes only a few seconds per spot.
Pain Assessment and Downtime
The TCA Cross procedure is minimally painful, though patients may experience a stinging or burning sensation during the application. Most patients tolerate the procedure well without the need for numbing cream, but it can be applied if necessary.
After treatment, there is some mild redness, swelling, and scabbing at the treatment sites, which generally subsides within 5-7 days. The downtime is minimal compared to other scar treatments, and most patients can resume normal activities within a day, though they should avoid sun exposure and strenuous exercise during the healing period.
What To Expect
Immediately after treatment, the treated areas will appear white (frosting) due to the chemical reaction. This will fade over the next few hours, leaving the area red or slightly inflamed. Scabs will form in the treated areas over the next few days, and these will naturally slough off within a week. Patients should avoid picking at the scabs to prevent scarring.
As the skin heals, collagen production begins, gradually improving the appearance of the scars over the next several weeks.
FAQs
Results are not immediate, as it takes time for the skin to heal and for new collagen to form. Most patients begin to notice improvements in their scars about 4-6 weeks after the first treatment. However, full results typically take 3-6 months to become evident as collagen remodeling continues over time.
The number of sessions required depends on the severity and number of scars. Most patients need 2-4 treatments spaced about 4-6 weeks apart for optimal results. Deep scars may require more sessions for significant improvement.
When compared to other scar treatments, such as laser resurfacing or microneedling, TCA Cross offers a more precise, spot-focused approach. Laser treatments tend to treat larger areas of the skin and are effective for overall skin texture improvement, while TCA Cross specifically targets deep, isolated scars where TCA CROSS excels.
For enhanced results, TCA CROSS should be combined with other treatments including:
Microneedling with Radiofrequency: Helps improve overall skin texture and reduce fine lines while TCA CROSS focuses on deeper scars.
Laser Resurfacing: For patients with both surface-level and deep scars, combining laser treatments with TCA CROSS can improve overall skin smoothness and clarity.
Manual subcision: Subcision helps to further break up the scar tissues tethering the atrophic scars down. We usually inject products such as polynucleotides for healing or enzymes for further breaking down of the scar tissue
After each session of TCA Cross, proper aftercare is essential to ensure optimal results and minimize the risk of complications:
Sun Protection: It is crucial to protect the treated areas from sun exposure to prevent hyperpigmentation. Use a broad-spectrum sunscreen with at least SPF 50 and avoid direct sunlight for at least 2 weeks post-treatment.
Gentle Skincare: Use mild, non-irritating skincare products to cleanse and moisturize the skin. Avoid exfoliating products, retinoids, or strong acids for at least a week after treatment.
Do Not Pick Scabs: Let the scabs fall off naturally to prevent any new scars or pigmentation.
Hydration: Keep the skin well-moisturized to promote faster healing.
While TCA Cross is a safe and effective treatment for many individuals, it is not suitable for everyone. Contraindications include:
Active infections: If you have an active skin infection or condition like herpes, it must be treated before undergoing TCA Cross.
Pregnancy or breastfeeding: Chemical treatments like TCA are not recommended for pregnant or breastfeeding women.
Keloid-prone skin: Patients who are prone to keloid formation may not be suitable for TCA Cross, as the controlled injury can potentially lead to hypertrophic scarring.
Dark skin types: While TCA Cross can be used on darker skin tones, there is a higher risk of post-inflammatory hyperpigmentation (PIH), and careful consideration is required. Pre-treatment with lightening agents may be recommended.
Patients should also be aware of potential side effects, such as redness, temporary hyperpigmentation, hypopigmentation or, rarely, infection if aftercare instructions are not followed properly.