What is TCA CROSS?
TCA CROSS stands for Trichloroacetic acid Chemical Reconstitution of Skin Scars. TCA CROSS is a procedure invented by a Korean dermatologist to help improve the appearance of enlarged pores, deep ice-pick acne scars as well as linear and shallow box-car acne scars.
TCA CROSS only treats the acne scars themselves and not the surrounding skin. This treatment can be used on all skin types including those with skin of colour (Asian skin, Indian skin, African skin etc).
2-4 treatments spaced 6-8 weeks apart are needed for optimal outcomes. TCA CROSS is superior to even the most advanced Fractional lasers for the treatment of ice pick and deep scarring, as well as pore size reduction. Treatments are quick with minimal discomfort. No anaesthetic is required.
TCA breaks down the collagen within the scar and stimulates new collagen to form. This new collagen ‘fills in’ the hole in the skin. The deeper the scar the better it works.
The process of collagen stimulation takes at least 3-4 weeks and is maximal at about 3 months.
At Chroma Dermatology, we employ a few different techniques for application of TCA CROSS to optimise outcomes.
We use the traditional method of TCA CROSS with a toothpick as well as newer delivery methods via 1 ml syringes (not injected, just dropped on the skin) along with skin paint brushes.
The treatment itself usually takes between 15-35minutes depending on the area of scarring being treated.
TCA CROSS feels like subtle stinging or heat, or like an ant bite for a few minutes. No local anaesthetic or numbing creams are required.
The skin turns white then red (or slightly brown in those with darker skin types). After treatment is finished, instructions will be provided to you about how to care for your skin in the post procedure phase.
The recovery period is between 5-6 days, however the area will be red for several weeks. You can cover this with tinted sunscreen or makeup after the first week. Those with skin of colour will see post inflammatory hyperpigmentation for up to 12 weeks post TCA CROSS and rarely post inflammatory hypopigmentation is noted. These changes are usually temporary (12-16 weeks). Makeup and special creams can be used to improve and camouflage the area as it heals.
Skin colour changes are very rare in patients with fair skin types (Caucasian skin). Redness occurs after treatment, but it is important to know that this is something that occurs in everyone and is not a side effect. The redness may take 4-8 weeks to subside but can be covered with makeup.
In skin of colour, pigment changes will occur will fade over 8-12 weeks with the use of lightening creams. Picosecond lasers such as PicoSureTM can also improve pigmentation changes following TCA peels.
Skin infection after TCA CROSS is rare providing you follow the antibiotic balm instructions. In some cases, a prescription for antibiotics may be needed, however this will be discussed with you at your appointment.
Between 2-4 sessions are generally needed for the best results. The number of sessions will depend on the severity, depth and type of your scars and your individual skin type. Those with darker skin tones (those with skin of colour) will require a few more treatment sessions. If multiple treatments are needed, treatment is spaced about 6-12 weeks apart. TCA CROSS can be combined with lasers and fillers in the same session.
Each treatment may provide about 20% improvement and three treatments are likely to give a 50-70% improvement in the depth of the scars.
If you think TCA CROSS will help your acne scars or pores, your next step is email or call us to book an appointment with our dermatologists. Before treatment, we must take a comprehensive medical history and establish your skin type and scar types. We then discuss what approaches might work for you. Each person is different, and an individually tailored treatment plan is needed to get the best results. We will discuss how to best prepare your skin for the treatment.