TCA Cross

Chemical Reconstruction Of Scars

TCA Cross is a treatment for improving acne scars. Trichloroacetic acid (TCA) is applied to individual scars in order to make them less shallow. TCA Cross works best for ice pick scars and boxcar scars. TCA may work for other types of acne scars as well as for dilated pores.

TCA Cross treatment is most commonly used for acne scars that are deep. The benefit of TCA Cross is that the liquid is able to reach the very bottom of the scar where it can have an effect.

The types of acne scar which are treated with TCA Cross :

  • Ice pick scars
  • Boxcar scars

Before & After

What You Should Know About TCA Cross

How does TCA Cross work?

Studies show that TCA Cross causes damage to the epidermis and dermis in the area of the scar. The body then heals the injury to lay down more type I collagen and elastic fibres. This raises the depths of the scar.

TCA Cross is a very successful treatment for the right type of acne scars. About 75% of patients receiving this form of treatment feel their results are good or excellent.

Research also supports TCA Cross as being both safe and effective for acne scars.

A Korean medical report showed that 94% of people receiving 100% TCA had a good response. Complications were not reported.

Treatment will involve the skin being cleansed and the TCA being placed in the scars. The stages that will follow are:

  • Frosting. The skin will go white. This is because the TCA has reacted with the proteins in the skin. Frosting lasts for about 30 minutes.
  • Redness. When the frosting disappears, the skin will become red.
  • Scabbing. A scab will form within 1 or 2 days. This will cover the redness and lasts for 3 to 7 days.
  • Redness for 7 to 28 days. Once the scab separates, the skin will be red. The redness will gradually fade over a month (sometimes two).
  • Your skin may become sensitive and it is best to use a very gentle lotion,  and cleanser twice per day.
  • The scabs need to be moisturised four times a day. 
  • Let the scabs separate naturally. Do not pick them. They will separate as soon as the skin below has healed.
  • You can wear make-up from day 3 onwards.
  • It is important to protect your skin from the sun as the sun can cause pigmentation in the healing areas. We ask you to avoid tanning for 2 weeks before treatment until 2 months after your final treatment. If you do develop pigmentation, you may need a skin-lightening treatment from your doctor.

What are the risks of TCA Cross?

As with any medical treatment, there are some risks of treatment as well:

  • Redness can persist for several months

  • Post-inflammatory hyperpigmentation can occur. This is when there is a darkening to the skin that has been treated

  • Rarely post-inflammatory can rarely occur This is when there is lightning to the skin which has been treated.

  • Scars can widen

  • Scars can look worse

  • There may be no results or very minimal results

  • Infections can occur

How many treatments are required?

Between 4 to 6 treatments are usually required. A treatment is carried out every 4 to 6 weeks. Results may not start being apparent until the second or third treatment.

Can all skin types be treated?

We offer treatment to skin type I to V patients (white to Indian skin tones). 

Combining TCA with other treatments

TCA Cross may be combined with other skincare treatments which can include subcision, Tixel, surgical excision of scars, and laser resurfacing.


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