TCA CROSS is the chemical reconstruction of skin scars using a high percentage of trichlorecetic acid that is precisely placed into the base of atrophic scars.
The TCA CROSS procedure involves depositing small amounts of TCA at high concentration (50–100%) into the base of the atrophic scar. This causes a local inflammatory reaction that triggers a wound healing response by the body. As the skin heals and collagen is formed the scars will start to elevate, or rebuild from within, which results in a smoother overall texture of the skin.
- Ice pick acne scars
- Box car acne scars
- Dilated pore
- Some rolling scars
We mainly use this technique on facial scars, but it can be used off face with lower percentages of TCA.
30 minutes or less depending on how many areas are treated. When you arrive to your appointment you skin will be cleansed. The TCA will be applied using a toothpick, or small needle. Once all areas have been treated the skin will be neutralized with cool water and SPF will be applied.
Multiple treatments are needed for best results. We usually recommend 3-6 treatments spaced 6-8 weeks apart.
TCA cross also works best when performed in conjunction with other scar treatments such as microneedling, chemical peels, subcision, dermal fillers or ablative and non-ablative skin resurfacing.
There are no add-on for this treatment but this can be combined with other treatments the same day such as our Diamond Glow Facial.
Very minimal. Even though we are using much higher concentrations of TCA, due to the small surface area this treatment is not uncomfortable. You will feel a mild heat/stinging sensation in the areas that have been treated.
Areas that have been treated will immediately frost (turn white) for approximately 12 hours. Redness can surround the frosted area which is normal. The white or frosted areas will then turn dark and slowly start to flake off in about 7 days. Once the skin has flaked you can experience some redness on those areas for about 7 days, or sometimes longer in fair skin types. You can easily cover this with make-up if desired.
TCA cross results take about 6-8 weeks to start seeing a result with your body continuing to make collagen up to 6 months post treatment. It is normal for the scar to appear worse in some cases for the first few weeks.
The results from this treatment are “permanent”. The collagen your body produces is your own, however as with any non-invasive cosmetic procedure they cannot stop the aging process. Medical grade skincare and daily UV protection is always recommended to maintain results.
- Strict sun protection 2-4 weeks prior to the treatment is essential for the best results.
- Discontinue retinoids as well as chemical exfoliants such as AHA/BHA 3 days prior to treatment.
- Topical melanin suppressants such as transexamic acid or hydroquinone may be required a few weeks prior to treatment for patients prone to PIH.
- Gentle skincare for 7 days. Avoid harsh chemicals, scrubs or retinoids for 7 days.
- UV protection must be worn daily to avoid prolonged erythema and/or pigmentation changes post treatment.
- On the areas that have scabbed Vaseline, Aquaphor or CeraVe healing ointment can be applied for faster healing.
- Do not pick at the skin while healing. Let the skin slough off on its own.
This treatment is unique that in that when performed by an experienced practitioner it can provide quick, safe and effective results in nearly all skin types with little risks.
Any patient that wants to improve the appearance of acne scars. It works best on certain types of acne scar, which is determined in your consultation.
- Actively tan patients
- Patients that have poor wound healing or delayed wound healing
- Not usually recommended for patients that have a history of vitiligo as inflammation can induce a flare.