Undergo Chemical Reconstruction of Depressed Acne Scars
Acne is a chronic skin condition that occurs when dead skin cells and sebum clog hair follicles, causing the follicles to potentially be infected with Propionibacterium acnes, or more commonly known as P. acnes. Although acne is a temporary inflammatory skin condition, it can result in permanent atrophic scars that may lead to significant psychological distress.
What is TCA CROSS?
TCA CROSS is an abbreviation for TriChloroacetic Acid: Chemical Reconstruction Of Skin Scars. It is typically used in concentration of about 20-35% designed to improve appearance of depressed scars and skin ageing. The concept of TCA CROSS works very similarly to a chemical peel.
How does TCA CROSS work?
It involves placing tiny amounts of TCA at high concentration of about 70-100% directly on the depressed scar tissue with a toothpick or a needle. Immediate reaction occurs, prompting the skin to “frost” or turn white. The strong chemical activates and burns the surface of the depressed scar, stimulating the skin to form new collagen fibers.
The aim is to improve the appearance of the scar by inducing collagen remodeling specifically in the depressed scar. However, it is not likely for the scar to resolve completely just with this treatment alone.
Over the next 4 to 6 weeks during the healing process, the skin creates new cells to plump up the scar, resulting in a smoother texture and reducing the appearance of the depressed scar.
Can TCA CROSS treat all types of acne scars?
TCA CROSS is particularly useful for treating the following atrophic scars:
- Boxcar scars
- Rolling scars
- Ice-pick scars
How is TCA CROSS carried out?
It is a straightforward treatment that should be done only in a medical clinic. It can be done in a matter of minutes, depending on the number of scars to be treated.
The area to be treated should first be cleansed with saline or chlorhexidine. A fine blunt end-point tool such as a toothpick will be dipped in TCA. The excess is removed before applying directly on the crater in the skin. After about 10 seconds, the treatment site will begin to “frost” and turn white. The skin will then be cleansed once more with saline. After some time, the treated area may turn red or irritated.
Taking care of the skin after TCA CROSS
You may notice that the frosting of the scar may last for about 12 hours. Subsequently, the treated area will turn red and inflamed. After a few more days, a small scab will develop and the scab should fall after 3 to 7 days. Do not pick the scab or it may worsen the condition.
You may wash your face as normal and apply make-up or concealer during this period. Applying sunscreen of at least SPF50 is necessary to reduce the chance of post-inflammatory hyperpigmentation.
How many sessions are required?
You should be able to see some result after the first session. However, doctors usually recommend a minimum of 3 sessions every 4 weeks to see visible improvement.
Are there any side effects of TCA CROSS?
The treatment is straightforward and it is generally well-tolerated. Some side effects that may arise include:
- Potential scarring if TCA is administered at the wrong place
- Post-inflammatory hyperpigmentation if post-treatment care is managed properly
- Painful ulceration of the skin if applied on mucosal surfaces such as lips, eyes nostril etc.
- Prolonged skin irritation and redness
Can TCA CROSS be combined with other treatments?
TCA CROSS is rarely performed as a standalone treatment for the management of acne scars.
Acne scar treatments that are usually combined with TCA CROSS are:
- Genius RF microneedling or INFINI RF microneedling
- Fractional CO2 skin resurfacing laser
- AGNES RF microneedling
- Dermal fillers
- Chemical peel
How do we do it differently?
There is no singular approach to treating acne scars. We complement TCA CROSS with a customised treatment of non-invasive or minimally-invasive treatments – including chemical peels, dermal filler, RF microneedling, CO2 skin resurfacing laser and subcision – to resurface the skin and achieve a smoother skin texture.
At Radium, our doctors often combine TCA CROSS with RF microneedling treatments such as Genius and INFINI to stimulate collagen production and trigger the skin’s natural healing process while reducing appearance of acne scars.
- Improve deep, stubborn scars such as ice-pick and boxcar scars
- Targeted treatment to induce collagen production for specific deep pitted acne scars
Those with deep acne scars and wish to undergo targeted treatment to remove them more quickly.