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How to get rid of Acne Scars!

Updated: Oct 10

TCA cross treatment for ice-prick acne scar

What is TCA CROSS?

TCA CROSS is short for Chemical Reconstruction Of Skin Scars (CROSS) by using trichloroacetic acid (TCA).

An established peeling agent, Trichloroacetic acid (TCA), is mostly used for superficial as well as medium depth peel. The depth of effect varies according to its concentration; that is, higher concentrations can modify the deeper scars by reaching lower levels of the skin. TCA is a self-neutralizing agent; it does not get absorbed in the blood stream. Hence high concentrations such as 100% can be safely used.

TCA cross, how does it work?

The TCA CROSS causes a local inflammatory reaction leading to the formation of new collagen fibers. Application of TCA to the skin in the concentration of 90% causes a local inflammatory reaction, which in turn leads to the formation of new collagen fibers and dermal collagen remodeling, this process continues for several months after the treatment. As collagen production, glycosaminoglycan, and elastin fragmentation and reorganization increase, so too does the dermal volume. Resulting in improved appearance of the scar by increasing collagen reflectance and reducing shadows cast over scar depressions.

TCA cross procedure

Small amounts of TCA at high concentrations (70–100%) are deposited onto the surface of the atrophic scar. Local anesthetics or sedation were not used. Patients experienced mild burning, which was well-tolerated. This was followed by frosting, redness, and mild swelling, which decreased in four to six hours. The formation of crust over the treated area was observed on the next day, but it had subsided by three to four days in most patients.

TCA cross result

The CROSS technique with 100% TCA is a safe, cost-effective, minimally invasive technique, with good efficacy, for the cosmetic management of ice pick acne scarring that can be used safely for all skin types.

Eight patients (80%) showed considerable improvement [more than 70% improvement after four sessions.

TCA cross aftercare

  • DO NOT pick at the crust during the healing process

  • If desired make-up may be applied

  • To reduce the chance of coloration, it is recommended a strong sunscreen be worn

  • For optimum improvement, most patients require 3 to 6 treatments with TCA CROSS at 2 to 8-week intervals.

Further Reading


- Medical Journal Articles on Acne Scarring and different modalities

by Dr. Chontirot Srikasedsarakul

Dr. Chontirot Srikasedsarakul is a specialist in Genomics, Dermatology and Aesthetics.  She has received qualifications from numerous educational institutions like Stanford University, U.S.A.; the University of Queensland, Australia; Chulalongkorn University, Thailand and the American Board of Anti-Aging Medicine.

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