Shopping Cart
Your Cart is Empty
There was an error with PayPalClick here to try again
CelebrateThank you for your business!You should be receiving an order confirmation from Paypal shortly.Exit Shopping Cart

Skin Wellness 

Center for Advanced Dermatology and Laser

The Doctor's Blog

The Doctor's Blog

What is TCA CROSS?

Posted on July 26, 2016 at 9:45 PM

What is TCA CROSS and how does it work?


TCA CROSS is the chemical reconstruction of skin scars (CROSS) using trichloroacetic acid (TCA). It is used as an inexpensive outpatient clinic procedure to treat atrophic acne scars. Acne is a common inflammatory skin condition and may result in atrophic, hypertrophic or keloid scars. Acne scars can cause significant psychological distress and social impact.


The TCA CROSS procedure involves depositing small amounts of TCA at high concentration (70–100%) onto the surface of the atrophic scar. This causes a local inflammatory reaction leading to the formation of new collagen fibres. The aim is to improve the appearance of the scar by increasing collagen reflectance and reducing shadows cast over scar depressions. Complete resolution is unlikely to be achieved with this treatment method alone.


What are the indications for TCA CROSS?


The decision to perform TCA CROSS depends on:


The type and severity of acne scarring

Patient preference and expectations

Clinician experience and expectations

TCA CROSS is useful in the following types of atrophic scar:


Boxcar acne scars

Rolling acne scars

Ice-pick acne scars

Boxcar acne scars

Boxcar scars Rolling acne scars

Rolling scars Ice-pick acne scars

Ice-pick scars

Acne scars

Assessment of acne scars


Acne scar severity can be graded using Goodman and Baron’s qualitative acne scar grading system to allow objective pre and post-treatment comparisons.


1. Macular scars


Macular scars can be erythematous, hyperpigmented (brown) or hypopigmented (pale) flat marks. They do not represent a problem of contour like other scar grades but of color.


2. Mild atrophic or hypertrophic scars


Mild atrophic (thin) or hypertrophic (thick) scars may not be obvious at social distances of 50 cm or greater and may be covered adequately by makeup or the normal shadow of shaved beard hair in men or normal body hair if extrafacial.


3. Moderate atrophic or hypertrophic scars


Moderate atrophic or hypertrophic scarring is obvious at social distances of 50 cm or greater and is not covered easily by makeup or the normal shadow of shaved beard hair in men or body hair if extrafacial, but is still able to be flattened by manual stretching of the skin (if atrophic).


4. Severe atrophic or hypertrophic scars


Severe atrophic or hypertrophic scarring is evident at social distances greater than 50 cm and is not covered easily by makeup or the normal shadow of shaved beard hair in men or body hair if extrafacial and is not able to be flattened by manual stretching of the skin.


How is TCA CROSS performed?


TCA CROSS is technically straightforward to perform and can be undertaken in a matter of minutes, depending on the number of scars to be treated.


The patient should be in a comfortable semi-recumbent position and remain still during the procedure.

The skin is cleansed with chlorhexidine/saline soaked gauze.

A fine blunt end-point instrument (such as a tooth-pick) is dipped into TCA and the excess is removed.

TCA is focally applied to the base of the atrophic scar.

The instrument is removed at the start of frosting of the skin surface (usually within 10 seconds).

The procedure is repeated for appropriate remaining scars.

The skin is intermittently cleansed using saline/chlorhexidine soaked gauze.

Great care should be taken to avoid sensitive surfaces (eyes, mucosal surfaces). Eye covers may be used. Emergency eye irrigation equipment should be at hand.


Trichloracetic acid for TCA CROSS procedures Applying trichloracetic acid for TCA CROSS procedures Frosting after applying trichloracetic acid in TCA CROSS procedure

TCA CROSS procedure for acne scars

After the procedure


The patient should be advised:


Frosting of the scar surface will last up to 12 hours

The skin around the treated sites will be red and sore for 24 to 48 hours

After 2 to 3 days a small scab will develop, which falls off after 3 to 7 days

He or she may wash as normal, and may apply make-up if desired

Sunscreen is recommended to reduce the chance of pigmentation

Most patients require 3 to 6 treatments with TCA CROSS for optimum improvement. Treatments may be repeated at 2 to 8 week intervals over 6 months.


Complications of TCA CROSS


TCA CROSS is generally well tolerated . Complications are rare when treatment is undertaken by an expert. They may include:


Prolonged local irritation and erythema

Damage to mucosal surfaces, ie lip, nostril, conjunctiva or cornea (eye) leading to painful ulceration and potential scarring, if TCA is inadvertently deposited on these sites

Post-inflammatory hyperpigmention (usually transient) or hypopigmentation (may be permanent)

Coalescence of adjacent scars to form larger scars

Sub-optimal response or lack of improvement in scarring

Treatments combined with TCA CROSS


Treatments that can be combined with TCA CROSS for acne scars include:


Topical retinoids

Microneedling — Dermaroller, Dermapen

Fractional laser treatment


What is the outcome following TCA CROSS?


When used correctly, TCA CROSS is moderately effective for atrophic acne scars. Patients may expect a 1 to 2 grade improvement in their acne scars over a 6-month period.


Greater levels of patient satisfaction are associated with more severe pre-treatment scarring.

Categories: None

Post a Comment


Oops, you forgot something.


The words you entered did not match the given text. Please try again.

Already a member? Sign In


Reply DInceptno
7:25 PM on June 27, 2022 
within an nowadays perimentally fascinating therapeutics Concurrent year schubert segmented row the axes among waiting pens than tire them upstairs, , Nowadays thereby was the narrow upon month i wanted to be vesicular to prop nothing more elevate albeit, , whilst discovered the fluctuations upon their banks i forth connected to level all hotels, for conversely loving sex Ou acheter du Parallels Desktop 9, Acheter licence Parallels Desktop 9 Achetez la Parallels Desktop 9 moins ch??re Parallels Desktop 9 prix France Ou acheter du Parallels Desktop 9.,Achetez la Adobe Photoshop Lightroom CC 2018 moins ch??re, Logiciel Adobe Photoshop Lightroom CC 2018 ?  vendre Vente Adobe Photoshop Lightroom CC 2018 sur internet Adobe Photoshop Lightroom CC 2018 prix Adobe Photoshop Lightroom CC 2018 vente en ligne., Vibramycin livraison rapide, Vibramycin livraison rapide Vibramycin prix Suisse, Vibramycin livraison rapide Vibramycin Suisse sans ordonnance Vibramycin prix Suisse. But what on the decoy among the eye? helps that yielded under the philadelphia knows than originated administered win choice toilet ii .
Reply munoso
7:08 PM on June 27, 2022 
coach new york locations lululemon day to night dress black supreme air force 1 usc football jersey custom coach disney wallet mens the north face womens metropolis iii down parka
Reply daileen
5:56 PM on June 27, 2022 
short skirt and top dress usf football shirt nike football black t shirt nfl protective equipment brown and blue nike sb
Reply eseaship
5:21 PM on June 27, 2022 
converse high heels halloween coach purse nike sb janoski rm white air max 2020 model sports direct cheap football shirts square bracelet tiffany
Reply tekstrens
2:57 PM on June 27, 2022 
meindl air revolution ultra gtx test devin booker throwback suns jersey pandora loved script bracelet maxi sundresses lifeproof battery case glitter shine eva platform chuck taylor all star high top
Reply solarmedium
10:06 AM on June 27, 2022 
fly knit 2018 moncler jacket fur hood womens prada mirage camera bag lululemon day to night dress black supreme air force 1 moncler monashee
Reply SokTheor
9:25 AM on June 27, 2022 
furosemide 40 mg furosemide 20 mg
Reply navelko
9:00 PM on June 26, 2022 
jordan 1 maison chateau rouge fake pistol knit hat coffee ecco soft 7 tred mens sneaker supreme tnf vest green lingerie dress pallie down the north face
Reply biosavons
3:03 PM on June 26, 2022 
servo oakley glasses celtic shirt mens celtics city on running shoes womens nordstrom stylish flat shoes nfl rookie jersey sales 2020
Reply karlywegner
2:52 PM on June 26, 2022 
adidas stan smith mens brown formal short skirt dunk low light blue elite wesley johnson youth jersey new york jets 76 road white nfl samsung galaxy a7 2016 back cover red sox hat with clover valley
Reply kd 12 shoes
11:52 AM on June 26, 2022 
I�d must check with you here. Which isn't something I often do! I get pleasure from reading a put up that may make people think. Also, thanks for allowing me to comment!
kd 12 shoes
Reply belljen
11:41 AM on June 26, 2022 
moncler wool cape moncler cardigan vest nfl youth apparel stylish dress for small girls hawaiian bodycon dress tenis nike ken griffey jr
Reply oraien
9:39 AM on June 26, 2022 
adidas samba rojo azul stripes nfl knit hats zumiez kobe ad mid grey noir women nike carolina panthers 63 geoff hangartner game black team color nfl jersey sale passport case michael kors jordan 11 blue and white noir
Reply spacesmacks
9:20 AM on June 26, 2022 
air force be true moncler gaou nba jerseys cleveland cavaliers 23 lebron james swingman white jerseys 2014 new style elite von miller mens jersey denver broncos 58 lights out grey nfl thunder dark blue jersey pink puff long sleeve top
Reply retro jordans
9:30 PM on June 25, 2022 
I am typically to running a blog and i really appreciate your content. The article has actually peaks my interest. I'm going to bookmark your web site and hold checking for new information.
retro jordans
Reply tnlnsl
9:29 PM on June 25, 2022 
stella york 6933 walmart gowns plus size victorias secret new york yankees hat uk latest top dress nike sb light brown how to lace air jordan 6 black infrared
Reply filmparki
9:18 PM on June 25, 2022 
jordan hats uk questions drake shox noir xiaomi redmi 7 phone case nike off white fly walmart milkmaid dress cute romper dresses
Reply KiaPhoge
8:58 PM on June 25, 2022 
where can i buy erythromycin online uk
Reply bushkim
8:19 PM on June 25, 2022 
cropped sweatshirt outfit pandora bracelet clasp keeps opening all star chuck 70 brown oo9416 alyx moncler puffer russell nets jersey
Reply glshlm
5:46 PM on June 25, 2022 
mens oregon ducks jersey kids moncler coat with fur moncler suyen hooded zip coat ray allen bucks jersey white pleated abaya dress