TCA (trichloroacetic acid) CROSS (Chemical Reconstruction of Skin Scars) is the chemical reconstruction of facial scars. It is commonly used to treat challenging acne scars like atrophic acne scars in Singapore. TCA CROSS uses up to 70-100% of TCA (trichloroacetic acid) to destroy proteins found at the deeper layers of the skin where scar tissue is found. This allows for collagen synthesis, improvement of acne scars and dermal thickening. Due to the high concentration of trichloroacetic acid used to fill indented scars up, impeccable technique when doing TCA CROSS is essential.
TCA CROSS is suitable for all skin types and skin tones. It is especially useful for patients who struggle with deep acne scarring like icepick or pitted acne scars due to the specialised focal technique that regular lasers can’t reach. TCA CROSS can be employed as a single-method treatment on patients with mild to moderate acne scar types or light icepick acne scars. More often, TCA CROSS is used in combination with treatments like laser resurfacing or fractional microneedle radiofrequency to treat acne scars and improve overall skin texture.
TCA CROSS is performed either by a toothpick or syringe technique depending on your condition. There is minimal difference in terms of the outcome when comparing both techniques but syringe tends to be more precise due to the finer needle vs thicker toothpick.
After cleansing the patient’s face to remove any impurities and to facilitate absorption, an applicator is used to insert the TCA within the base of the selected scar tissue. The treatment area will turn white (frost), which means that the proteins in the skin are destroyed. The frost will disappear in 20 to 30 minutes. This process is repeated to treat each scar individually.
Patients might feel a warm heating sensation, but it is generally well tolerated by most individuals. Mild redness may persist for several hours after the procedure, but an antibiotic ointment will be applied to facilitate scar healing and to reduce the risk of infection.
TCA is a safe non-toxic chemical that has bee used to perform skin peels for most than 10 years. However, some rare side effects include temporary skin redness/swelling, skin colour changes (hyperpigmentation), poor response to the treatment (possibly due to delayed collagen synthesis) and infection.
Downtime after the TCA CROSS treatment is minimal. Patients might experience some redness that lasts 3-5 days. Pain is minimal.
Depending on the severity of the patient’s acne scars, TCA CROSS can take one to several treatments. Generally, patients can expect a 1 to 2-grade improvement in their acne scars over three to six TCA CROSS treatments within a 6-month period. A 4 to 6-week interval between treatments is required to allow for skin healing, rejuvenation, and collagen remodelling.