Skin Wellness 

Center for Advanced Dermatology and Laser
Board Certified Dermatologists

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 GloriaTooto
10:14 AM on August 16, 2019 
Useful information, I will follow the topic
Reply LindsayRip
7:26 AM on August 15, 2019 
Useful information, I will follow the topic
Reply Stevgono
10:22 AM on August 2, 2019 
Zithromax Price Walmart Viagra Per Ragazzi Medicina Levitra
url= says...
cialis generic
Achat Alli Online Viagra Prescription
Reply Stevgono
6:42 AM on July 30, 2019 
Cheap Viagra Pleasure Get Legally Amoxicilina Website Overnight Shipping Amex Store
url= says...
Fluconazole Buy Amoxicillin Dosage And Administration
Reply TutuDoke
5:23 AM on April 6, 2019 
Today anyone has an Android phone all across the world. This has lead to developing a millions of apps that provide servises such as games, entertainment playgrounds and others. To download this applications a user must get an account at Google Store. But not all apps are available there as they don't meet the Android rules. To combat this a new app was developed named TutuApp. This helper works on Android run phones and tablets and it has the biggest library of APK games. We name a few: Clash of Clans, Pokemon and many others. They come with zero ads and locked content! Whant to know more? Visit TutuApp Helper for Android to download Tutu App APK for free on your Android phone. Installation instructions for TutuApp Helper are available at that page.
Reply GregoryHer
8:30 PM on January 14, 2019 
Eharmony online dating:
1.html says...

Asian free dating site online
url= says...
Free online dating site
40668.html says...

Secret online dating
- Sdfrankl, 31st October

932288.html says...

Online scam dating format

.html says...

Is online dating successful

-47382.html says...

Free online dating games rpg

url= says...
Reply opaline
2:47 AM on July 4, 2018 
Hi! Look at an important offering for you.
Reply BoveLox
2:52 AM on July 1, 2018 
If you need something super new? Take a look at this website. Only here the choice of money making jobs for every unique and completely free! They are cool opportunities to make implement for anything you will buy !
Reply Stormy
7:48 PM on January 15, 2018 
best us casinos online
vegas casino games
casino online for fun
casino g
Reply Princess
11:05 PM on January 3, 2018 
payday loans online no credit check
online loans for bad credit
payday loans bad credit
online loans direct lenders
Reply Keren
1:13 AM on December 2, 2017 
Hello can you tell me the rates for this..i am interested in thia when i go home to philippines
Reply StephenUnoma
2:42 PM on November 2, 2017 
Your Rights to know the uses of Zyloprim, Visit now
now buy Tadalafil Super Active on easily and cheaper. is on Top Rank at google for searching Vantin 200mg online
There are several Online pharmacies where you can buy Viagra Professional online but you will always find cheaper prices at
Valtrex 500mg for sale at Online pharmacy Book your Product now. provides you appropriate information regarding the side effects, Product compositions and usages.
Reply RonaldWek
5:51 AM on September 3, 2017 
This Article is associated with the United States Healtcare Business and Revenue. United States Healthcare is a grooming Business of the world.
Investment in this Business can grow up your own Business faster than the other Business, even the Revenue of United States Healthcare is more than the few countries like India, Korea, Japan etc
Basically this Business is divided into few major sections. 1. Insurance 2. Pharmacy 3. Physicians 4. Hospitals. you can contact to any of the Hospitals for getting the Business outsourced to you
Pharmacies, You can supply medicines to the United States Pharmacies, Hospitals and Physicians such as Blood Pressure medicines, Cancer medicines, Birth Control medicines, Condoms, Erectile Dysfunction medicines (Prodcuts like Viagra, Cialis and Levitra), Creams, Eye drops, Anti Diabetic medicines, Antibiotics and many more.
So there are several opportunities to grow up your Business within the USA or if you are from out of United States than of course you can fulfil the legalities and earn good amount.
Reply Stevynden
3:22 AM on August 26, 2017 
Hello. And Bye.
Reply MichaelOrinc
1:25 AM on August 26, 2017 
Дешево Steam key
Reply Robcrtrek
7:57 AM on August 20, 2017 
Hello. And Bye.
Reply Ashiadoq
11:42 AM on August 17, 2017 
can you use domperidone and metoclopramide together albuterol sulfate for sale
Reply Miguelriz
2:59 PM on August 14, 2017 
Xanax is an effective Medicine to deal with Anxiety.
Xanax Online Pharmacies sells these pills on cheapest prices
Xanax effects effeciently.
Alprazolam means Xanax in USA is prescription Free.
Xanax comes in the form of Xanax Bars and Xanax pills
Now You can Buy Xanax Online worldwide
and Yes Can Buy Xanax Legally by showing your prescription.
In reality cheapest Xanax are available in Market
Xanax High is the High demand of the Patients
What does Xanax do in terms of curing the sleepless nights
Xanax recreational use are easy
Xanax addiction is also a probability for Xanax customers
Xanax and Alcohol must not be together
GG249 and Yellow Xanax are the best generic Xanax
Xanax comes in two strength, Xanax 2mg and Xanax 1mg
Xanax composition is know as Alprazolam
Some companies prepare generic Alprazolam in Alprazolam 3mg strength
Always go for Alprazolam 2mg and Alprazolam 1mg

You can Buy Xanax Bars Online at
Reply Richardlop
6:52 AM on August 13, 2017 

Cialis Pharmacy is the best online pharmacy to buy cialis .
Why they are best to buy cialis online because
they have several branded cialis and generic cialis and the cialis price is cheaper than the other pharmacy.
Cialis is better medicines to treat ED Problems from Viagra and everyone can buy cialis online. We have measured the cialis cost is much lower with

More References :-

canadian pharmacy cialis
tadalafil online
generic cialis online
cialis online pharmacy
tadalafil generic
online cialis
cost of cialis 5 mg
discount cialis
generic tadalafil
cialis from canada
where to buy cialis
cialis prices
cialis generic name
cialis on line
cialis discount
cialis prescription
buy tadalafil online
generic for cialis
cialis 5mg price
buy tadalafil
cialis for sale online
Reply Bobbiepap
11:46 AM on July 26, 2017 
Проблема многих нынешних женщин в том, что все они инициативно примеряют на себя мужские позиции. Женщины уже забыли о женственности, преобразились в бизнесвумен. Именно по этой причине в обществе довольно сильно выросло количество разводов, разрушенных и несчастливых семей. Попытаемся разобраться, как это – являться женщиной?

Подробнее как выбрать цвет комнаты