TCA Cross technique is the application of Trichloroacetic Acid 100% into ice pick or boxcar scars, stimulating collagen production in the scar. It is very effective but may need to be repeated multiple times, typically 3 times. Patients can experience significant improvement. It is safe in all skin colors however one must be careful in darker skin individuals.

TCA Cross Chemical Peels Santa Monica

In darker skin individuals, a test spot is performed. If there are no side effects, then the TCA CROSS technique can be performed on the entire face. Bleaching cream can be used before and after the procedure.

Facts on TCA Cross chemical peels and acne scars

  • Deep acne scars, such as ice pick scars can be very difficult to treat and do not respond to laser treatments
  • TCA Cross chemiacal peel method does not treat the full face, however TCA is placed in focal areas of acne scarring
  • In specialist hands, results are excellent. Patients will require two to three treatments for best outcomes
  • Treatment with the TCA cross method is well tolerated and recovery is quicker than with laser treatment
  • TCA cross can be used on all skin types, including darker skin patients
  • In darker skin types, temporary darkening of skin can be seen for several weeks or months following TCA Cross peels, light skin types recover much faster
  • We combine TCA CROSS with other treatments such as Fractional laser, full laser resurfacing and RadioFrequency treatments for scar revision

What types of acne scars respond best to TCA CROSS peels?

  • Ice pick scars
  • Mixed acne scars
  • Enlarged pores

How does the TCA cross chemical peel work for acne scars?

TCA, or Tri-Chloroacetic Acid, applied at a very high concentration stimulates collagen formation from the bottom of a deep acne scar. This collagen formation is gradual, and over 2-3 treatments, collagen fill up from the depths of the pick scar. The concentration of TCA will vary between skin types, and depth of scarring. TCA CROSS at the Acne Specialist Clinics range from 30% TCA to 100% TCA.

How is TCA cross performed?

Scars are mapped an photographed before any treatment. This provides a record for both patients and the treating Dermatologist. Under sterile conditions in a procedural room, the treating Specialist uses an applicator to instill a tiny amount of TCA into the base of the scar. Each scar is treated individually. On average it take between 20-30 minutes to perform a session of TCA cross. The procedure itself is very well tolerated, with little discomfort.

After the procedure we use a healing balm or an antibiotic ointment to cover up the treated acne scars.

You will be prescribed an antibiotic to take for 5-7 days following TCA Cross, as this can prevent any secondary infection.

Deep ice pick scars respond poorly to Fraxel/ Fractional lasers. TCA cross is the treatment of choice for deep scars like this.

How long will I take to recover from TCA cross chemical peels?

Immediately following TCA cross, the treated skin turn white. Over a few hours, the area becomes much redder than the surrounding skin. Pin-point areas surrounding the treated area may peel over the next 3-4 days. The skin slowly returns to its normal colour over 8-21 days. In darker skin patients, pigmentation changes maybe more prolonged. It is essential that sun exposure is avoided in all patient for at least 2 weeks following a TCA chemical peel.

Recovery is also dependent on the strength of the TCA CROSS chemical peel- a higher concentration means a longer recovery time.

How many treatments will I need?

As with many other acne scar treatments, multiple sessions are advised for the best results. As a guide we encourage patients to complete 2-3 sessions, over a period of 3-4 months.  Very deep scars can be treated with surgical techniques during the time of TCA Cross, whilst laser can also be conducted during the procedure. Individualized treatments will give the best results.

How much will my acne scars improve with TCA cross?

As a guide we should aim for at least 50-80% improvement of deep ice pick scars after a series of 2-3 TCA cross chemical peels. Scar specialists do not recommend fractional laser resurfacing for deep ice pick scars, as TCA peels or punch surgical excision out performs lasers in this setting. Once deep acne scars are raised up to form a shallow scar, we then use laser to complete the scar revision process.

Can lasers be combined with TCA cross?

Yes. Specialist often combine a number of techniques to give the best possible results to patients. We can combine subscision, punch excision, punch elevation, laser and TCA cross. Remember, most patients will have a number of different types of scars, and hence a combination of treatments will be needed.

TCA cross for acne scars forms an integral part of our Program for acne scar revision. The concept is to map and treat each scar individually, using the best method available for the scar type. Once the depth of scars are in the same plane, laser treatment can finish off the treatment.

Is TCA cross chemical peel safe in dark skin types?

TCA cross can be used to treat acne scars in all skin types. Darker skin patients may develop slight darkening of the treated skin (1-2mm areas), but this fades over a period of weeks. Occasionally post treatment darkening may last a few months. The use of sunscreen after this procedure is very important.

Treating acne scars in darker skin types can be more challenging as post -treatment darkening of the skin can be encountered. As a guide, Specialist recommend that an extra one or two treatments be performed, as a lower concentration of TCA is used in darker skin patients. Often we will prescribe a bleaching agent before and after the TCA Chemical peel procedure, as this can fade darkened scars.

What is the cost for TCA cross procedure for acne scars?

The cost of this procedure will vary depending on the complexity of scars and the areas treated.

*Medicare rebate may apply for some treatments

We offer payment plans for acne scar treatments.

More on cost and payment plans for patients

Why choose a Specialist for TCA cross chemical peels treatments for acne scars?

Trusting a physician who is an expert in acne scar revision can be daunting for many patients. Remember, there are many types of acne scars, in different skin types. Cosmetic and laser dermatologists are equipped with training, expertise and the latest technology to deliver the best results to patients. The doctors at Acne Specialist Clinics are doctors who undergo Specialist training in dermatology and then further their skin training in treating acne scarring.

Our Specialists have extensive training in the treatment of acne scars in darker skin patients, including Asian, Hispanic, Middle Eastern, as well as African skin types.

Dr Ben Behnam
Consultant Dermatologist
Acne Specialist