Is TCA CROSS the Right Treatment for Me?

There are several factors to consider in deciding whether or not TCA CROSS is the most suitable treatment option for you and your skin. TCA CROSS is particularly effective for deep, narrow scars such as ice pick scars or boxcar scars, and may not be as effective for rolling, or tethered scars.

TCA CROSS works best on patients who are in good health, stable skin without active acne, and realistic expectations about the results. It is important to note that skin types and color also play a role; individuals with darker skin tones may have an increased risk of post-inflammatory hyperpigmentation and should discuss this with their provider.

Every individual has a unique profile of acne scarring, so it is vital to consult with a qualified dermatologist who can help form a personalized treatment plan. To determine if TCA CROSS is recommended, your specific scars, skin type, and medical history should all be taken into account. Taking all of these factors into consideration ensures that you receive the most appropriate and effective treatment for your skin concerns and acne scarring.

What is the Downtime After TCA CROSS Treatment?

The length of recovery for TCA CROSS varies based on skin type, treatment extent, and TCA concentration, but is generally much quicker than other acne scar treatments. Most patients can expect the recovery timeline to span a few weeks, as the skin heals and rejuvenates the acne scars. Below is a sample of what post-treatment may look like: 

• Immediate Post-Treatment (Days 1-3): The treated acne scars will likely turn red and may feel tender to the touch immediately after the TCA is applied. In addition, small crusts or scabs may start to form over the treated areas. 
• Early Healing Phase (Days 4-7): The redness and swelling will begin to die down and the scabs will dry out. At this stage, it is important to let the scabs fall off on their own and refrain from picking.
• Mid-Recovery Phase (Week 2): Most scabs will have fallen off naturally by the second week. New and healthier skin will continue to form from the peel, appearing pink and tender. 
• Continued Healing (Weeks 3-4): Any residual pinkness will begin to fade during this time as the new skin gradually heals, blending into the surrounding areas.
• Long-Term Healing (Month 2 onwards): Collagen production and remodeling continues for months after the chemical peel, further smoothing and improving the skin’s texture.

During recovery, it is important to follow all aftercare instructions provided by your dermatologist, including avoiding direct sun exposure and using recommended products to support healing and prevent complications.

How is TCA CROSS Applied?

TCA CROSS is a meticulous chemical peel procedure that requires precision and care by a trained dermatologist. Here is a step-by-step summary of how the chemical is typically administered:

1. Preparation: The skin is cleansed to remove any oils, and an antiseptic is applied to reduce the risk of infection. The area is then dried completely to ensure the peels adheres properly.
2. Application: Using a fine-tipped instrument, such as a toothpick or a small, sharp applicator, the dermatologist carefully applies a small amount of high concentration TCA directly into each scar. This minimally invasive technique confines the peel to the scarred tissue thus sparing the healthy surrounding skin.
3. Neutralization: Unlike some other chemical peel procedures, TCA self-neutralizes, so no neutralizing solution is applied. The reaction stops once the desired depth is reached with minimal discomfort.
4. Immediately After: The treated skin may frost or turn white, which indicates that the acid has penetrated the skin’s surface. This frost typically subsides within a few hours.
5. Monitoring: The dermatologist will monitor the reaction and the treatment response, adjusting the application if necessary according to your skin type during subsequent sessions.

What Happens During TCA CROSS Treatment?

Patients may experience a brief stinging sensation as the trichloroacetic acid chemical is applied to the acne scars. After being treated, the acne scars will appear slightly red and swollen with small scabs eventually forming. These TCA CROSS chemical reconstruction scabs will naturally shed within about a week.

As your skin continues to heal, your acne scars will gradually improve and full results will develop over several months as your skin undergoes collagen remodeling. Your dermatologist will provide TCA CROSS aftercare instructions to aid healing and ensure the best outcomes for your acne scars, helping you understand how to care for your skin during the recovery process.

Instructions for Recovery

Proper post-care is essential after undergoing TCA CROSS treatment to ensure the best results for your acne scars and minimize potential side effects. Here are key guidelines to follow:

• Avoid Sun Exposure: Protect the treated acne scarring areas from the sun as UV exposure can exacerbate skin discoloration. Use a broad-spectrum sunscreen with at least SPF 30, and consider wearing a hat or seeking shade when outdoors to further shield your skin.
• Use Lightening Creams if Recommended: If you have a darker skin tone or have a history of post-inflammatory hyperpigmentation, your dermatologist may prescribe a lightening cream. Apply as directed to help manage and prevent uneven skin tones.
• Leave Scabs Alone: The scabs that form over the treated acne scars are part of the healing process. Picking at them can lead to scarring and infection. Allow the scabs to fall off naturally to ensure the new skin underneath can heal smoothly.
• General Care: Keep the treated acne scarring area clean and moisturized. Avoid using harsh products that can irritate your face. Stick to gentle, non-comedogenic products during the recovery process.

Following these instructions carefully will help manage the TCA CROSS healing process and enhance the effectiveness of the treatment, while protecting your skin from long-term complications of chemical peel treatment.

How Many Times Do I Need TCA CROSS Done?

The number of TCA CROSS treatment sessions required can vary significantly among patients, depending largely on the severity and types of acne scarring, such as ice pick and atrophic scars. Most patients typically undergo multiple sessions of TCA CROSS to achieve optimal results, especially for deeper ice pick scars.

It is important to note that significant improvement is often gradual and may require several sessions. Given the diverse nature of acne scars, combining TCA CROSS chemical peels with other treatments is commonly recommended for comprehensive acne scar revision.

Integrating techniques like microneedling, laser treatments, and subcision enhances the effectiveness of combination therapy, addressing various aspects of scarred skin. Sessions are spaced several weeks apart to allow sufficient healing time and to maximize the response of your acne scars to treatment. Your acne scar specialist will monitor progress closely and adjust the treatment plan as necessary.

Combinatorial Treatments with TCA CROSS

For the best results, the TCA CROSS procedure can be combined with other dermatological treatments that address different elements of acne scarring. Here are four treatments that are frequently combined with TCA CROSS chemical peels to see further improvement:

1. Subcision
2. Fractional Laser Resurfacing
3. Platelet-Rich Plasma (PRP)
4. Microneedling

TCA CROSS can play a significant role in treating your acne scars, whether they are deep acne scars, ice pick scars, atrophic scars, or rolling scars. Reach out to our specialist in acne scar treatments today to discover one of the most effective solutions available to patients in Tustin!