TCA — CROSS, and how it works for Ice Pick Scars
Part IV . Acne Scar Revision Guide — The Complete Series
Here’s an image of the ice pick scar from my previous post in this series of acne scar treatment posts.
The problem with the ice pick scar is not so much its depth, or its shape — but it very sharp margins, which make it very visible. And since they tend to be often numerous, this can mimic a premature ageing of the skin with its appearance of widened and loose pores.
The TCA CROSS is a pretty simple procedure. The concentrations of Trichloracetic acid used vary all the way from 50 to 100% in different studies. In my practice, I adjust the concentration to skin quality — thickness, and maturity of the skin. The TCA is applied to the depth of the ice pick scar using a tooth pick, with the aim of bringing up the collagen all around the well of the scar.
This is a very popular technique, primarily where no lasers or Microneedling Radiofrequency (MRF) equipments are available. It is relatively less expensive, and the post procedure care is quite doable as well.
However, we hardly do any TCA CROSS these days, at my practice. Reason being — Radiofrequency Microneedling and Fractional Carbondioxide laser are two procedures that can do the work of TCA CROSS, much more efficiently, and with much less downtime. Most importantly, post inflammatory dyspigmentation (both darkening as well as lightening of skin) which is a very real problem with TCA, is not at all an issue with MRF and frac CO2. Instead, we combine the regular TCA peels with the laser/ MRF procedures for better resurfacing and finish.
So to conclude, definitely a pioneer of a technique, but then there are much better options available now. More about these techniques, in the posts to come.
If you liked reading these articles on procedural dermatology, do let me know by clapping for them. I post this information here for my patients to browse, before and when they take up scar treatment procedures. Your dermatologist may have a different take on procedures and treatments, and your clinic may have a different algorithm too. As acne scar revision treatments depend on a lot on experience, and our learning from our patients — it s best to be guided by your dermatologist at all times.
