TCA Cross for Acne Scars
TCA Cross, or trichloroacetic acid chemical is an advanced procedure to treat acne scars.
Dr. Rapaport has mastered the application of TCA cross for the treatment of acne scars for more than 30 years. TCA cross treatment makes skin texture smoother and more attractive by encouraging the development of new collagen, which lessens the appearance of scars. Applying trichloroacetic acid directly to acne scars with a toothpick or other small applicator is known as the TCA cross treatment. For atrophic acne scars like boxcar and icepick scars, TCA cross is the most effective treatment. In order to get the best possible cosmetic outcome and avoid any unintended consequences like hyperpigmentation or scarring, it is always advised to undergo TCA cross-treatment with a skilled board-certified dermatologist like Dr. Rapaport in New Jersey.
In order to lessen acne scarring, Dr. Rapaport uses the most advanced procedures and tools available. He has been recognized by Castle Connolly and Super Doctors as one of the greatest dermatologists in New Jersey for his skill and commitment to patients. When you see Dr. Rapaport, he will customize a treatment plan specifically tailored to your skin type, skin tone, and the kinds of acne scars you currently have.
What is TCA Cross?
TCA stands for trichloroacetic acid, which is the chemical that Dr. Rapaport uses for TCA cross therapy and chemical peels. The term “Cross” refers to a technique for chemically reconstructing skin scars that involves injecting potent trichloroacetic acid directly into atrophic scars. A Korean dermatologist created TCA Cross many years ago, and it works particularly well for healing scars left behind by ice-pick acne. TCA Cross is mostly used for rolling acne scars, boxcar scars, and ice-pick scars. Tiny amounts of TCA are applied directly to the atrophic scar’s surface in high concentrations (70–100%). Stimulating the creation of new collagen and elastin is the aim of TCA Cross. For the best cosmetic outcomes, TCA Cross can be used on the majority of skin types (skin types 3 and darker are not acceptable candidates). Three to five treatments spaced six to eight weeks apart are usually recommended. TCA Cross is an even more effective treatment than Fraxel (TM) laser treatments for certain patients with atrophic scars. TCA Cross treatments provide very little discomfort and are both safe and effective.
What are the 3 main types of acne scars?
- Atrophic scars: These can be further divided into ice-pick scars (60%, narrow and deep), boxcar scars (25% and wide), and rolling (15% ). Ice pick scars can be some of the most difficult acne scars to treat.
- Hypertrophic scars
- Keloidal scars
How is the TCA Cross technique performed?
TCA Cross does not treat the surrounding skin; rather, it targets the depression or scarring area directly. The entire skin surrounding the atrophic scar is preserved when the acid is applied directly to it using the edge of a syringe, toothpick, or applicator. Box car scars, noticeable pores, and deeply open pores can all be treated with TCA Cross. These deep ice-pick scars can be treated with up to 100% TCA, depending on the type of acne scar and the type of skin. After the surgery, the recuperation period is typically shorter than one week. To prevent hyperpigmentation, it is advised to use specific emollients and sunscreen following the treatment in addition to avoiding the sun entirely. It usually takes three to four treatments, depending on your skin type, to enhance the cosmetic appearance of your acne scars.
How does TCA Cross work for ice-pick scars?
- TCA Cross should not be performed on skin that is sun damaged or has recently had laser treatments, microneedling, chemical peels, or other skin treatments.
- Discontinue use of all Retinols, Retinoids, Tazorac, alpha hydroxy acids, or exfoliants for 3 days before TCA Cross is performed.
- Patients with darker skin types may need to pre-treat with skin-lightening creams for several weeks before the procedure. TCA Cross is not suitable for skin types 3 or darker.
- Patients should avoid tanning and direct sun exposure for 2 weeks before reaching treatment.
- Refrain from wearing makeup or using other skin care products on the day of the procedure.
- At the start of the procedure, the skin is degreased with alcohol before applying any trichloroacetic acid.
- Photos are taken of the treatment area to document the procedure’s progress.
- Each scar is carefully treated with between 50 and 100 % TCA, and each area is neutralized with water directly after treatment.
- After the acid is applied, you will observe frosting of the skin where the treated area initially turns white and later red.
- Each atrophic scar is treated with the acid on a wooden applicator, toothpick, or insulin syringe.
Does TCA Cross work for acne scars?
Yes. In many cases, TCA Cross treatment works better for certain atrophic acne scars than laser treatments. Darker skin types may need to use a 50% TCA solution to treat their scars, as opposed to 100% TCA in lighter skin patients. Due to the weaker strength of an acid in darker skin tones, more TCA Cross treatments may be needed to reduce unwanted acne scars. The TCA concentrations differ, and the correct strength is based on the type of scar and the skin type of the patient. Meticulous treatment must be performed using TCA Cross to prevent pigmentation changes or worsening of acne scarring. Hydroquinones are commonly prescribed by Dr. Rapaport in darker-skinned patients to be used before your treatment and for several weeks after TCA cross to prevent and treat resulting hyperpigmentation.
What is the difference between a trichloroacetic acid peel (TCA peel) and TCA cross?
The main difference between TCA Cross and a TCA chemical peel is that TCA Cross treats individual acne scars with a very high concentration (50 to 100%)of trichloroacetic acid. A TCA chemical peel is generally at much lower concentrations, from 10 to 30%, and treats the entire face, chest, back, arms, or buttocks. TCA chemical peels treat discoloration, sun damage, actinic keratoses, hyperpigmentation, brown spots, sun spots, fine lines, wrinkles, and acne breakouts. Chemical peels are very effective in treating various skin conditions and generally require a series of peels to effect the most change. TCA peels improve skin texture, tone, and overall complexion. When you consult with board-certified dermatologist Dr. Jeffrey Rapaport in his private dermatology office in New Jersey, he will evaluate the types of acne scars present and recommend the acne scar treatments best suited to reducing their appearance and providing smooth, clear skin.
How many treatments of TCA Cross are needed?
For optimal cosmetic outcomes, three to four TCA Cross sessions are typically required. Individuals with severe acne scarring might require additional care. TCA cross treatments are to be given at least six to eight weeks apart. More than four sessions can be necessary for patients with deeper scars or darker skin tones. In order to achieve and maintain healthy, smooth, clear skin, Dr. Rapaport will collaborate with you to develop a customized treatment plan for skin rejuvenation that includes both in-office treatments and carefully developed skincare products.
How often can I do TCA Cross for acne scars?
It is recommended to postpone the next treatment session for 6 to 8 weeks following TCA Cross. During this time, the skin can recover, discolorations can be addressed, and the production of new collagen and elastin can begin. At each follow-up consultation, Dr. Rapaport will examine your skin to see how your acne scars are healing. Since a combination approach is the most effective in minimizing the appearance of scars and improving the texture of the skin, many patients with acne scars choose for it. Depending on their individual needs and concerns, patients using a combination acne scar treatment technique may undergo sporadic sessions of laser treatments, microneedling, or subcision with dermal fillers. Upon your consultation with Dr. Rapaport in New Jersey, he will collaborate with you to develop a personalized treatment plan and determine the most suitable treatment timetable.
Are the results of TCA Cross permanent?
Does TCA Cross hurt?
What is the downtime for TCA Cross?
What should I do post-op after TCA Cross?
Can I do TCA Cross at home?
No. TCA Cross uses a very high medical-grade acid that only physicians like Dr. Rapaport are licensed to use, requiring expert skill and knowledge to use effectively and safely. Serious and damaging side effects may result from improper TCA cross technique, including hyperpigmentation, hypopigmentation, and scarring. For this reason, it is always recommended to have TCA cross and other acne scar treatments with an experienced board-certified dermatologist, such as Dr. Rapaport in NYC.
What are the side effects of TCA Cross?
- One of the main potential side effects, especially in darker skin types, is post-inflammatory hyperpigmentation or PIH. Darker skin types are more susceptible to discoloration, especially when utilizing these higher-strength trichloroacetic acid solutions. This skin darkening can last for several months and fade over time. Many patients will use a bleaching cream with hydroquinone or Cosmelan for several months, a week after TCA cross, to treat this PIH. Strict sun avoidance is always necessary to lessen the side effect of facial discoloration and pigmentation.
- Hypopigmentation is a possible side effect and may be permanent.
- Increased acne scarring
- Infections
- Scarring
- Blisters
- Allergic reactions
- Peeling
- Acne breakout
- Activation of viral infections such as herpes simplex
Which procedures can be done with TCA Cross?
- Treating acne scars usually requires a combination of treatments. Although TCA Cross can be used alone to treat some patients with atrophic scars, many patients require a combination of treatments to have the best cosmetic results, including:
- Subcision
- Microneedling with Dermapen or Eclipse Micropen
- Platelet Rich Plasma facials
- eMatrix radiofrequency laser treatment
- Punch excision
- CO2 laser
- Erbium laser
- Erbium laser
- Bellafill
- Bellafill
- Hyaluronic acid fillers such as Restylane and Juvederm
- Laser resurfacing
- Vbeam laser treatment
Is TCA Cross the best treatment for all acne scars?
Acne scars are unique to each individual, and a customized treatment plan needs to be created for each patient. Dr. Rapaport will create a tailored treatment plan for you since each pattern of acne scarring needs to be based on your individual needs. Whether it be combining TCA Cross with punch excision or dermal fillers, or laser treatment, Dr. Rapaport will create the best treatment plan for you.
Am I a good candidate for TCA Cross?
Seeing a board-certified dermatologist and expert in treating acne scars, such as Dr. Jeffrey Rapaport, in person is the best method to find out if you are a good candidate for TCA Cross. He will examine the pattern of scars left by your acne and determine the most effective ways to help you treat these scars. Then he’ll create a customized treatment plan based on your particular requirements and aesthetic objectives. Note that skin types 3 and darker are not suitable for TCA Cross.
How to get rid of boxcar acne scars
Boxcar scars feature steep vertical sides and a rounded or oval look. The look of boxcar scars is wider than that of ice-pick acne scars. When inflammatory acne breaks down the skin’s collagen strands, boxcar scars appear. The lack of collagen causes this kind of acne scar to produce a depression in the skin. Because there is insufficient tissue support as a result of this collagen loss, the skin typically appears sunken. The depth of boxcar scars varies based on the degree of skin atrophy brought on by infected and inflammatory acne lesions. For patients with boxcar scars, Dr. Rapaport suggests a number of cosmetic procedures, including as TCA cross, dermal fillers, punch excision, punch grafting, and laser treatment. In your appointment with Dr. Rapaport for acne scar therapy, she will assess the sorts of acne scars you have and work with you to decide which combination of treatments will best address your unique skin issues, skin tone, skin type, and acne scars.
Can TCA cross make scars worse?
When you have TCA cross-treatment with a board-certified dermatologist, like Dr. Jeffrey Rapaport in NYC, the result is a smoother complexion and visible reduction in acne scars. Patients with a history of keloid scars should refrain from having TCA cross performed, as the procedure may worsen the appearance of the skin’s texture instead of improving it. An incorrect or poor TCA cross technique may cause the appearance of scars to worsen, which is why it is always recommended to have treatment with an expert, such as Dr. Rapaport. In some patients, the appearance of acne scars may slightly worsen before improving as part of the healing process. When you work with Dr. Rapaport for your TCA cross-acne scar treatments, she will regularly evaluate your progress to ensure you achieve and maintain healthy, smooth, clear skin.
Is TCA cross good for acne scars?
TCA Cross is a safe and effective treatment option for certain types of atrophic acne scars called ice pick acne scars and boxcar scars. Ice pick acne scars get their name due to their deep, narrow appearance and for looking as though they were created with a sharp puncturing tool, like an ice pick. Boxcar scars are round or oval-shaped in appearance and have deep vertical sides. Boxcar scars are wider in appearance than ice-pick acne scars. Typically, a combination treatment approach is required to achieve optimal cosmetic results. When you consult with board-certified dermatologist Dr. Jeffrey Rapaport at the Cosmetic Skin and Surgery Center, he will work with you to develop a personalized acne scar treatment plan best suited to your skin type, skin tone and types of acne scars you have to achieve and maintain healthy, smooth, clear skin that lasts.
How long does it take to see results from TCA cross?
It is possible to see the effects of a TCA cross-treatment in a matter of weeks. After the initial treatment session, some patients notice a noticeable difference in the way their scars look, while others might not notice a noticeable improvement for several sessions. Dr. Rapaport suggests a four-week interval between TCA cross treatment sessions so that the results can be assessed at each follow-up visit. Dr. Rapaport suggests stopping that course of therapy if, after the third session, there is no discernible improvement in appearance.
How many TCA peels to remove acne scars?
For the best cosmetic outcomes, patients with moderate acne scars often need three to six TCA cross or TCA peel therapy sessions. The severity of a person’s acne scars will ultimately determine how many treatment sessions are required. Individuals who have more severe or many scars will need more therapy sessions than those who have fewer and less severe scars. For the desired outcome, patients with severe acne scars might need more treatment sessions than usual. You will get the chance to talk in-depth with board-certified dermatologist Dr. Jeffrey Rapaport about your unique skin concerns and cosmetic objectives during your consultation at the Cosmetic Skin and Surgery Center in NJ. Together, you and Dr. Rapaport will develop a customized skin rejuvenation treatment plan that combines in-office treatments with carefully chosen skincare products to achieve and preserve healthy, clear, glowing skin.
Are TCA cross results permanent?
The aesthetic outcomes attained with TCA Cross are long-lasting. But TCA cross cannot stop the aging process from beginning in the first place or stop the skin’s natural collagen deterioration in the future. In order to retain the greatest cosmetic outcomes, many patients who receive treatment for acne scars eventually decide to undergo further skin rejuvenation procedures like microneedling, dermal fillers, laser treatments, and more. Board-certified dermatologist Dr. Rapaport will collaborate with you to create a personalized treatment plan that addresses your particular concerns and distinct aesthetic objectives, as well as a schedule for your treatments.
How much does TCA cross cost?
Ultimately, the final cost of TCA cross-treatment will be influenced by several contributing factors, including the geographic location of the office in which you are treated, the experience level of your provider, and the number of treatment sessions required to produce your ideal cosmetic results. Although it is often more costly to have acne scar treatment with a very experienced board-certified dermatologist, such as Dr. Rapaport in NYC, it is always recommended to have scar revision with an expert. Acne scar treatments performed incorrectly, poorly, or on the wrong skin tone or skin type can cause unwanted side effects such as hyperpigmentation and scarring. During your consultation for acne treatment with Dr. Rapaport in her private dermatology office, located in the Upper East Side neighborhood of Manhattan, you will discuss in-depth your medical history and any previous treatments you may have had. You will then have the opportunity to develop with Dr. Rapaport a customized acne scar treatment plan that works best for your skin tone, skin type, and the types of acne scars you have. At that time, the total cost of your acne scar treatment can be better estimated.