Is TCA Cross effective for deep acne scars?

Doctor's Answers (1)

There are actually a few types of acne scars – you’ll need to determine which type of scar you have to get the right treatment. Atrophic, hypertrophic, deep box scars, wide shallow scars each require a different treatment approach to achieve optimal results.

TCA CROSS is a good first-line treatment for many types of acne scars, especially ice pick scars. Ice pick scars tend to be quite difficult to treat, due to its depth and narrowness (they are more narrow and deep than they are wide). See picture:

TCA Cross (Cross = Chemical Reconstruction Of Skin Scars) involves using a toothpick/needle to place TCA 100% solution within the ice pick scar. This leads to improvement of the scar from new collagen formation.

Immediately following application, treated areas turn frosty white, and then crusts over the next few days.

You’ll typically require about 2-3 sessions, 4-6 weeks apart to allow for healing and new collagen formation. The deeper and narrower the scar, the better the results.

This study linked HERE reviewed 36 different studies on acne scar treatment techniques. It found that TCA CROSS achieved >70% improvement in 73.3% of patients.

One treatment generally improves the scar by 30-40%. Another effective method for treating ice pick scars is to use a 2 mm punch excision.

You’ll likely get the best improvements for deep acne scars when you use a combination of different types of treatment: eg. TCA cross in conjunction with Infini micro-needling, subcision, etc. Your doctor will be the best person to advise you on this after assessing your scars.

The main stumbling block for you is that not many clinics in Singapore offer TCA CROSS, as it can be quite time-consuming to perform, and can potentially worsen existing scars if done by someone inexperienced.

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