What is TCA CROSS Peel?

​TCA CROSS stands for TRICHLOROACETIC ACID (TCA) CHEMICAL RECONSTRUCTION OF SKIN SCARS (CROSS). It is one of the most successful treatments for deep acne scars such as ice pick scars, boxcar, and rolling scars. By using a very strong acid, placed directly in the scar to promote dermal remodeling.

What causes acne scars?

Inflammation is the single greatest reason for acne scar development. Consequently, the extent of scarring is associated with acne severity and delay in treatment. Each scar is different and therefore requires a customized approach.

Acne scars are currently classified into 3 different types:

1. atrophic
2. hypertrophic 
3. keloidal

A net destruction of collagen in the dermis results in atrophic scarring. It can be further classified as ice-pick (narrow and deep, 60%), boxcar (1.5-4 mm wide, 25%) or rolling (15%). Ice-pick (deep pit) scars are frequently the most severe, and, unfortunately, represent around 2/3 of cases.

The Chemical Reconstruction of Skin Scars (CROSS) technique is very effective for ice pick and deep scarring. They also tend to work well for boxcar and deep rolling scars. Three to four treatments at monthly intervals will serve many patients well.

What is the process for the TCA CROSS Peel?

• You will be in a comfortable semi-recumbent position during the procedure.
• Your skin is cleansed
• A high-strength TCA peel (50-100%) is focally applied to the base of your scars to ablate the epithelial wall and to promote dermal remodeling.
• The degree of clinical improvement is proportional to the number of sessions.
• Excellent results can be seen in almost all patients after 3-6 sessions.
• Treatment is very well tolerated.
• Treatment sessions are typically 20 - 30 minutes.

What is the recovery time after TCA CROSS Peel?

​This is a minimally invasive procedure, with little downtime or recovery. Almost everyone returns directly to normal activities following treatment. You may have scabbing, blistering or swelling for 7-10 days after the procedure. 

How do I prepare for the procedure?

• Avoid tanning and direct sun exposure for 2 weeks prior to each treatment
• Apply a sunscreen with SPF 30 or greater every day for the duration of treatments.
• Discontinue use of any products containing alpha hydroxy acids (such as glycloic and lactic acids) and prescription retinoids (such as Retin-A, Renova, and Tazorac) 2-3 days prior to treatment.
• Treatment areas must be free of any open sores or skin infections.
• CONTRAINDICATIONS: Pregnancy, breastfeeding

What are the after care instructions? ​

• Frosting of the scar surface will last up to 12 hours.
• Treated areas may feel sensitive, tight, or dry and may appear pink, red, and slightly swollen for 24 - 48 hours
• After 2-3 days a small scab will develop, which falls off after 3-7 days.
• Discomfort is rare, and may be alleviated with over-the-counter acetaminophen (Tylenol) or with the use of a cool compress 15 minutes every hour a few times per day.
• Avoid becoming overheated, perspiring excessively, using hot tubs, steam rooms, saunas, or excessively hot showers in the first few days after treatment, as this may promote blistering and increase the risk of complications.
• Apply only post-procedure topical products as instructed.
• Regular home skin care products (including alpha hydroxy and retinoic acids) may be resumed 1-2 weeks after treatment or as suggested, usually after your skin returns to normal.
•  Moisturizer may be applied twice a day or more frequently as needed for hydration and to decrease the appearance of flaking.
• During the healing process, avoid picking, scrubbing, exfoliating, or abrading sensitive or peeling skin as this may result in irritation and increase the risk of pigmentation changes and scarring.
• Mineral makeup may be applied after the treatment if desired. It is preferable to apply makeup the day following treatment.
• Avoid direct sun exposure and tanning bed use for 2-4 weeks after treatment and use a broad spectrum sunscreen with SPF 30 or greater containing zinc or titanium daily to minimize the risk of pigmentation.
• Avoid hot tubs, swimming, and other water activities for 1 week.
• Avoid electrolysis, facial waxing, or the use of depilatories for 2 weeks after treatment.

What are some of the potential side effects? ​

There are several potential side effects of the TCA CROSS Peel that are usually temporary. These include but are not limited to the following:

• Prolonged redness or swelling.
• Treated areas may feel sensitive tight, or dry and may appear pink, red, and slightly swollen for 24 - 48 hours.
• After 2-3 days a small scab will develop, which falls off after 3-7 days.
•  Discomfort is rare, and may be alleviated with over-the-counter acetaminophen (Tylenol) or with the use of a cool compress 15 minutes every hour a few times per day.
• Allergic reactions.
• Blistering.
• Visible flaking/peeling
• Hyperpigmentation or hypopigmentation
• Acne outbreak or the activation of recurrent viral infections such as herpes simplex may occur.
• Infections or scarring
• Suboptimal response or lack of improvement in scarring

What are some additional procedures that can enhance the results of my acne scar treatments?

To enhance the results of TCA CROSS Peel, Stem Cell microneedling and Picosure laser treatments can be used to augment and accentuate your results.

Are you in interested in TCA CROSS Acne Scar Reduction?

Schedule your consultation now by calling us at 760-337-8500 or click below to schedule your cosmetic consultation online.

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