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TCA CROSS is a great treatment for acne scars & enlarged pores. This cost-effective procedure shallows even the deepest scar. It is frequently combined with fractional lasers for better outcomes.

Key Points

  • TCA is the best treatment for ice-pick, boxcar acne scars & deep wide-open pores
  • The application method & concentration depends on your skin type
  • Recovery is fast, typically 3-5 days
  • Combination treatments with fractional CO2 lasers gives faster results
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TCA CROSS at a glance

For: Ice-pick scars, enlarged pores
Procedure time: 10-30 minutes
Duration of results: Permanent
Back to work: 2-5 sessions
Recovery: 3-5 days
Anaesthetic: Nil
Your specialist: Dermatologist, nurse
How much: $

Our results speak for themselves



Acne scars treatment cutis dermatology brisbane 19

Laser Resurfacing, TCA CROSS/Paint. For mature patients, dermal fillers provide scar support.

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    Acne scars treatment cutis dermatology brisbane 38

    TCA Paint- CROSS can treat box car & ice pick scars.

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      fractional laser brisbane treatment cutis dermatology brisbane 1

      TCA CROSS & Fractional CO2 laser. Simple combinations can give good outcomes.

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        What type of acne scars respond to TCA CROSS?

        Traditionally TCA has been used to treat ice-pick scars, however our group has published new research on using a modified technique called TCA Paint to treat boxcar scars, linear & undifferentiated polymorphic scars


        This technique is now practiced by dermatologists in Australia & internationally.

        Can scars completely disappear with this method?

        Yes, appropriate scar types can be totally erased with TCA. The number of sessions depends

        on the depth of the scar & your expectations. 

        How would I know if this technique is best for my acne scars?

        It’s hard to match your scar pattern for an optimal treatment. Let our experienced nurses help you. They offer a FREE* consultation service & have over 6 years of experience in acne scar revision. 



        If you have complex acne scars, book to see one of our dermatologists at Cutis, consultation fees apply. 


        *T&C applies. 

        Is the TCA CROSS/Paint painful?

        No, we use local numbing gel prior to the procedure. At most, pain is a 2/10…& that’s only for 10 seconds. 



        Skin heals painlessly over the next few days after the procedure.

        How long does it take to heal?

        Healing is predictable with TCA & goes like this-


        • First 30 minutes; white dots
        • First 3 days. Open erosions the size of the scar treated
        • 3-6 days. Crusts over
        • 6+ days, fully healed



        Redness & post inflammatory hyperpigmentation takes 2-8 weeks to fully settle.

        Sunscreen/makeup can be worn on day 6.

        How many sessions will I need?

        2 to 5+, depending on the following factors-


        • Depth of your scars
        • Width of your scars
        • Your skin type, darker skin types, lower concentration, more treatments
        • Combination treatments such as laser can accelerate the results
        • The activity of acne, if you have background inflammation, it can double the time needed
        • Your skin’s health, namely if you smoke, it may take triple the number of sessions
        • Your expectations & goals

        How much is it?

        • Prices start from $130* per area**. It is super affordable, & in cases of deep ice pick scars THE treatment of choice. *This is performed by our lead nurses at Cutis Dermatology. They have had over 6 years’ experience in this technique. To see if this is the CORRECT treatment for your scars, book a nurse consultation. **Area defined as one cosmetic unit. A cosmetic unit is each cheek, temple, forehead, nose. Discounts apply for multiple cosmetic areas treated.


        Medik8 Physical Sunscreen SPF50+

        Dermaceutic All Things Pigment 21 Day Kit

        TCA CROSS & the more effective paint technique was invented by our dermatologists. Our work has been published in leading journals internationally. TCA is best for ice-pick, box car as well as undifferentiated superficial acne scars. 

        What other procedures do we combine TCA CROSS with?

        We combine procedures as indicated; this means we target your scar pattern with-



        • Lasers; including CO2, erbium, hybrid, non-ablative, pico & vascular
        • RF energy devices including Genius, Infini RF
        • Subcision
        • Excision

        Can TCA CROSS be combined with microneedling?

        Yes, but laser resurfacing is much more effective. Fine spot lasers can deliver the beam to the side walls of scars, whilst micro needling cannot. 



        Lasers provide controlled heating, & thus are much more effective at producing collagen.

        What are the side effects of TCA?

        Side effects are uncommon, but include-



        • Infection- rare
        • Hypopigmentation- 1 in 10,000 in our hands
        • Scar widening- less than 1%
        • Post inflammatory pigment changes lasting greater than 2 months



        The biggest concern we have is not with the side effects, it is the activity of your acne. 

        Procedures work so much better if there is no background inflammation.

        Can all skin types be treated with high strength TCA?

        Yes, skin types 1-6, namely fair to dark can be treated with this technique. For darker skin types we-



        1. Modify the concentration
        2. Commence on bleaching creams
        3. Modify the application techniques



        For darker skin you will have post inflammatory pigmentation for a period of 2-8 weeks. We will warn you of this prior to any treatments. You do have the option of going for a weaker concentration, but this will triple your treatment sessions.


        If you are concerned about PIH, we have pico lasers that can efficiently remove pigment within 2-3 sessions. 

        What scar types are not treatable with TCA CROSS?

        TCA is only indicated for certain scar patterns. Scars that are not amenable to this treatment include –



        • Rolling scars
        • Large volume atrophic scars
        • Hypertrophic scars
        • PIE, PIH, hypopigmented scars

        What is better phenol or TCA for acne scars?

        We use both, but our group has published our findings on TCA. We find it more effective, with a very low side effect rate. Our concentrations vary from 70 to 100 % TCA.



        If you have had phenol in the past (mostly US patients from California), & have had good results, we can use this chemical- it’s not a problem if you think this treatment is better for your skin type. 

        What to consider if you are thinking about acne scar revision?

        It’s an investment in your time, effort, & money, so you want to get it right the first time around. Here are some pointers-


        • Absolute control of acne. This means no active disease. If you have inflammation, your skin’s collagen generating potential is markedly decreased.  If you still suffer from acne, or nurses & dermatologists will find effective solutions for you.
        • Scar typing is the second step. TCA is only indicated for sharply demarcated scars. If you have other types including bridging, saucer, rolling & large volume atrophic scars, TCA  is not for you.
        • Revision methods; are then matched to the scar types.



        At Cutis we employ an array of revision methods including fractional ablative, fully ablative, hybrid, non-ablative lasers as well as vascular & pico lasers. We also use microneedling, RF microneedling, phenol & retinoid peels, & surgical methods including subcision with cannula, tri beveled instruments, Taylor dissectors, Toledos, Nokor, cataract blades, & RF assisted devices. Surgery includes punch excision, elevation, ellipse excisions, micrografting & many more.

        • Downtime. It will take a minimum of 3 days to heal. You can wear tinted sunscreen or special makeup 48-72 hours post-treatment.
        • PIH or post-inflammatory hyperpigmentation is expected after TCA if you have darker skin types. It can last 2, up to 8 weeks or more depending on your sun exposure. This can easily be treated with pico lasers.
        • Experience. Cutis Dermatology is an internationally recognized destination for scar revision. Our dermatologists are internationally renowned for their work & skill sets, as well as their ethical approach to scar revision.

        Can you perform TCA at home?

        Not a good idea. TCA at concentrations over 35% have traditionally been used by dermatologist & plastic surgeons. 



        Accidental spillage can often result in-



        • Spread scars, namely scar widening & worsening
        • Post inflammatory hyperpigmentation lasting > 2 years
        • Post inflammatory hypopigmentation lasting a lifetime
        • Post treatment redness that persists for >12 months
        • Keloid & hypertrophic scars



        Our group sees half a dozen DIY mishaps on a yearly basis as well as side effects from other cosmetic practitioners. 

        We run a nurse-led acne scar revision clinic to keep things affordable, so don’t be tempted to DIY – it is much harder than it looks. Stay safe. 

        Ask us more about this treatment

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