TCA Cross for Acne Scarring

TCA CROSS stands for trichloroacetic acid chemical reconstruction of skin scars and provides the perfect solution for atrophic (ice-pick, rolling or boxcar) acne scars. This technique applies high concentration TCA within the affected acne scar, resulting in chemical reactions that cause local inflammation. Inflammatory processes such as these stimulate the production of new collagen fibres that change the appearance (and depth) of the acne scar. TCA CROSS is usually combined with other treatments to improve facial skin texture and tone.

Consider TCA Cross as the first step in removing deep scars and sealing open pores.



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  • TCA peels also effectively and safely address sun damage, wrinkles and hyperpigmentation
  • Can be performed on the face, neck and chest areas
  • TCA peels should always be prescribed by a specialist dermatologist
  • Recovery and results depend on the concentration of TCA used and the treated area

Deep acne scars and the bottom of enlarged pores lie much deeper than the safety zone of lasers.  CO2, erbium and Fraxel lasers are all capable of reaching these depths but not in compliance with stringent safety standards.

TCA Cross overcomes this problem through the application of an acid that targets the scar and stimulates collagen production that raises the scar. You will notice a difference even after a single treatment. Deeper ice-pick scars require 2-3 treatments before they reach the ‘safe to laser’ mark.

Our dermatology specialists select a concentration of TCA ranging from 35% to 100% dependent on your skin colour and acne scar depth.

An examination and map of the to-be-treated area is made by a specialist prior to any scar revision treatment. Scar sites are assessed and photographed. Your treating dermatologist will discuss your options for each scarring type.

The TCA Cross treatment is carried out by a specialist dermatologist trained in this technique. Using an applicator, TCA is injected into the base of each deep acne scar. The procedure is well tolerated with minimal pain and only takes between 5-15 minutes to perform. A healing balm and face wash is prescribed for use after the procedure.

We  recommend 2-3 treatments at 8 week intervals for deep scarring.

‘Shallow scars and rolling scars are best treated with fractionated lasers/Fraxel; deeper scars such as ‘ice-pick’ acne scars are best treated with TCA Cross or punch excision.’ Dr Davin S. Lim

No. The treatment is slightly uncomfortable but not painful. To date, our specialist dermatologists have carried out 1500 TCA Cross procedures and none have required a local anaesthetic. The procedure can be compared to ‘nettle stings’ or small ant bites and is over within minutes.

This is the most effective treatment for deep and ice-pick scars. Laser treatments are not able to safely reach the bottom of an ice-pick scar. TCA can.

Remember, TCA Cross is often a preceding step before laser treatment as this procedure raises scars closer to the surface and into the safe range of laser beams.

Recovery is quick and painless. Treated areas are initially white for several hours, then each treated area (1-2mm) remains red for 3-4 days. This redness will then be shed or peel off. Full recovery is expected within 5-7 days; however, residual redness may need a week or two to disappear. Sun protection is vital during the entire recovery period.

Yes. All skin types can be safely treated with TCA Cross. Darker skin types such as Asian, Middle Eastern or Latino have an increased risk of post-treatment darkening where treated areas maybe darker than the surrounding skin for weeks to months. The use of sunscreen and a bleaching cream can reduce this effect. Your specialist will discuss this with you upon assessing your skin type.

Treating darker skin types at Cutis Clinic uses a modified TCA Cross technique that lowers the risk of side effects; darker skin therefore requires one or two more treatments to achieve optimal results.

Yes. In some cases pore size can be reduced by TCA Cross. You will need 2-3 treatments for a 30-50% reduction in pore size.

The larger the pore, the greater the improvement.

Please contact us for pricing.

2-4 treatments are recommended for optimal results.

This procedure is often combined with specialist surgical scar revision- Medicare rebate may apply in these cases.

Trusting a physician to revise scars can be a daunting experience. As acne scars can be a complex mixture of scar types, specialists should be  laser trained procedural dermatologists  equipped with the expertise and the latest technology to produce optimal results.

At Cutis Clinic, all TCA treatments are performed by our highly qualified dermatologists. You will always be in safe and experienced hands.

Call us directly to make an appointment or to discuss issues regarding the referral process. For unbiased opinions on acne and acne scar revision, ask your GP for a recommendation.

TCA Cross is our favourite treatment for acne scar revision because it works so well and is predictable in the excellent results it delivers. The deeper the scar, the better it works. Patients notice the difference after a single treatment and are eager to see the further effects of another 1 to 2 sessions. Our patients have described the procedure as relaxing and well tolerated. In our specialists’ hands, TCA Cross really works!


Dr Davin S. Lim
Laser Dermatologist
Cutis Clinic

TCA Cross is a simple, proven and safe procedure  ideally suited to treating deep acne scars. Even with the invention of complex lasers such as  fractional lasers, TCA plays an important part in ice-pick scar revision. Patients who have suffered from acne often have several types of scars including rolling scars, ice-pick scars, box scars and bound scars. Optimal treatment involves combining laser, subscision, TCA chemical peel and punch excision treatments for the best results.

Personally, TCA Cross is my favourite procedure; it is relaxing for both doctor and patient and is well tolerated with very predictable results. Furthermore, it can be performed on all skin types including Asian and very dark skin types.

Patients should view this treatment as the very first step in the treatment of deep acne scars and enlarged pores. Once the scars have risen to a level that is safe for laser use, I initiate CO2 or erbium laser treatment to finish the job. In some cases, up to 80% scar improvement can be seen after this deep scar program.