Have you heard about TCA CROSS?
TCA means trichloroacetic acid; it’s an acid popular for its use as a chemical facial peel. It has been used to reduce skin pigmentation but is now also used in the dermatologist’s office to treat scars. The procedure is called ‘chemical reconstruction of skin scars’ or CROSS, hence the name TCA CROSS.
What is it for and how is it done?
This is typically done for post-acne scars, some of which appear like box cars or ice picks.
The procedure involves application of high concentrations of TCA focally on the atrophic acne scars. The higher the concentration of TCA, the deeper it reaches beneath the scar. Your skin will then develop some discoloration and heal in a few days to weeks. Repeat application may be done as deemed necessary by your dermatologist.
How does it work? TCA induces inflammation followed by collagenisation, leading to a reduction in the appearance of scars and cosmetic improvement. Inflammation is often misunderstood as harmful; but it is actually how our body gets on the road to recovery. In this case, the skin is stimulated to undergo a healing process so that it can ‘bounce’ back.
The results? Well, these are what I found from some published studies online: there was a decrease in the depths of acne scars and increase in collagen fibers histologically. The dermal volume is increased and elastin fragmentation and reorganization was also seen. This means that the fibers making up our supportive connective tissues are multiplying or getting thicker, bringing back our skin’s previous appearance. There are tons of online images of before and after TCA application. Here’s one of them and it’s pretty amazing:
Drawbacks, you ask? Perhaps, it’s the downtime of waiting for healing to happen as well as the initial discoloration. Compared to other methods, the healing from TCA CROSS is rapid and associated with fewer complications since the chemical is applied specifically to the scars, sparing normal tissue around it. Despite the high concentrations, it is still safe to use because of its self-neutralizing property (it doesn’t get absorbed into the circulation).
So for people contemplating on whether to use it or not, the best advice I can give is to do your research first. It is also best if you consult a dermatologist since he/she can gauge the severity of your scars. Good luck and hope to hear from someone with a success story!
Bhardwaj, D. and Khunger, N. (2010). An Assessment of the Efficacy and Safety of CROSS Technique with 100% TCA in the Management of Ice Pick Acne Scars. J Cutan Aesthet Surg. 2010 May-Aug; 3(2): 93–96.