• TCA Cross

    Chemical Reconstruction of Skin Scars

Acne scarring is a challenge for cosmetic dermatologists. Dr Hussein has carefully combined multiple techniques in order to manage this challenging this condition. His expertise in this area has been developed over many years and treating many challenging cases.

Ice pick scars are one of the most challenging types of acne scar to treat. These are small epithelial tracts within the skin. Techniques for treating these scars often involve physical removal of the ice pick scar with punch excision.

TCA CROSS is a technique used by Dr Hussein in the management of ice-pick acne scars. This technique involves application of 90% trichloroacetic acid (TCA). The high strength TCA is delivered using a fine 30G needle directly into the base of the ice pick scar/enlarged pore. This induces synthesis of new collagen, elastin and ground substance. The resultant skin thickening causes elevation and narrowing of the ice-pick scars.

This is a technique that requires up to six treatments at 4-6 week intervals in order to deliver marked improvements. Once this treatment is complete Dr Hussein will usually perform a fully ablative laser treatment with CO2 or Erbium YAG laser (depending on skin type). This will give the most optimal results.

Recovery after TCA CROSS

The procedure itself is quite tolerable and the time taken to perform it varies depending on the amount of scarring to be treated. Typically this is between 5-30 minutes. The patient will experience a mild burning and prickling sensation. It does not usually need to be performed with local anaesthetic.

Following the procedure the patient may develop crusts which will persist for about one week. The patient should not wash the face for at least 24 hours after treatment. Make-up should only be applied a week after treatment. Redness will be persistent around treated areas for several weeks. Patients should expect to have redness around the treated areas for the duration of all treatment cycles. This will eventually settle on completion of treatment.

Side-effects/Complications

The potential side effects that can result from TCA CROSS treatment are Post Inflammatory Hyperpigmentation (treated areas become darkened) and prolonged redness. However these side effects usually spontaneously resolve. Permanent redness or pigmentation is exceptionally rare. Redness can take up to 3 months to settle. Any post inflammatory hyperpigmentation will take several weeks to settle.

Follow-up & Laser resurfacing

TCA CROSS will usually form part of a treatment pathway for acne scarring that will usually followed by laser resurfacing. The resurfacing procedure will usually be performed 6 weeks following the final TCA CROSS treatment cycle. For lighter skin types Dr Hussein uses a fully ablative CO2 laser resurfacing technique. For darker skin types Dr Hussein uses a fully ablative Erbium YAG laser technique to further improve scarring. Both laser techniques can also be combined with fractional laser techniques if there are residual wide based intradermal atrophic scars remaining.