Precare – TCA Cross Information Sheet

This precare document is designed to give you information about the procedure, including what to expect, how to prepare, and the potential risks and benefits. If you have any questions after reading this, please don’t hesitate to contact us.

What is TCA CROSS?

TCA CROSS (Chemical Reconstruction of Skin Scars) is an in-office procedure designed to treat deep acne scars (ice pick scars) by applying a very small amount of high-strength trichloroacetic acid (TCA) directly into each scar. The acid triggers a controlled wound-healing response that encourages collagen production and improves skin texture over time. This technique allows us to target individual scars, making it particularly suitable for treating deep, narrow scars that do not respond well to other treatments.

What effects does TCA CROSS have on the skin?

TCA CROSS can help to to improve acne scar depth and appearance, and reduce the visible contrast between scarred and healthy skin.

How is the procedure performed & does it hurt?

The skin is cleansed and prepped before treatment. Using a fine applicator (such as a toothpick or needle tip), a tiny amount of high-strength TCA is applied precisely into each scar. This produces an immediate white frosting effect, followed by controlled healing over the next few days.

The procedure may cause a mild stinging or burning sensation for a few seconds per application, but discomfort is usually very manageable and subsides quickly.

The procedure typically takes 15–30 minutes, depending on the number of scars treated.

Can it be performed on any skin colour?

TCA CROSS can be used safely on all skin types, but patients with darker skin tones may be more prone to pigmentation changes, such as post-inflammatory hyperpigmentation (PIH), which can take several months to improve. Your doctor will advise on how to minimise this risk e.g. sun protection and potentially skin lightening creams.

How often can the procedure be repeated?

We recommend starting with 3–6 sessions, spaced 4–6 weeks apart, depending on the severity of scarring and your skin’s healing response. Improvement is gradual and continues over several months as collagen production builds.

What is the downtime after a TCA CROSS treatment?

After treatment, each scar will develop scabbing or crusting that typically resolves within 1-2 weeks.

You may experience:

• Skin sensitivity during the healing phase
• Redness of the treated areas (this may last for several weeks)
• Mild swelling or irritation
• Dryness or flaking
• Darkening or lightening of the treated areas (this may last for weeks or months)

Makeup should not be applied until the scabs fall off naturally. Sunscreen must be worn daily.

Risks of post-treatment infections?

As long as post-care instructions are followed, the risk of infection is low. Treated areas are small and isolated, and they typically heal quickly without complication.

Is there anyone who is not suitable for treatment?

You should not undergo TCA CROSS if:

• You are pregnant or breastfeeding
• You have active skin infections or cold sores (herpes simplex)
• You have a history of keloid or abnormal scarring
• You have used oral isotretinoin (Roaccutane) in the past 6–12 months
• You are on immune-suppressive medication or have an immune-compromising condition
• You have open wounds or irritated skin in the treatment area
• You are allergic to TCA or any components used in the procedure

What precautions should I take before my treatment?

• Avoid active skincare ingredients (AHAs, BHAs, retinoids, vitamin C) for 5–7 days before treatment
• Do not perform any facials, peels, laser, waxing, bleaching or hair removal treatments for 1–2 weeks before your appointment
• Avoid excessive sun exposure for at least 5 days prior to treatment
• If you are prone to cold sores, start a preventive antiviral medication up to 5 days before and after treatment (ask your doctor in advance)
• Arrive with clean, makeup-free skin
• Allow adequate healing time if you have upcoming events or occasions, as scabbing may be visible for up to 2 weeks