Jump to content
Acne.org
Search In
Find results that contain...
Find results in...
ObservantMoon

Is TCA Cross legit?

Recommended Posts

I know TCA cross has been around a while and a lot of people have tried it, but does it work? Dr Lim says he belives ice pick scars are the easiest to treat because tca cross works so well with lasers as well but im not able to really find any cases on the internet of people getting success with tca cross and im afraid about it making the scars wider or deeper.


thanks

Share this post


Link to post
Share on other sites

Of course TCA is "legit" please search for posts and read the accounts here on the fourm. Instructions are under the FAQ - first post, tca section, mega post link.

Yes it will make your scars wider, as it's morphing the scar to a more superficial textural issue to be resurfaced with laser or a peel. We're raising the floor of the scar. You then resurface with fully ablative erbium after several Crosses or tca peels.

Share this post


Link to post
Share on other sites

Oh, man, I love these Doubting Thomas's. >_<

Icepick scars were the hardest to treat in the past. Thanks to the daredevils who came up with new treatments like TCA Cross, largely bucking the status quo that always stand against new ideas, icepicks are now the easiest to fix.

Share this post


Link to post
Share on other sites

sorry i just wasnt aware because like @beautifulambition said there is a lot of people who post about tca cross and say that all it does is change the scar into a shallower but larger scar which is what confused me about the efficacy of it. Does this mean that tca cross is pretty much pointless unless you follow it with a laser to resurface the shallower scars?

Share this post


Link to post
Share on other sites
1 hour ago, ObservantMoon said:

sorry i just wasnt aware because like @beautifulambition said there is a lot of people who post about tca cross and say that all it does is change the scar into a shallower but larger scar which is what confused me about the efficacy of it. Does this mean that tca cross is pretty much pointless unless you follow it with a laser to resurface the shallower scars?


The simplistic view on the morphology of acne scar is that the more deeper scars such as the icepick, will get shallower with treatment. Hence, depending on how disfiguring the scars are, an icepick scar will morph into a boxcar and a boxcar into a rolling scar. So by the time you have reached the point where laser resurfacing is required, your icepick scar would look more like a shallow boxcar or rolling scar.

For more info on TCA CROSS, check out the following article.

Lee and colleagues reported the use of high-concentration trichloroacetic acid (TCA) applied focally to atrophic acne scars. The authors labeled this technique chemical reconstruction of skin scars (CROSS).2 The authors treated 65 patients with acne scars and Fitzpatrick skin types IV to V. The study demonstrated that 27 of 33 patients (82%) treated with 65% TCA and 30 of 32 patients (94%) treated with 100% TCA experienced a good clinical result.2 Outcome was based on clinical photographs before and after five to six treatments. Patient satisfaction was high and there were no complications.

Application of TCA to the skin causes cellular necrosis of the epidermis and necrosis of collagen in the papillary and reticular dermis. Brodland and coworkers3 studied the histologic changes and measured the depth of epidermal and dermal necrosis of 20% to 80% TCA applied to porcine skin. Brody4 studied the histologic changes of 35% TCA application to actinically damaged human skin between 3 and 90 days after peel. There are no reports of the histologic effects of acne scars treated with highconcentration TCA.


https://www.scribd.com/document/380436112/TCA-Cross

Share this post


Link to post
Share on other sites
7 hours ago, Sirius Lee said:

The simplistic view on the morphology of acne scar is that the more deeper scars such as the icepick, will get shallower with treatment. Hence, depending on how disfiguring the scars are, an icepick scar will morph into a boxcar and a boxcar into a rolling scar. So by the time you have reached the point where laser resurfacing is required, your icepick scar would look more like a shallow boxcar or rolling scar.

For more info on TCA CROSS, check out the following article.

Lee and colleagues reported the use of high-concentration trichloroacetic acid (TCA) applied focally to atrophic acne scars. The authors labeled this technique chemical reconstruction of skin scars (CROSS).2 The authors treated 65 patients with acne scars and Fitzpatrick skin types IV to V. The study demonstrated that 27 of 33 patients (82%) treated with 65% TCA and 30 of 32 patients (94%) treated with 100% TCA experienced a good clinical result.2 Outcome was based on clinical photographs before and after five to six treatments. Patient satisfaction was high and there were no complications.

Application of TCA to the skin causes cellular necrosis of the epidermis and necrosis of collagen in the papillary and reticular dermis. Brodland and coworkers3 studied the histologic changes and measured the depth of epidermal and dermal necrosis of 20% to 80% TCA applied to porcine skin. Brody4 studied the histologic changes of 35% TCA application to actinically damaged human skin between 3 and 90 days after peel. There are no reports of the histologic effects of acne scars treated with highconcentration TCA.


https://www.scribd.com/document/380436112/TCA-Cross


Can you please provide link/source to your following statement.


“””The simplistic view on the morphology of acne scar is that the more deeper scars such as the icepick, will get shallower with treatment. Hence, depending on how disfiguring the scars are, an icepick scar will morph into a boxcar and a boxcar into a rolling scar. So by the time you have reached the point where laser resurfacing is required, your icepick scar would look more like a shallow boxcar or rolling scar.””



I have researched TCA Cross for hours (including all the specialists comments (Dr Novick, Dr Lim. None of them mention anything about a ice pick scar forming to a boxcar after TCA Cross. Nor have a read this anywhere else online.


And before somebody says “that’s because they laser resurface after tca. Several if not most patients have success with TCA alone WITHOUT laser resurfacing. 

Share this post


Link to post
Share on other sites
4 hours ago, Johnjoeman said:

Can you please provide link/source to your following statement.


“””The simplistic view on the morphology of acne scar is that the more deeper scars such as the icepick, will get shallower with treatment. Hence, depending on how disfiguring the scars are, an icepick scar will morph into a boxcar and a boxcar into a rolling scar. So by the time you have reached the point where laser resurfacing is required, your icepick scar would look more like a shallow boxcar or rolling scar.””



I have researched TCA Cross for hours (including all the specialists comments (Dr Novick, Dr Lim. None of them mention anything about a ice pick scar forming to a boxcar after TCA Cross. Nor have a read this anywhere else online.


I'm sure it's there if you or I look hard enough, but I wonder if that is even necessary. For the moment, let's forget about "this guy said this" and "that guy said that"  and just analyze the morphology of each scar. Icepick has a V-shape, boxcar has a square shape, and rolling scar has a U-shape. With that in mind, what would happen to the icepick when TCA Cross is performed? Well, we already know that it elevates the pit and widens the overall scar shape. So we're essentially going from a deep V-shape to either a square or a U-share, more likely to be somewhere between boxcar and rolling scar. Also bear in mind, I'm talking about deep icepick scars. If you have a shallow icepick that looks more like enlarged pores, then that's another story.

 
4 hours ago, Johnjoeman said:

And before somebody says “that’s because they laser resurface after tca. Several if not most patients have success with TCA alone WITHOUT laser resurfacing.


Again, not if you have deep icepick scars. Even if you have moderate icepick, I don't think 1 session of TCA Cross is enough to fill the hole completely. There will be a sign of some wavy undulation similar to rolling scars. Anyway, these are mere my own useless 2-cents worth. I suggest you do your research and, as always, exercise due diligence before jumping on any treatment bandwagon.

Share this post


Link to post
Share on other sites

TCA cross widened and deepened a few scars for me. Again, maybe it's just my skin or whatever, but the whole science behind dropping acid in an already unhealed hole sounds pretty damn stupid to begin with. I would avoid it and even if you're desperate making things worse can be just as heartbreaking, especially with these scammer doctors all around trying to sell anything even if they make things worse.

Back in the day, my dermatologist was milking visits for 2 years and did not tell me about Accutane which cured me in a few months. So my scars got a lot worse. I have VERY little faith in doctors unless I do extensive research on the procedure first.

Share this post


Link to post
Share on other sites

I've been seeing Davin Lim talk about a procedure called TCA multi coat paint technique which seems to be a variant of CROSS, but with lower concentrations and is meant for boxcar scars. Unfortunately, I couldn't find much info about it other than some posts here and there as well as a couple of realself replies.

Share this post


Link to post
Share on other sites
3 hours ago, Raster said:

I've been seeing Davin Lim talk about a procedure called TCA multi coat paint technique which seems to be a variant of CROSS, but with lower concentrations and is meant for boxcar scars. Unfortunately, I couldn't find much info about it other than some posts here and there as well as a couple of realself replies.


Obiwan might be able to answer this more to the point, but I believe paint technique involves applying multiple coats of TCA at different concentrations. For example, you apply the first coat at 100%, frost, second coat 75%, frost...etc.

Share this post


Link to post
Share on other sites
20 hours ago, Sirius Lee said:

Obiwan might be able to answer this more to the point, but I believe paint technique involves applying multiple coats of TCA at different concentrations. For example, you apply the first coat at 100%, frost, second coat 75%, frost...etc.


NOT 100% or 75% MULTIPLE COATS. Sirius be more careful stating things such as %  even though it was just an ‘example’

Link below Dr Lim comments on he states that 30-70%

giving an example of 100% for multiple coats has the potential for somebody mis read and actually try it 

https://www.realself.com/question/los-angeles-ca-tca-cross-tca-paint-technique-difference
 

TCA CROSS vs other peels and paint

 1 

This technique of painting uses a needle - however others will use a different instrument including toothpicks. Picking the exact scar and amount of layering of TCA is vital, as is the concentration- the percentages I work with range from 30 to 70%, and the amount of multicoats range from 2-4. Painting a high concentration on a broad scar such as a chicken pox scar can worsen the scar. Ideally TCA should be used on deep narrow scars, however experienced specialist can extend the use and treat broad based scars in the correct setting. Dr Davin Lim. Brisbane. Australia. 

2764084277001_4150525564001_acne-640.jpg
Davin Lim, MBBS, FACD 
 104 reviews 
 
 TOP CONTRIBUTOR

Share this post


Link to post
Share on other sites

Dr Lim has explained it. The use of a lower concentration on broad based scars can help raise up box car scars. If a scar is too broad, surgical methods such as surgical elevation (not punch elevation) can help. TCA is a very useful tool in the correct hands, however picking concentration, amount of TCA or layering- coats, as well as the correct context of use- namely the scar type is super important. 

Share this post


Link to post
Share on other sites

It is exactly what happened to me, the boxcars became deeper and wider after Dr.Chu treated them with 90%tca. I asked if the lower concentration should be be used because it was boxcars not icepicks... so all the broad bottom was treated...No- was the answer... and Dr.Lim says clear that low concentration tca paint could be used for shallow broad chicken pox type scars...After the experience with Chu I trusted and who is highly reccomended here as scar revision specialist I have very very little faith in doctors.. 

I have tried 15%tca paint on one scar two coats after dermapen this scar 1,5mm with single needle...will see..

Share this post


Link to post
Share on other sites

Hi Dear @Sibel can I please know when did you have your TCA treatment that you’re saying your scars became deeper and wider?  And how many sessions did you have it? I have also done TCA cross on my scars by prof Chu.. so I’m curious these results that you have seen is how long post treatment? 

Looking forward to hear from you. 

Dear @harmlessboy1441 can you please say did you have TCA done on your scars by Prof Chu? And when was it done? Did they get better now because you said they became bigger and deeper? So they didn’t get better after they get bigger? Because after I had TCA, my scars are a bit bigger too and I don’t know if they will improve or not ..

Share this post


Link to post
Share on other sites

@Reinha, your spamming all the tca cross posts, this is not constructive, I left you a long response in your post. By design your scars are supposed to get wider with cross, several sessions. Eventually you resurface the skin when the floor of the scar has been lifted. If you do not like this I suggest you do nothing, or the more invasive surgical procedure of punch excision to deal with the scars, this highly depends on how you heal and it's best to see a very experienced surgeon, I never suggest this first as it's cutting - healing. 

Share this post


Link to post
Share on other sites

Just my experience, I had it done and I do think it helped a tiny bit (especially in combination with botox). I have a post about it so I won't go into a lot of detail. However, even though it did work pretty well, I still consider it a risky procedure and you're right to really do your research and seek out a professional. Best wishes to you.

Share this post


Link to post
Share on other sites
Posted (edited)

In hands of god-tier doctors like Davin Lim, its capable of doing miracles.  However people should not expect achieve this kind of results with normal doctors.

I think the technique of using  syringe droplets is the best one by far, because it will allow the TCA in its liquid form to concentrate and penetrate to break the tissue more agressively

Toothpicks often doesnt get deep enough because the TCA is partially dried in the toothpick, making it harder to evaluate how deep the TCA has penetrated in since even with a single mildly dried touch TCA at high percentages will make your skin frost, even if it didnt penetrate enough.

TCA seems to be easy to manage but unfortunately a average doctor that isnt specialized in it will not give you the best results because the secret relies on the concentration in the exact area and thats demand alot of experience

Edited by De Rerum Natura

Share this post


Link to post
Share on other sites

My tca cross 90% was done with the toothpick, some scars were missed, some were missing the edge..the scars got wider and stayed that way..I asked Chu twice about lower % for cross in my case or tca paint in lower % for boxcars...No answer unfortunately...

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


  • Personalized Advice Quiz - All of Acne.org in just a few minutes

×