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Hi All, I have some queries in regards to TCA Cross. FYI, I have no intention of doing TCA on my own without professional help. I just want to get more info. So please do share if you have the knowledge on my queries below

1. How long would the Cross completely dried up, not transferring to surrounding skin even if the area is wiped? Is there any correlation with the percentage used ie. lower percentage dried up faster?

2. If the Cross area is frosted, does it mean it dries up completely?

3. is it alright to wipe the Cross area with peeling solution (low TCA Cross % and low peeling%) afterwards, would there be possibility the Cross "spilled over" to surrounding skin?

4. what would happen if the Cross spilled over to the surrounding skin area? Would it "dissolve" the surrounding area and could create shallow crater?

5. i read that TCA Cross could be used on certain wide box scars too. What is the max size/shape of this wide box scars to be ideally treated with TCA Cross and could we do Cross all the way until the box scars filled up because the bottom would rise up and the box scars are getting shallower?

Edited by poorbunny888
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10 hours ago, Jack817 said:

Do not DIY TCA 

I do not have the intention of doing it myself. Just want to get some additional info so if you have any knowledge on my queries, please kindly share.

Thanks

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Here's my non-expert opinion on this:

Generally you wait a few mins after applying TCA on your face.

Once it's frosted you can wash your face with water. After that you wipe your face with a towel and apply some vaseline/aquaphor.

Wouldn't doing the reverse be better? Do a low% peel on your face and then a higher one on a specific scar. You wouldn't be spreading it to surrounding areas then.

Yes, there's a possibility that if it spills over it may create a new scar. That's why you need to be very careful with percentages above 50%. You can easily botch your skin if you/your derm don't have the right technique.

Per Dr davin lim TCA cross works very well for narrow boxcars with defined edges and icepick scars/scarred pores.

All this said and done if you're doing it yourself I'd urge you not to try more than 50% on yourself. It needs some technique. Even Dermatologists mess this up.

Edited by scarryface
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Before I answer, I would like to emphasize that applying TCA is not as easy you think. For those who have experience with this procedure, you know it's nearly impossible to apply just to the pits and avoid the surrounding areas. Also it's very time-consuming. If you only had a few scar, then it's no problem. But those with widespread scars, you can forget about it. You would be doing this all day and still not get done. It's just not practical, either for you or the doctor.

  

On 11/22/2020 at 3:02 AM, poorbunny888 said:

1. How long would the Cross completely dried up, not transferring to surrounding skin even if the area is wiped? Is there any correlation with the percentage used ie. lower percentage dried up faster?

I don't know if I completely understood your question, but here it goes. TCA, unlike other chemical peels, need not be neutralized. If self-neutralizes once coagulation (frosting) takes place. This takes about 15 seconds. Unless you apply so much TCA to the point of running down your face, there's no need to worry about whether it "dries up faster" or not. This pretty much applies to the entire spectrum, whether it 35% or 100%.

On 11/22/2020 at 3:02 AM, poorbunny888 said:

2. If the Cross area is frosted, does it mean it dries up completely?

Yes. Again, you shouldn't need to wipe TCA off your face.

On 11/22/2020 at 3:02 AM, poorbunny888 said:

3. is it alright to wipe the Cross area with peeling solution (low TCA Cross % and low peeling%) afterwards, would there be possibility the Cross "spilled over" to surrounding skin?

You can reapply (double coat) using the same concentration or lower concentration. 

On 11/22/2020 at 3:02 AM, poorbunny888 said:

4. what would happen if the Cross spilled over to the surrounding skin area? Would it "dissolve" the surrounding area and could create shallow crater?

TCA is known to widen scar. That is from the way it interacts with the skin (coagulation and denaturation), and not due to spill-over effect. Speaking from experience, there were a lot of times when I've applied TCA to the "healthy" skin and nothing happened.

On 11/22/2020 at 3:02 AM, poorbunny888 said:

5. i read that TCA Cross could be used on certain wide box scars too. What is the max size/shape of this wide box scars to be ideally treated with TCA Cross and could we do Cross all the way until the box scars filled up because the bottom would rise up and the box scars are getting shallower?

That's up to your doctor to decide. Currently, medical literatures claim TCA Cross is only effective on icepick scars.  

However, I'm of the opinion that it is effective for all types of scars. That's all I will say, otherwise, I might piss some people off.

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@scarryface @Sirius Lee

Thanks so much for responding and sharing your  knowledge. I really appreciate it. The reason behind the queries was because I just did a combination of treatment of Fractional ER YAG (Dermablate) + TCA Cross  + light peel. Additional information I received after the treatments from the derm assistant, the TCA they used is not pure, they mix it with other ingredients (she only mentioned Mandealic Acid). The percentage of the TCA Cross itself was mentioned by the derm during the treatment as 7%, done 2 passes total +/- 15% and the derm described it as pretty strong (I'm a bit confused with the percentage as I think derms use at least 70% so initially i thought that's what he meant but then after knowing the TCA is not pure then the percentage wise might be different).

The "light peel" after TCA Cross was described as to neutralize the TCA Cross. The assistant also mentioned the neutralize is needed so the frosting would not go deeper (only few frosted and they're the deeper ones). When the derm treated the deeper scars, he was quite taken that they frosted straight away. When I questioned further is it good or bad, he vaguely responded "Maybe". The assistant then mentioned, she used it with no frosting at all. 

I would say I'm pretty pleased with the 1st combined treatments. It gives me more visible improvement than the previous Dermapen + PRP , 5 sessions with little to no improvement!. These 1 combined treatments already yield around 15-20% improvement with all TCA Cross treated areas have responsive results. Well all but 1 area have a slightly lesser wanted result hence my queries. I attach pic.

The 1st pic was the deepest box scar (saucer type) circled in red. It frosted straight away during TCA Cross application. 

The 2nd pic was few hours after treatment. The red circled area was the area of the deepest box scar. See the enlarged pigmentation compared to the size of the box scar treated. BUT the frosting area was just the box scar. Somehow the area below it got slightly more pigmented too and becomes slightly depressed. I'm not sure is it because of the neutralized solution after the Cross made the Cross wiped down a bit? but 15seconds should pass before they "neutralize" the area. 

The saucer scar itself improved significantly with now almost having the same size with the scar next to it. I would have to ask my derm to treat just the saucer one with TCA on next appointment as they're adjoined and at risk of emerging together if not careful. @Sirius LeeAfter experiencing it myself, I agree that TCA Cross is effective on all type of scars actually but the wider the scar with less edge would be at more risk of overspilling hence, ones with narrow depth are preferrable. It's very cost and time effective too. you mentioned nothing happened when you spill them, did you wipe them  directly or put some kind of neutralized solution?

I will post my result close to my next appointment since it's less than 1 month after treatment, i just get back to the retinol usage and it could bring much more improvement, hopefully to the slight depressed area i mentioned above too. i plan to get back for 2nd treatment after 2 months. 

The biggest box scar treated by TCA Cross.jpg

Few hours after treatment.jpg

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