TCA CROSS Melbourne

What is TCA CROSS?

TCA CROSS stands for Trichloroacetic Acid Chemical Reconstruction Of Skin Scars. It was a technique that was first studied in Korea by Dr. Jung Bock Lee for the treatment of atrophic (indented) acne scars.

It involves the careful placement of trichloroacetic acid (TCA) into acne scars with a toothpick. This helps to re-organise the dermal structure and stimulate new collagen production to help to lift the indented scars back to the normal skin level.

Unlike chemical peels or laser resurfacing, TCA CROSS is a very localised treatment, and does not unnecessarily treat normal parts of the skin. This helps to significantly reduce the risks and side effects of the treatment.

What does TCA involve?

The procedure is a simple procedure, but needs to be done by a medical professional who is experienced in how to perform the procedure. It involves the administering high concentrations of trichloroacetic acid (TCA) from 65 to 100% to the scars with a toothpick. This needs to be done extremely carefully to ensure that the right amount of TCA is placed in the acne scar.

The procedure is only minimally uncomfortable, with most patients reporting a mild and temporary stinging sensation as the TCA works on the scars. Local anaesthetic or sedation is not required. The skin immediately appears ‘frosted’ after the procedure over the areas where the TCA is placed, and this quickly resolves. The skin then becomes red and small scabs form which naturally fall off after about seven days. New collagen develops in the treated areas, eventually leading to an improvement in the skin indentation.

The post-care involves putting an ointment such as Bactroban on the healing wounds for approximately one week, or until the scabs flake off. Dressings are not required.

Multiple sessions are required for the best results, and these can be spaced at least one month apart. The final outcome of the procedure is usually only seen after several months, as collagen production from the procedure is slow and ongoing.

What are the potential risks and side effects?

While TCA CROSS can be effective in stimulating collagen and improving skin texture, it is a targeted chemical treatment and carries some potential risks and side effects, particularly if aftercare is not followed properly or if the treatment is performed too aggressively.

Common side effects include:

  • Redness and inflammation: Mild redness and swelling at the treated site are common and typically resolve within a few days to a week.
  • Scabbing or crusting: As the treated area heals, a small scab may form, which usually falls off naturally within 5 – 10 days.
  • Mild discomfort or stinging: A burning or tingling sensation may be felt during and immediately after treatment.

Less common risks include:

  • Post-inflammatory hyperpigmentation (PIH): Especially in patients with medium to darker skin tones, the treated area may darken temporarily. Strict sun protection is essential to minimise this risk.
  • Hypopigmentation: In rare cases, treated areas may heal with lighter pigmentation, particularly if multiple high-concentration treatments are performed too closely together.
  • Infection: While rare, there is a small risk of bacterial infection if the treated area is not cared for properly during healing.
  • Scarring: Although TCA CROSS is used to improve scarring, improper application or picking at scabs can potentially worsen scarring or lead to new scar formation.
  • Prolonged redness or delayed healing: Some patients may experience slower recovery depending on skin sensitivity, concentration of TCA used, and other individual factors.

Aftercare instruction for TCA CROSS

  • Avoid picking or scratching the treated areas.
  • Use gentle skincare products as advised by your practitioner. Bactroban should be used for approximately one week following treatment.
  • Apply high SPF sunscreen daily to protect healing skin and reduce the risk of pigmentation changes.
  • Follow all post-procedure instructions provided by your practitioner.

Why choose Victorian Cosmetic Institute as your provider of TCA CROSS?

At Victorian Cosmetic Institute, our doctors are highly experienced in the procedure of TCA CROSS. We see and treat many patients with acne scarring and will be able to advise you on the most suitable treatment for your skin, and look at all the options we have available.

Phone our Customer Care team on 1300 863 824 to schedule your consultation, or you can book your appointment online.

Last updated May 2025