TCA Cross Acne Scar Treatment

What is TCA CROSS for Acne Scar?

Chemical Reconstruction of Skin Scars (CROSS) with Tri-Chloroacetic Acid (TCA), is a simple but effective procedure to treat atrophic acne scars. We prefer using this technique to treat ice pick scars.

TCA Cross Singapore for ice pick scars

How does TCA CROSS work?

Tiny amounts of concentrated TCA (70 to 100%) is applied onto the surface of the atrophic scar. This causes an inflammatory reaction in the area, leading to collagen remodelling.

This collagen remodelling and skin regeneration resurface the skin; resulting in the depression becoming shallower and scar shadowing lightened.
It’s important to note that it is not possible to restore the scarring to its former state.

However, a combination treatment with Fractional CO2 Laser, Subcision and Fillers can improve your final results.

How is TCA CROSS performed?

TCA liquid toothpick procedure

Depending on the number of scars, this is a relatively simple procedure that can be completed in a matter of minutes.

  1. An assistant will clean and prepare your skin for treatment.
    The doctor dips a blunt pointed instrument (usually a toothpick) into the TCA liquid and the excess is removed.
  2. Avoiding sensitive areas like your eyes and nostrils, the doctor applies TCA to the deepest surface of your atrophic acne scars.
  3. There will be “frosting” or white spots over the scar, usually within seconds of application of TCA.
  4. The doctor repeats the application for your remaining acne scars.


What are the pre- and post- treatment instructions?

Pre- Treatment Instructions: Always inform your doctor of all medications, including supplements you may be taking as well as your medical history. If you have had cold sores, you must also inform the doctor at least a week before as preventive treatment may be required.

Plan ahead. Schedule your treatment at least 1 week and a half prior to any special event as it may take 7 days or more for full recovery. Avoid any ablative lasers and/or excessive sun exposure/sun tanning at least 1 month before treatment.

Post- Treatment Instructions:

TCA Cross frosting spots
  • Frosting spots can last up to 12 hours.
  • The skin around the treated spots will turn red and sore for up to 2 days.
  • Tiny scabs will develop 2 to 3 days later, and fall off after another 3 to 7 days.
  • Use a gentle cleanser during the recovery period. We do not recommend applying any makeup.
  • Always use sunscreen to reduce the risk of post-inflammatory hyperpigmentation (PIH).

How many treatments are required?

We recommend a minimum of 3 treatments done at a 4-8 week interval for optimal results.

What are the risks?

Although rare, some risks may include:

  • An extended period of skin irritation and redness.
  • Damage and potential scarring of sensitive skin areas if TCA is accidentally deposited.
  • Temporary hyperpigmentation (PIH) or permanent hypopigmentation.
  • Scars coalescing into larger scars.
  • Skin discolouration, mainly in darker-skinned individuals.

Who is suitable or unsuitable for TCA CROSS?

TCA CROSS is suitable for any healthy adult looking to treat deep ice pick scars.

It may be unsuitable in the following circumstances:

  • Unrealistic expectations or those seeking complete elimination of acne scarring or returning to a previous look.
  • History of forming hypertrophic scars or keloids.
  • Current or recent (within 12 months) of systemic oral retinoid medication.
  • An active bacterial or viral infection.
  • Active acne close to the site of treatment.
  • Allergy to trichloroacetic acid.
  • Hypersensitive skin.

How much does it cost to get TCA CROSS?

TCA CROSS is priced from $300 at SL Aesthetic Clinic.

[12 May 2020] Written by Dr. Gabriel Wong

Medical Aesthetic Doctor

Dr. Gabriel Wong – Photographer Enthusiast
MBBS, Singapore

Having graduated from the Yong Loo Lin School of Medicine – Dr Gabriel Wong worked in several hospitals in Singapore where he honed his medical acumen.

Fate was at work when he met Dr Kelvin Chua, which sparked his interest in aesthetic medicine.

Growing from strength to strength under the tutelage of Dr Chua, Gabriel developed an eye for detail and beauty – perfectly in tune with aesthetic medicine, a confluence of art and science.

He applies this in a range of non-invasive procedures such as Botox treatments, soft tissue augmentation (Dermal Fillers with the Cannula Method), skin rejuvenation with lasers (Fotona5D Laser Lift), and effective acne and acne scar treatments (Fractional CO2 Laser, subcision).

In his free time, Gabriel loves to travel in search of that perfect snapshot. His works of art have won praises by many patients.

For more information, write to .
To contact Dr Gabriel Wong, write to .