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TCA CROSS is the Chemical Reconstruction of Skin Scars (CROSS), using Trichloroacetic Acid (TCA). It is used to elevate atrophic or depressed scars and is usually used together with other scar treatments, including surgery, IPL, lasers and radiofrequency. Common causes of these atrophic scars are acne and chickenpox.


Please wear sunscreen every day, treatment may be cancelled if there is marked tanning or sunburn. Darker skin may benefit from using a bleaching cream nightly for 2 weeks before the procedure. If you have had cold sores, please tell me as preventive treatment may be required, starting the night before and continuing 2 x daily for a few days. A prescribed anaesthetic cream is sometimes used, please discuss with me. If so, apply a maximum of 5mls to clean, dry skin 45 minutes beforehand and extending 1cm outside the area to be treated.


Please come without makeup or sunscreen. Photos will be taken. Your skin is cleansed with alcohol and protective eye patches are applied. The TCA is applied to each scar and causes some stinging. Most people do not need any anaesthetic. The treatment will take 15-30 minutes. A white frosting of the skin occurs immediately. Antibiotic ointment or Vaseline is applied.


The white frost lasts up to 12 hours and is followed by 1-2 days of redness and soreness. After 2-3 days, a small scab develops and should be allowed to fall off by itself after 3-7 days WITHOUT PICKING. Subsequent redness takes up to a few weeks to settle. Darker skin often develops brown discolouration which may take several weeks to months to resolve and is treated with sun avoidance, sunblock and bleaching cream (Superfade or similar).

Cleanse your skin 2 x daily (Aveeno positively radiant or QV face gentle cleanser), gently pat dry and apply antibiotic ointment or Vaseline until the scabs come off. After this, sunscreen must be applied daily throughout the course of treatment and for 3 months afterwards to prevent pigmentation. Darker skin should have bleaching cream applied nightly.

Treatments are repeated every 4-8 weeks. Usually, 2-3 treatments are needed but 1-2 extra treatments are needed in darker skin as lower strength TCA is used. Improvement is a gradual process due to the body’s formation of collagen over the three months following the last treatment.


Some scars are resistant to treatment and may require a greater number of treatments or a change in the type of treatment. Complications are uncommon but may include prolonged irritation and redness, changes in colour (brownish discolouration is usually temporary but lightening may be permanent), permanent hair loss in the treated area, worsening of acne, infection and scarring, including joining together of adjacent scars to form larger ones.

If you have any questions or problems during the course of your treatment please call:
Adelaide Skin & Eye Centre 8211 0000 (Monday to Friday 9am to 5pm)