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Cross TCA Techniques

Acne sufferers are often left with scars, most noticeably on the face. Numerous treatments like chemical peels are available for scarring, depending on the type and severity. One agent used for chemical peels is trichloroacetic acid, or TCA. Chemical peels are not always appropriate, so a new method for using TCA has been developed. Known as Cross, or chemical reconstruction of skin scars, this technique involves the application of TCA directly to individual scars.

  1. Study

    • The Cross TCA technique was the result of a study by Drs. J.B. Lee, W.G. Chung, H. Kwahck and K.H. Lee of the Leejiham Skin Care and Department of Dermatology, Yonsei University College of Medicine. Their study was conducted in Korea between 1996 and 2001. The findings were reported in the November 28, 2002 issue of "Dermatologic Surgery." Their findings concluded that Cross TCA was a safe and effective method of treating acne scarring with no significant complications.

    Scars

    • The study from Korea referred to the acne scars as atrophic, indicating they were depressed, exhibited a loss of tissue or created indentions. The skin had basically wasted away. Not all acne scars are identical. Three main types include ice pick, boxcar and rolling scar. These descriptive names relate to the texture. Ice pick scars, known for being very deep, best respond to TCA treatment. The Cross TCA treatment has been shown to produce favorable results, according Dr. Christopher Harmon in "Dermatology Times."

    Technique

    • TCA was used for chemical peels prior to the Korean study. Problems arose with its use for deep scars, making it too risky. Deeper scars require higher concentrations of TCA. Those concentrations lead to scarring in some cases. The Cross method solves the problem with the use of a wooden instrument to apply TCA to the deep scar. The instrument is dipped in TCA and then pressed hard against the entire depressed area of each scar. Frosted white spots appear on each scar. TCA is only applied to the scar and not to any area of the face that is free from scars. Healing and recovery is quicker than full facial peels.

    Results

    • The original study involved 65 patients over a five year period. The patients were divided into two groups -- 33 received 65 percent TCA and 32 were treated with 100 percent TCA. For the 65 percent group, 27 of 33, or 82 percent, experienced a good response. For the 100 percent group, 30 out of 32, or 94 percent, reported that same "good" response. All patients in the 100 percent group who received five or six treatments reported excellent results. No significant complications were reported.

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