If you have acne scars, you may have noticed that some of them look like small, deep pits or holes in the skin. These are often called ice-pick scars.
Many patients who visit me at Sahawas Skin Clinic in Kothrud and Karvenagar, Pune, have already tried creams, facials, peels or other treatments for their acne scars, but the deeper pits have remained.
This is where TCA CROSS can be useful.
We use TCA CROSS as a targeted treatment for selected deep acne scars, particularly ice-pick scars. But before recommending it, I first look closely at what type of scars you have, because not every acne scar should be treated with TCA CROSS.https://sahawasskinclinic.com/acne-after-moving-to-pune/
— Dr. Mukta Tulpule
Sahawas Skin Clinic, Kothrud & Karvenagar, Pune
What exactly is TCA CROSS?
TCA CROSS stands for Chemical Reconstruction of Skin Scars.
It is different from a regular chemical peel.
In a normal peel, the solution is applied over an area of the skin. With TCA CROSS, the treatment is applied very precisely to individual acne scars.
The aim is to create a controlled healing response inside the scar. As the skin heals, new collagen is formed and the scar can gradually become shallower and less noticeable.
The improvement happens gradually over time rather than immediately after the procedure.
Which acne scars can TCA CROSS treat?
This is one of the most important things I explain to my patients.
TCA CROSS is particularly useful for deep, narrow ice-pick scars.
Acne scars can broadly be divided into:
Ice-pick scars
These are narrow but deep scars that look like small pits in the skin.
These are the scars for which I most commonly consider TCA CROSS.
Boxcar scars
These are wider depressions with more defined edges.
Some selected boxcar scars may respond to TCA CROSS, depending on their depth and characteristics.
Rolling scars
These are broader, shallow depressions that can make the skin look uneven or wavy.
Rolling scars often have fibrous bands underneath the skin. In these cases, subcision or another treatment may be more appropriate than TCA CROSS alone.
What if you have more than one type?
This is actually very common.
Many patients have a mixture of ice-pick, boxcar and rolling scars.
In such situations, I don’t believe in using the same treatment for every scar.
The treatment needs to be planned according to the scar type.
Sometimes TCA CROSS is combined with other acne-scar procedures to achieve a better overall result.
How do we decide whether TCA CROSS is suitable for you?
During your consultation, I look at several things:
- What type of acne scars you have
- How deep the scars are
- Your skin type and tendency to develop pigmentation
- Whether you still have active acne
- Previous treatments you have undergone
- Your expectations from treatment
This assessment is important because there is no single best acne-scar treatment for everyone.
If you visit us at Sahawas Skin Clinic in Kothrud or Karvenagar asking specifically for TCA CROSS, we may recommend it — or we may tell you that another treatment would be more suitable.
That is part of getting the treatment right.
How is TCA CROSS performed?
The skin is prepared and the TCA solution is carefully applied to the selected scars.
Because the treatment is concentrated only on the scars, you may see small treated spots rather than the entire face being peeled.
You may experience some burning or stinging during the procedure.
A controlled frosting reaction occurs at the treated areas, followed by healing and collagen remodelling.
Small crusts may form afterwards.
It is very important not to pick or remove these crusts.
We will also explain the skincare and sun-protection precautions you need to follow after the procedure.
What should I expect after TCA CROSS?
The treated areas can initially look red or darker and may be more noticeable before they start improving.
Small scabs or crusts may develop.
This is part of the healing process.
As the skin heals, the treated areas gradually settle. However, collagen remodelling continues for weeks to months, so you should not judge the final result immediately after treatment.
One of the common mistakes I see is patients expecting a deep scar to disappear after one session.
Acne-scar treatment is usually a gradual process.
How many sessions will I need?
There is no fixed number of sessions that is suitable for everyone.
The number depends on:
- The number of scars
- Depth of the scars
- Your skin type
- How your skin responds to treatment
- Whether we are combining TCA CROSS with other procedures
Some patients may require multiple sessions. At Sahawas skin clinic we ususally do a combination of treatments
During your consultation, I can give you a more realistic estimate after examining your scars.
Will TCA CROSS completely remove my scars?
I always like to be realistic about this.
No acne-scar treatment can guarantee completely scar-free skin.
Our aim is to make the scars shallower, smoother and less visible.
The amount of improvement varies from person to person.
Your result depends on the type and depth of your scars, your skin’s healing response and whether additional treatments are required.
My approach is to focus on improvement that looks natural, rather than promising unrealistic perfection.
Is TCA CROSS safe for Indian skin?
TCA CROSS can be used in Indian skin, but pigmentary changes are an important consideration.
Patients with darker skin types can be more prone to post-inflammatory hyperpigmentation or hypopigmentation after skin procedures.
This is why I assess your skin type and pigmentation tendency before treatment.
After the procedure, following the recommended skincare and strict sun protection is particularly important.
The concentration and application of TCA should also be carefully controlled.
TCA CROSS is not a treatment I recommend attempting at home.
TCA CROSS vs laser for acne scars
Patients often ask me:
“Doctor, should I do TCA CROSS or laser?”
The answer depends on your scars.
If you have predominantly deep ice-pick scars, TCA CROSS may be particularly useful.
If you have rolling scars with tethering, subcision may be more appropriate.
If you have widespread textural irregularity, fractional resurfacing or another treatment may be considered.
If you have mixed acne scars, a combination approach may give a better result.
So rather than choosing a procedure first, I prefer to identify the scar type first and then choose the treatment.
TCA CROSS Before & After
If you are considering TCA CROSS, looking at properly documented clinical cases can help you understand what improvement may realistically look like.
For every case, I recommend showing:
Before treatment → Treatment course → Follow-up
The photographs should be taken under similar lighting, camera distance and positioning wherever possible.
Clinical photograph: Before and after treatment of acne scars with TCA CROSS. Individual results vary. The response depends on scar type, depth, skin type and other individual factors.
Only photographs obtained with appropriate patient consent should be published.
Why does scar assessment matter so much?
One of the most important things I tell my acne-scar patients is:
“Your scar type decides your treatment.”
A treatment that works very well for one type of scar may have little benefit for another.
That is why I don’t recommend choosing a treatment simply because you have seen a good before-and-after photograph online.
At Sahawas Skin Clinic, I first assess your scars and then discuss which treatment or combination of treatments is likely to be appropriate for you.
Thinking about TCA CROSS for your acne scars?
If you have deep acne scars, particularly small ice-pick scars, TCA CROSS may be one of the treatment options worth considering.
If you are looking for acne-scar treatment in Kothrud, Karvenagar or elsewhere in Pune, you can consult me at Sahawas Skin Clinic for an assessment.
I will examine your scars, explain which type of scars you have and discuss the treatment options, expected improvement, number of sessions and possible risks before you decide.https://sahawasskinclinic.com/acne-scars-treatment-pune/
Dr. Mukta Tulpule
Sahawas Skin Clinic
Kothrud & Karvenagar, Pune
Individual results vary. TCA CROSS may not be suitable for every type of acne scar. Treatment choice should be made after an appropriate dermatological assessment.
