TCA CROSS for Icepick Scars

How it works

A very high-strength trichloroacetic acid is applied with a fine tip into the bottom of each narrow scar. The acid causes a controlled injury, followed by a small dark crust, and the skin rebuilds from the base. Sessions are spaced weeks apart to allow healing. How much improvement occurs varies by person and by scar.

Who it may suit

• Ice-pick scars
• Narrow, deep scars that other lasers may not reach well
• People who can attend several visits
• Those willing to follow careful aftercare

The treatment day

1. Examination. The doctor identifies which scars suit TCA CROSS. Ask to be shown the list or map.
2. Skin preparation. The skin is cleaned and degreased.
3. Acid application. Acid is placed in each scar. You may feel brief stinging, and the spot turns white.
4. Aftercare. You are told how to care for the small crusts. Ask for written aftercare in English.

Aftercare

• Do not pick the crusts, which usually fall off in about a week
• Keep the skin moisturized as directed
• Avoid sun exposure and use sunscreen
• Skip retinoids and acids on the face until cleared
• Contact the clinic if you see spreading redness, pus or persistent dark marks

Things to know first

• Small dark crusts and redness last about a week
• Pigment change, scarring, infection and irritation are possible
• Darker skin has a higher risk of post-inflammatory darkening
• Not advised in pregnancy, with active infection or with recent isotretinoin use unless cleared
• Improvement varies and often needs repeat sessions

Talking through TCA CROSS in English

Tell the doctor your skin tone history and how your skin marks after pimples or cuts. Mention isotretinoin, keloids, cold sores and pregnancy plans. This helps the doctor judge the risk of dark marks.

Ask which scars will be treated and how strong the acid is. Ask how many visits are suggested and how many weeks apart. Ask what normal healing looks like and which signs mean you should call.

Words such as ice-pick, crust and post-inflammatory hyperpigmentation may come up. The last one means dark marks after irritation. Request aftercare in English, and keep dated photos to share with the clinic after you leave.