Why is TCA CROSS not used more widely?

Question

If TCA CROSS is supposedly such an effective treatment for atrophic icepick acne scars, then why can I not find one board certified dermatologist who performs it? I can only find med spa doctors or ENTs, and, honestly, often their reviews are not so great. There must be a reason dermatologists are hesitant to perform TCA CROSS.

Nelson Lee Novick, MD · Answer

I have been performing TCA CROSS routinely, practically on a daily basis, for treating ice pick scars, dilated pores and very narrow based boxcar scars, for well over twenty years now, since it was first introduced in the States by South Korean physicians who had developed it originally for their patients with ice pick scars. I can offer only one possible answer to your question. In a day and age when all kinds of relatively expensive, bells and whistles "next big thing" fraxel laser, radiofrequency and ultrasound machines are being heavily advertised and aggressively marketed by the device manufacturers and the physicians and medspas that have purchased these devices, relatively inexpensive, low tech (but proven) methods, like TCA CROSS (and subcision and simple microneedling) have been pushed to the side in favor of these less proven, less time-tested, but flashy and more expensive, devices that have not stood the test of time nor are backed by any hard science to date. I am truly sorry that you are having such difficulty finding someone to help you, and I wish you much luck in finally doing so. But the reason for not finding someone who performs TCA CROSS (and the other simple, but effective techniques mentioned above) is not because the techniques have not proven themselves, but instead due market/economic forces for flashy technology. Best of luck.

Barton Sterling, MD · Answer

TCA CROSS is an excellent treatment for individual ice pick acne scars. It can't be used over the entire face because it would be too strong. Many patients are helped by this treatment.

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