TCA Cross VS TCA Paint Technique difference?

Question

What are the differences? The concentration strength ? if so what is the concentration range for paint technique? Is the delivery method still the same, toothpick/needle droplet or its actually “painted” ? What scars are more suitable to paint vs cross. I have a shallow narrowish boxcar scar, I imagine paint technique would be better suited ? I will have Specialist performed this Thanks so much

Jason Emer, MD · Answer

Acne scar treatment needs a combination approach for improvement.  For the best results, one should target the acne scar type.  As everyone has a unique pattern of acne scarring, the best solution is a tailored one.  Typically you need fillers like bellafill and sculptra for atrophic indented type scars with or without subcision.  Subcision for depressed tethered scars.  Vascular lasers like yellow laser, aerolase, excel V or IPL for redness or thick scars. And lasers such as fraxel, erbium, co2 or fractional radiofrequency like venus viva, skinfinity, intensif microneedling RF for textural issues and superficial scarring.  Deep ice pick scars and narrow box car scars are best treated with TCA CROSS and punch excision.  All lasers are combined with microneedling and PRP to get even better results and improve healing times.   The majority of patients will have a collection of different scar types, and hence a tailored treatment plan is needed by an expert physician.  It is never about the laser or product that gives the results, its about the expert behind the equipment that gets you the outcome.  Scars cannot be cured and will need life-long treatments to maintain and build on the results.  you need an expert to evalute you and see if you are a candidate for TCA cross and there is no such thing as "TCA paint" that is dangerous at teh strengths used for TCA cross.  Best, Dr. Emer.

Johnson C. Lee, MD · Answer

Individual scar treatment is better with TCA cross to directly stimulate the very bottom of a narrow scar to fill up with collagen relative to the surrounding skin. A paint is more similar to a chemical peel which will treat all areas and stimulate collagen equally across all areas. You may be better served with subcision and filling of the boxcar scar with a filler such as Bellafill which is specifially approved for acne scars. Hope this helps!Johnson C. Lee, MD 
Board-Certified Plastic Surgeon
IG: @drjohnsonlee

Davin Lim, MBBS, FACD - Account Suspended · Answer

This technique of painting uses a needle - however others will use a different instrument including toothpicks. Picking the exact scar and amount of layering of TCA is vital, as is the concentration- the percentages I work with range from 30 to 70%, and the amount of multicoats range from 2-4. Painting a high concentration on a broad scar such as a chicken pox scar can worsen the scar. Ideally TCA should be used on deep narrow scars, however experienced specialist can extend the use and treat broad based scars in the correct setting. Dr Davin Lim. Brisbane. Australia.

TCA Cross VS TCA Paint Technique difference?

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TCA Cross VS TCA Paint Technique difference?

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