Tca cross - acne scarring?

Question

Is there an average cost for this? I know this is one method I will likely need to have done, but i have no clue how much this runs. Thanks

Larry S. Nichter, MD, MS, FACS · Answer

We do not offer the "TCA Cross" treatment at use of 100% TCA is potentially dangerous, unpredictable,and more likely to cause permanent loss of pigmentation and potentially other scarring.There are other methods in my hands that seem to work better including "diamond wire" undermining or direct mini-excision of acne pits under magnification to leave a flat scar.

Raffy Karamanoukian, MD, FACS · Answer

Acne scars are usually characterized within the subtypes of atrophic, hypertrophic, pigmented, or inflammatory. These subtypes of acne scars can be visually discerning in ambient light and can cause significant cosmetic concerns. Indented and atrophic scars require a combination approach to stimulate collagen and elastin, thereby smoothing contour and uneven skin. These are usually combined with lasers and depigmentation protocols to reduce inflammatory hyperpigmentation (Melarase AM and Melarase PM). Our Hidef protocols for acne scars include fillers such as Sculptra, Juvederm, Radiesse, and Restylane to improve deep acne scars; Vascular lasers to reduce inflammation and post-inflammatory redness and erythema; Fractional lasers to smooth contour and collagen; and Fractional RF to stimulate production of collagen within atrophic scars. Textural improvement and superficial scarring can be improved with Cosmelan peels, TCA Cross for ice-pick scars, deep chemical peels, and fractional CO2. We offer a personalized approach to your combination of scars and a formal evaluation with consultation is recommended to help you achieve your final results. Our plastic surgery office offers subcision and combination TCA Cross to help reduce deeply pitted scars. In terms of pigmentation and skin resonance, we recommend daily use of Melarase AM and Melarase PM coupled with Retinoid creams to achieve brilliant skin.

Best,
Dr. Raffy Karamanoukian
Realself100 Surgeon

Best, 
Dr. Raffy Karamanoukian
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

Before embarking on a "How much does it cost" approach, it would be essential first, if this has not already been done, to have a consultation with an experienced, board certified aesthetic dermatologist with experience with all types of acne scar treatments in order to be sure that the CROSS Technique is what is best for you. The fact is that many people with acne scarring have several types of scars (There are atrophic, hypertrophic, deep box scars, wide shallow scars, and pits of all sizes and depths), each requiring a different approach to treatment achieve optimal results. For this reason, price quotes are of little value until a thorough examination of the scars is completed and an actual treatment plan tailored.

	The TCA Cross Technique (which strands for Chemical Reconstruction Of Skin Scars) is an excellent method for treating ice pick acne scars, a kind of scar, which owing to its depth and narrowness is typically quite difficult to nonsurgically treat otherwise. CROSS involves the deep placement of TCA 100% solution, using a narrow needle or toothpick, within the ice pick scar. The intent is to cause a brisk reaction that leads to inflammation and ultimately closure of the scar as new collagen formation is promoted in the treated area. The same technique may be used for very dilated, patulous pores. (For other kinds of acne scars, the Punctuated Phenol Peel might be more appropriate).

	Immediately following application, treated areas turn stark white and then may ooze and crust over the next couple of days. Healing areas may resemble scratched pimples.

	 

	In general a series of treatments is usually required to achieve best results. I prefer a minimum of four to six weeks between treatments to allow for maximum healing and new collagen formation.

	It is important to note that it is not uncommon for the scar to widen and deepen after treatment with this method. This can be quite disconcerting if one is not warned of this in advance. In time, generally over several months, the depressions elevate and the results tend to be quite gratifying.

Tca cross - acne scarring?

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