Skin not responding to TCA CROSS, should I discontinue? (photo)

Question

I went through 2 sessions of TCA CROSS (100% concentration was used in both sessions, according to my Dermatologist), with the first session, only the tiny scars on my left cheek reacted. Went for the 2nd session 5weeks later, I did raise my concern that the scars on my right cheek that is bothering me has not reacted in the least, during the session, 2application was done in that session on those concerned scars, but still, barely any scabing is happening. Should I be continuing on with this?

Nelson Lee Novick, MD · Answer

Perhaps the most distressing part of your question is not that you haven't seen any appreciable response after just two treatment sessions, but that your dermatologist likely did not explain this to you and emphasize this to you to prevent just this kind of needless mid-treatment frustration and disappointment. For you, and for all readers of this column interested in TCA CROSS, it is important to understand that for the vast majority of people being treated in this fashion for ice pick scars, enlarge (dilated) pores and very narrow boxcar scars, to achieve optimal results, i.e. significant enough improvement to be noted with the naked eye, typically requires between two to four treatment sessions spaced at six week intervals (new collagen and new elastic fiber synthesis occurs between four and six weeks following each treatment session). So, in short, after just two sessions, it is not at all surprising that you have not yet seen any significant visual improvement. So, hang in there. You may need another one or two sessions to achieve that. Make sure that you are being treated by a board certified aesthetic physician and very importantly, discuss these issues with him/her. Best of luck.

Jason Emer, MD · Answer

Keep in mind, acne scars need 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.  Best, Dr. Emer.

Skin not responding to TCA CROSS, should I discontinue? (photo)

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Skin not responding to TCA CROSS, should I discontinue? (photo)

Answers (2)

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