TCA Cross

This is a technique of chemical peeling used to treat deep acne scars, such as ice pick scars. These scars can be very difficult to treat and tend not to respond well to laser treatments or microneedling. TCA, or Tri-Chloroacetic Acid, applied at a high concentration stimulates collagen formation from the bottom of a deep acne scar. This collagen formation is gradual, and over the course of treatments, collagen fills up from the depths of the scar. TCA Cross chemical peel does not treat the full face, however TCA is placed in focal areas of acne scarring. This process elevates the scar so that it may be more effectively treated, perhaps along with other types of scarring, by way of laser resurfacing and microneedling. As with many other acne scar treatments, multiple sessions are advised for the best results. As a guide, we encourage patients to complete at least 2-3 sessions, over a period of 3-4 months.

How long will I take to recover from TCA cross chemical peels?

Immediately following TCA cross, the treated skin turns white. Over a few hours, the area becomes much redder than the surrounding skin. Pin-point areas surrounding the treated area may peel over the next 3-4 days. The skin slowly returns to its normal color over 8-21 days. In darker skin patients, pigmentation changes may be more prolonged. It is essential that sun exposure is avoided in all patients for at least 2 weeks following a TCA chemical peel.

TCA cross can be used to treat acne scars in all skin types. Darker skin patients may develop slight darkening of the treated skin (1-2mm areas), but this typically fades over a period of weeks. Occasionally post treatment darkening may last a few months. The use of sunscreen after this procedure is very important.

Often we will prescribe a skin lightening product before and after the TCA Chemical peel procedure, as this can fade darkened scars.

Preparing for your appointment:

Products to avoid one week before your appointment:

  • Retinol products and prescription retinoids, such as Retin-A (Tretinoin), Renova, Differin, or Tazorac
  • Products containing hydroxy acids, such as glycolic acid (AHA), salicylic acid (BHA), or benzoyl peroxide
  • Any exfoliating products that might be drying or irritating


  • Open wounds, excessively sensitive skin, or inflammatory rosacea
  • Herpes Simplex (cold sores or fever blisters). An anti-viral medication may be necessary prior to treatment.
  • Chemotherapy or radiation treatment
  • Autoimmune disease (such as rheumatoid arthritis, psoriasis, lupus, multiple sclerosis, etc.) or any condition that may weaken the immune system
  • History of keloids
  • Lengthy sun exposure or tanning 3 days prior and 3 days post treatment
  • Accutane use within 1 year prior
  • Use of depilatories, electrolysis, or waxing of the treated area in the past 7 days
  • Aggressive peels and ablative treatments within the past 6 months
  • Pregnancy/lactating
  • Patients who have had Botox injections should wait until the full effect of their treatment is seen before treatment.