Dr Robert Ong of Medical Aesthetics.
Written By: Dr Robert Ong (MBBS, GDFP (Dermatology), Member - American Academy of Aesthetic Medicine)
Last updated: Jan 18, 2026

TCA Cross Singapore: Efficacy and Potential in Treating Atrophic Scars

Lady with the presence of acne scars on her face.

The field of dermatology continues to advance, with new treatment approaches being developed and refined on an ongoing basis. One method that has garnered considerable research attention and demonstrated favourable outcomes is the Trichloroacetic Acid Chemical Reconstruction of Skin Scars (TCA CROSS) technique. This procedure has shown particular effectiveness for certain types of acne scars and skin surface irregularities.

What is TCA CROSS?

TCA CROSS is a technique that utilizes high concentrations of Trichloroacetic Acid (TCA), typically 70% to 100%, applied focally to treat certain types of acne scars and skin conditions. The word 'CROSS' in TCA CROSS stands for "Chemical Reconstruction of Skin Scars", and the technique involves using a small applicator to apply the TCA to the scar or skin irregularity.

This treatment triggers a controlled inflammatory response in the skin, which stimulates collagen production and promotes remodeling of the scar. The TCA solution causes protein coagulation, leading to localized necrosis, which then initiates an inflammatory response and subsequent wound healing cascade. Over time, the appearance of the treated scar or skin condition can be improved significantly.

Lady undergoing facial treatment for her acne scars.
Man with acne scars on his face.
Lady undergoing facial treatment for her acne scars.

Who is a candidate for TCA CROSS?

TCA CROSS is particularly effective for treating atrophic acne scars, which are often difficult to treat with regular acne scar treatment techniques. These scars are typically small but deep, with steep edges. Ice-pick scars and boxcar scars are two common types of atrophic scars that respond well to TCA CROSS.

However, it's important to note that patient selection is critical for achieving good results with TCA CROSS. Individuals with lighter skin tones tend to have the best results because there is a lower risk of post-inflammatory hyperpigmentation. People with darker skin types can still be treated, but they should be made aware of the potential risks.

Procedure and Results

During a TCA CROSS procedure, the high-concentration TCA is applied directly to the scar using a small applicator like a toothpick. The solution is left to dry, and the patient can wash it off after a few hours. The treated area may appear frosted initially, then darkens and forms a crust that falls off after a few days, revealing new skin beneath.

Results can vary based on the individual and the severity and type of the scarring, but generally, improvements can be seen after a single treatment, with further treatments potentially leading to even better outcomes. It's common to require multiple sessions, typically 3-6, spaced 3-4 weeks apart.

Potential Side Effects

While TCA CROSS is generally safe, as with any treatment, there are potential side effects. These may include swelling, redness, crusting, and post-inflammatory hyperpigmentation, particularly in those with darker skin tones. However, these are typically temporary and resolve over time. There's also a risk of scarring from the treatment itself, but this is rare, particularly when the procedure is performed by a trained professional.

Chemical Peels at Medical Aesthetics

At Medical Aesthetics, we perform different varieties of chemical peels for acne scars, with varying levels of intensity and effectiveness. We are able to perform the TCA CROSS procedure for our patients. If you would like to find out more, please talk to our friendly doctor and staff.

Conclusion

TCA CROSS is a promising, minimally invasive treatment for atrophic acne scars and other deep, narrow skin irregularities. The procedure has a good safety profile and can significantly improve skin texture and appearance. However, as with any dermatological treatment, it's essential to have a thorough consultation with a doctor to discuss potential risks and ensure it's the right treatment for your specific condition and skin type.

Medical Disclaimer
Please note by reading this article, you agree that the information here should not be substituted for professional medical advice. If you have a medical concern, please talk to a doctor.

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