TCA CROSS — Chemical Reconstruction Of Skin Scars — is a precise technique for deep, narrow acne scars, especially ice pick scars. A high-strength trichloroacetic acid is placed only into the base of each pit, triggering focused collagen formation that lifts and tightens the scar from the bottom up.

Its power is precision: the acid stays inside the scar channel, so the surrounding skin is spared. That makes TCA CROSS the go-to for scars too deep and narrow for resurfacing or RF microneedling to reach — and it is usually staged alongside a resurfacing step that blends the overall texture.

Dr Azra Vaziri performs TCA CROSS in Dubai as part of a matched acne scar treatment plan. See where it fits in the scar-type guide.

Using a fine applicator, a small, controlled amount of concentrated trichloroacetic acid is deposited directly into the depth of each scar. The acid causes a focal, controlled injury at the base of the pit. As the skin heals, it lays down new collagen precisely where it is needed, gradually raising the floor of the scar and narrowing its opening. Because only the inside of the scar is treated, the healthy skin around it is left intact.

A small white “frost” appears at each treated point during the session — the visible sign the acid has taken. This settles into tiny scabs that heal over about a week. Results are cumulative, so the technique is repeated over several sessions to progressively shallow each scar.

Ideal for

• Ice pick scars — the classic indication
• Narrow, deep boxcar scars with steep walls
• Individual deep pits within otherwise treatable skin

Not the right tool for

• Rolling scars — use subcision instead
• Broad, shallow depressions — better resurfaced
• Raised or keloid scars, and flat pigmentation

1. Assessment — suitable ice pick and narrow scars are identified. Active acne is controlled first.
2. Application — acid is placed precisely into each pit; a brief sting and a small white frost are normal and expected.
3. Healing — tiny scabs form and shed over about a week. Sun protection is essential in the UAE to prevent pigmentation.
4. Repeat & blend — the scars shallow gradually over 3–6 sessions; RF microneedling is often added to blend surrounding texture.