- Cosmetic Dermatology
CROSS for Acne Scars
A precise technique that stimulates new collagen to remodel deep, narrow (ice-pick) acne scars.
Treats Certain Atrophic Acne Scars
Board-certified dermatologist Dr. Craig Singer performs CROSS for acne scars at his Bingham Farms practice.
Quick facts
Treats
Technique
Minimal
Sessions
Usually a series
Builds
New collagen
Pairs with
Subcision, microneedling
What is TCA CROSS Peel?
TCA CROSS Peel stands for TriChloroacetic Acid Chemical Reconstruction Of Skin Scars.
TCA CROSS peels are used to treat certain types of atrophic (“ice-pick” and “boxcar”) acne scars. The technique involves placing a small amount of high concentration TCA (85% to 100%) to the desired area. The acid causes destruction of the epidermis and dermis within the scar. New skin regenerates from adjacent hair follicles with production of dermal collagen and glycosaminoglycans over the next several weeks. The stimulation of new collagen helps elevate and improve the appearance of ice pick and box car type of acne scars. TCA CROSS peels are usually combined with other modalities in the treatment of acne scars.
Precise, scar-only treatment
By treating only the inside of each scar, CROSS can improve deep ice-pick scars that are difficult to address with resurfacing alone. A series of treatments gives the best result.
Ice-pick & boxcar acne scars
TCA CROSS targets atrophic acne scars: the deep, narrow “ice-pick” and sharply defined “boxcar” scars left behind by acne.
Actual patients of Craig Singer MD. Individual results vary.
How is the TCA cross peel performed?
The procedure is always performed by a physician.
1
Cleanse & map
After the patient’s face has been thoroughly cleansed and prepared, the areas to be treated are mapped out.
2
Apply TCA to each scar
High concentration TCA is applied using the point of a sterilized toothpick or wooden applicator to approximate the shape of the acne scar. The applicator is placed into the base of the scar until a white frost develops.
3
Protect & aftercare
A topical antibiotic ointment is then applied to all treated sites. Aftercare instructions are provided.
Treatments & timing
Most patients usually require anywhere from 3 to 4 treatments spaced 4 to 6 weeks apart.
The procedure takes between 10 to 20 minutes to perform depending upon the extent of scarring.
TCA CROSS recovery, day by day
Recovery is relatively quick with minimal discomfort. Here is what to expect after treatment:
First few hours
The treated areas frost white for several hours.
Day 2
A crust or scab typically forms on each treated spot.
First week
The areas turn red, and the crust or scab falls off spontaneously in about a week on average.
Day 7–10
Full recovery is expected within 7 to 10 days.
Following weeks
Residual redness may take a few weeks to resolve. Sun protection is essential during recovery.
Plan ahead
Do not schedule a TCA peel within 2 weeks of a social event.
What CROSS treats
CROSS is designed for deep, narrow scarring:
Ice-pick acne scars
Deep, narrow, pitted scars.
Deep, narrow scars
Scars too deep for resurfacing alone.
Some boxcar scars
Sharply defined depressed scars.
Pitted scarring
Improving the depth of each scar.
Often combined with
CROSS is one part of a complete scar plan:
Subcision
Releasing tethered rolling scars.
Microneedling
Laser resurfacing
Blending the overall surface.
A tailored scar plan
Matched to your scar types.
Frequently asked questions
What CROSS treats, how it works, comfort, downtime, sessions, and combination treatment.
Is the procedure painful?
There is some mild discomfort but no significant pain. A slight burning/stinging sensation lasts for minutes. No anesthesia is needed.
How long is the recovery after the TCA CROSS Peel?
Recovery from TCA cross peel is relatively quick with minimal discomfort. The treated areas frost white for several hours, thereafter turning red for one week. A crust or scab typically forms on day #2 but will fall off spontaneously in a week on average. Full recovery is expected within 7-10 days; however, residual redness may take weeks to resolve. Sun protection is essential during this recovery period. Do not schedule a TCA peel within 2 weeks of a social event.
Can darker skin types be treated with TCA cross peels?
Yes. All skin types can be safely treated with TCA cross peels; however, darker skin types, such as Latino, Middle Eastern or African-American, have a greater risk of hyperpigmentation. This means that treated areas may be darker than the surrounding skin for months. The use of sunscreen and bleaching creams are essential.
What are the risks of the procedure?
Significant complications are rare. Most scientific studies demonstrate a high level of safety with this procedure. The following complications are possible but rare:
- Persistent redness
- Persistent hyperpigmentation
- Persistent hypopigmentation
- Flare of herpes simplex virus
- Additional scarring
- Keloid formation
- Bacterial infection
What preparations do I need before the peel?
Priming the skin for several weeks beforehand with a topical retinoid (i.e Retin-A, tretinoin, tazorac, adapalene, etc.) is advisable. However, you must stop the retinoid 5 days prior to the peel. Patients with darker skin types should also use a bleaching cream for 2 weeks prior to the peel. Oral Valtrex (to prevent herpes infection) is started one day prior to the peel and should be taken one week afterwards. Direct sun exposure should be avoided 7 days before the peel and 2 weeks afterwards.
TCA CROSS for acne scars near Detroit, MI
Dr. Craig Singer’s Bingham Farms practice offers TCA CROSS and acne-scar treatment for patients across metro Detroit and Oakland County.
- Detroit
- Bingham Farms
- Bloomfield Hills
- Birmingham
- Southfield
- Farmington Hills
- Royal Oak
- Novi
- Troy
- West Bloomfield
- Rochester Hills
- Sterling Heights
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Patient testimonials
4.9
Based on Google reviews
HOUR Detroit Top Doc
Recognized dermatologist
About Dr. Craig Singer MD Dermatology
Located in Bingham Farms, Craig Singer MD Dermatology was founded in 2017 by Dr. Craig Singer, a board-certified dermatologist.
We specialize in medical, surgical and cosmetic dermatology, treating patients of all ages, newborn through elderly. We have expertise in a wide variety of skin conditions including eczema, acne, and warts as well as complicated dermatological issues that include hair loss and autoimmune disease. In addition, we are highly skilled in the evaluation of moles and skin cancer.
For more than 20 years, Dr. Craig Singer has helped thousands of patients look and feel their best.
20+ Years
Trusted by Thousands
Board-Certified
Dermatologist & Pediatrician
