Hey guys and welcome.
Today as you can tell I’m going to be talking all about TCA for Boxcar scars, atrophic scars, ice pick scars.
I’m going talk all about Procedure that you guys have asked me to go over and I’m rather fond of it.
It’s called TCA cross which stands for a trichloroacetic acid reconstruction of skin scars.
This procedure can be very very helpful for certain types of scars namely boxcar scars, ice pick scars and atrophic scars.
TCA cross is a procedure that can be used to treat these types of scars which most frequently occur in individuals with a current or past history of inflammatory and or cystic acne.
And unfortunately, these scars can be a very disfiguring really really impact and individuals overall emotional well-being self confidence.
Even though the acne may be may be a thing of the past and long gone.
The scars are a painful ongoing reminder of the acne as well as a real source of internal and external stress as far as emotional consequences.
So, you know, don’t be dismayed into thinking that nothing can be done.
There are a variety of procedures and the TCA cross is one that I’m a fan of and can be really really really helpful and imparting some beginnings of substantial Improvement to boxcar and ice pick scaring.
What exactly does TCA cross involved.
Okay, well TCA cross is a little bit different than a TCA peel.
All right, if you’ve ever heard of a TCA peel. A TCA peel is a type of a chemical peel and which the aim is to exfoliate the top layer of the skin at a different level.
Depending on the concentration of the TCA to a varying degree.
TCA cross however, it doesn’t is not intended to just exfoliate the top layer the skin.
What it is is focus delivery of a very very very high percentage strength of the trichloroacetic acid.
That is delivered exclusively to the base of the scar. right, so not around the surrounding skin just to the base of the scar.
This destroys The Superficial layer and the top layer of the skin the epidermis as well as the bottom layer of the skin the dermis.
It essentially creates a full thickness wound of the injury almost like a little basically what it creates is a tunnel.
Okay, A little tunnel wound and what this allows for is basically the body will then attempt to heal that little delivered wound.
New collagen will form and fill in that space and the skin will heal over.
The goal is to Fill up that space with new collagen and improve the surface appearance of that prior scar.
Which was a divot or a whole and now can be filled with new healthy collagen and new healthy tissue.
By creating this, this full thickness wound and new collagen coming in it can plump up the skin in that area and start scattering light and lesson and mitigate the appearance and start smoothing things out.
Alright, it will not it will not completely eraser the scar and take the scar away, but it will fill in that space and start to scatter and reflect light and smooth out the skin the appearance of the skin.
The way that the procedure is performed though is pretty straightforward.
You lie down on your back.
The area is prepped and cleansed.
Appropriate antiseptics antibiotics are applied on the skin because we’re going to be creating a full thickness wound and then with a blunt instrument sometimes even a toothpick.
A little bit of the TCA in a concentration ranging from seventy to ninety percent is applied specifically just to the base of that to that Scar.
It’s applied there until the application the end of visual performing the procedure begins to see something called frosting.
If you’ve ever had a TCA chemical peel you maybe familiar with frosting.
Frosting is what happens as the TCA is basically what happens, its sought of kind of chemically burning the skin.
It’s called it’s basically coagulating the Keratin proteins in the skin.
Think of it as cooking an egg. Alright, if you cook egg whites, you can see that as the proteins begin to denature the albumin in the egg white turns from colorless clear to opaque white.
That’s that’s basically what Happening in your skin when the TCA is applied particular at that concentration.
So the the surgeon physician will apply the TCA until they see a little bit of that frosting and then back off.
What you can expect after the procedure is that in about 12 hours the frosting will fade.
You’re going to have some soreness some redness in the area where it was apply.
It’s going to be red.
It’s going to be a little swollen.
That typically loss anywhere from 24 to 48 hours.
All right, and then over the next three to seven days the skin is basically in that little little area is going to start to heal like a wound and you’re going to get a scab somewhere around, you know, three four, five six seven days.
It will scab, very important not to pick that scab or or scratch at it.
It’s just something to be expected.
If you attempt to pick the scab or go exfoliating the area. The really you can you can take 10 steps backwards and create a problem for yourself.
So, you know leave it alone don’t attempt to pick at the skin or anything like that during this time.
It’s okay to wear makeup to camouflage the scabs.
It’s okay to cleanse your skin. Do your normal skin care routine and it is imperative that you exercise really really really militants sun protection.
I know I’m always like harping on the sun protection thing, but I mean if you’re doing anything to your skin, it has to be some protection otherwise, everything else is kind of useless.
TCA cross has yet another example of if you go out in the sun while your skin is healing from this procedure, you’re going have you’re going to have complications.
It’s going to heal with a dark mark.
You’re going to have problems healing is going be delayed and you’re going to have a less than ideal outcomes.
So make sure you protect the area with sunscreen avoid going out in the sun is best if you’re able particularly during the summer time while the skin is healing.
What can you expect as far as results?
Well, this isn’t going to revolutionize the appearance of your face overnight for certain it takes time. It takes patience.
And so it requires you to have a certain degree of trust in the physician performing the procedure that things are things are going to going to improve because you’re going to go through this period of time where the area is red and scabby and you’re not really seeing much results.
Generally it takes you know, three to six treatments spaced every six to eight weeks and it’s generally a six-month course of pursuing these treatments for the most part.
But at the end of the six months, you know, everyone is different.
It kind of depends on on what you wear.
Your starting point is what your expectations are going.
And so everybody’s level of satisfaction is going to vary drastically, but generally you can expect after about six months of going Back and having this done over and over again these you know several times over the course of six months.
You can expect anywhere from a grade one to two improvement in the appearance of your skin.
And that’s that can be quite substantial as far as your overall emotional health and well-being you may be more than happy with that.
Importantly though this procedure can and often is combined with other treatments to really get you to a whole new level of improvement other non procedural treatments as well namely a topical retinoid like Tretton Owen.
If you’re continuing, you know that may be prescribed and with continued and ongoing use can further stimulate more collagen production remodeling of the skin and in further Improvement in the appearance of those scars.
All right, so it can be combined with Trenton Owen and it can also be combined with a treatment micro-needling in a physician’s office.
Many dermatologists used micro-needling device has to two further stimulate collagen can be really helpful.
I don’t recommend people just blindly go out and buy these micro needling Derma roller things.
They can be associated with complications when people do it at home infection hyperpigmentation for their scarring the depth of the channels that they use in those micro needling devices is important.
So I don’t really, you know recommend just blindly going on Amazon and buying one of these things but in a physician’s office where it’s very controlled and they situation is controlled the Derma roller can definitely definitely improve the appearance of boxcar and atrophic scars in conjunction with TCA cross in conjunction with with a topical retinoid.
And you’ve got some really good stuff in in your bag of tricks. That’s going to get you going to get you Improvement.
You have to be patient. Unfortunately, it takes a while to get there on it takes continued trust in the physician and ongoing follow-up.
So that would be my overriding message to you is that have little bit of faith in the dermatologist and continue to follow up and be very very patient.
It’s not going get better overnight. It will take six months a year a couple of years depending on where you’re starting.
A dermatologist is a great starting point for this procedure or to talk about this procedure a board-certified dermatologist.
If you have a university an academic Medical Center in your area, like a medical school often times, you will have a department of Dermatology where they are training resident Physicians to become dermatologist, and they have dedicated scar clinics.
So, you know find out what is available in your community in your area as far as experts in treating scars.
You may be surprised how accessible this is how affordable it is and know, it takes a little bit of research and patience on your part.
But I encourage you to do it and to seek that out and to get that that evaluation that you deserve because acne is a disease .
It is not Simply a cosmetic thing acne scarring is you know has profound consequences on an individual’s emotional well-being.
So do not sell yourself short and that regard and do not dismay.
There are wonderful treatments that can be very very helpful and substantially improving the appearance of boxcar and atrophic ice pick scars from acne. But anyways, guys, I hope this is helpful to you