- Acne Scarring
TCA/Phenol CROSS Peel
Treats certain atrophic acne scars.
A focused medium-depth peel that places high concentration TCA or phenol into ice-pick and boxcar scars to stimulate new collagen and lift the scar.
What is CROSS peel?
CROSS stands for Chemical Reconstruction Of Skin Scars. It is a form of medium to deep peel used to treat certain types of ice-pick and boxcar acne scars. The technique places a small amount of high concentration TCA (85% to 100%) or 89% carbolic acid onto the targeted scar. The acid causes controlled destruction of the epidermis and dermis within the scar, and new skin then regenerates from the adjacent hair follicles, producing dermal collagen and glycosaminoglycans over the next several weeks. This new collagen helps elevate and improve the appearance of ice-pick and boxcar acne scars. CROSS peels are usually combined with other treatments, such as erbium fractionated ablative laser, as part of an acne scar plan.
Recent studies indicate that carbolic acid (also known as phenol) has efficacy equivalent to TCA, with less risk of widening an acne scar.
Watch
CROSS peel technique.
How many treatments are needed to see results?
Most patients require anywhere from 3 to 6 treatments, spaced 4 to 6 weeks apart.
How long does the procedure take?
The procedure takes between 10 and 20 minutes, depending on the extent of scarring.
TCA CROSS peels across metro Detroit
- Bingham Farms
- Birmingham
- Bloomfield Hills
- West Bloomfield
- Royal Oak
- Berkley
- Troy
- Farmington
- Shelby Township
- Novi
- Detroit
- Metro Detroit
Frequently asked questions
Is the procedure painful?
There is some mild discomfort but no significant pain. A slight burning or stinging sensation lasts for a few minutes, and no anesthesia is needed.
How long is the recovery after CROSS peel?
Recovery from a TCA CROSS peel is relatively quick with minimal discomfort. The treated areas frost white for several hours, then turn red for about a week. A crust or scab typically forms on day 2 and falls off on its own within a week on average. Full recovery is expected within 7 to 10 days, though residual redness may take a few weeks to resolve. Sun protection is essential during recovery, and you should not schedule a TCA peel within 2 weeks of a social event.
Can darker skin types be treated with CROSS peels?
Yes. All skin types can be safely treated with TCA or phenol CROSS peels. However, darker skin types, such as Latino, Middle Eastern, or African American, have a greater risk of hyperpigmentation, meaning treated areas may be darker than the surrounding skin for months. Sunscreen and bleaching creams are essential. It is advisable to avoid direct sun for 2 weeks before and 2 weeks after treatment, and to pretreat with triple therapy bleaching cream for 1 month prior.
What are the risks of the procedure?
Significant complications are rare, and most scientific studies show 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 (such as Retin-A, tretinoin, Tazorac, or adapalene) is advisable, but you must stop the retinoid 5 days before the peel. Patients with darker skin types should also use a bleaching cream for 2 weeks prior. Oral Valtrex, to prevent a herpes infection, is started one day before the peel and continued for one week afterward. Direct sun exposure should be avoided 7 days before the peel and 2 weeks afterward.
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About Craig Singer MD Dermatology
Located in Bingham Farms, Acne Center Of Michigan was founded by Dr. Craig Singer, a board-certified dermatologist.
We specialize in the treatment of acne and acne scarring, offering numerous therapeutic options tailored to each patient’s needs.
Dr. Singer experienced significant acne when he was in college and has personal experience with his teenage children’s acne as well. He has helped thousands of patients look their best.
Acne Center of Michigan offers the most advanced acne treatments, drawing from both traditional and alternative approaches. Dermatologists across the region refer their most complex acne-scar cases to Dr. Singer, and patients travel from across Michigan, neighboring states, and Canada for his care.
Board-Certified
Dermatologist
Thousands of patients
Helped look their best
