TCA CROSS in Marbella: medical treatment for deep acne scars

Acne scars can persist for years, even after the condition has been completely brought under control. Some of them form small, deep depressions in the skin that do not improve significantly with creams, cosmetic treatments or superficial peels.

At Clínica Valorian, in Marbella, we offer the medical treatment TCA CROSS, a specialised technique to improve certain atrophic acne scars through the localised application of trichloroacetic acid.

Its aim is to stimulate tissue repair and the formation of new collagen, encouraging a progressive improvement in the depth and appearance of scars.

What is TCA CROSS?

TCA CROSS stands for Chemical Reconstruction of Skin Scars, that is, the chemical reconstruction of cutaneous scars.

Unlike a conventional chemical peel, which is applied over a large surface of the skin, TCA CROSS involves applying a small amount of high-concentration trichloroacetic acid directly onto specific scars.

This localised application triggers a controlled tissue repair response that stimulates collagen remodelling.

Over the following weeks, this process can reduce the depth of the scars and improve the regularity of the skin surface.

For which scars is it indicated?

TCA CROSS is particularly well suited to deep atrophic scars caused by acne.

Ice pick

Main indication

Boxcar

Selected cases

Rolling

Other priority techniques

Ice Pick Acne Scars

These are narrow, deep, pinpoint scars that resemble tiny holes in the skin. They are one of the primary indications for TCA CROSS treatment.

Boxcar Acne Scars

These are skin depressions with well-defined edges. Some small, deep scars of this type may benefit from the technique.

Rolling Acne Scars

These are broader, wave-like depressions, frequently associated with fibrous adhesions. In these cases, TCA CROSS is generally not the primary treatment, and other techniques — such as subcision — may be more appropriate.

How is the treatment performed?

The procedure is carried out in a medical consultation, following an assessment of the skin and the characteristics of the scars.

The doctor applies the acid very precisely and exclusively to the selected scars, avoiding unnecessary treatment of the surrounding healthy skin.

The treatment produces a localised reaction that initiates the tissue repair and remodelling process.

The duration of the session depends on the number of scars to be treated.

How many sessions are needed?

Improvement is progressive and usually requires several sessions.

Many patients may need between 3 and 6 sessions, although the number and intervals are determined individually based on the depth of the scars, the skin phototype, and the cutaneous response.

Results are not immediate: collagen remodelling continues for weeks and months.

Recovery and aftercare

After the treatment, redness, small scabs, and a localised inflammatory reaction may appear.

These scabs usually fall off spontaneously over the following days.

It is essential to avoid picking at them, follow the medical instructions, and use adequate sun protection.

In certain patients, particularly those with higher phototypes, there is a greater risk of post-inflammatory hyperpigmentation.

For this reason, patient selection, the application technique, and aftercare are essential.

Can it be combined with fractional CO₂ laser?

Yes. Acne scars do not always present the same morphology or depth, so a combined treatment may be appropriate.

TCA CROSS allows targeted action on specific deep scars, while fractional CO₂ laser can be used to improve other textural irregularities and selected scars.

At Clínica Valorian, the indication for TCA CROSS, fractional CO₂ laser, or other procedures is established through an individualised medical evaluation.

Combined treatments are planned sequentially when indicated, respecting the skin's recovery times.

Is it a safe treatment?

TCA CROSS is a medical procedure that must be performed by professionals with training and experience in skin reconstruction techniques.

Although it is generally well tolerated in properly selected patients, it may cause hyperpigmentation, hypopigmentation, prolonged redness, infection, or even worsening of certain scars.

Not all patients or all scars are suitable candidates.

A prior medical assessment allows indications, precautions, and realistic expectations to be established.

Personalised Treatment at Clínica Valorian

At Clínica Valorian, we believe that each acne scar requires a specific assessment.

Not all scars respond in the same way, and sometimes the best strategy involves combining different medical procedures.

Our goal is to progressively improve skin texture through individualised treatments, based on medical criteria and adapted to each patient's characteristics.