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Effective Acne Scar Treatment with TCA CROSS | Aesthetic Studio Singapore

Dr. Jonathan Y. Lee discusses a safe and highly effective treatment method for deep and difficult ‘icepick’ acne scars utilizing TCA for focal chemical scar reconstruction – A method known as TCA CROSS. Many of our acne-scar patients have benefited from the simplicity, comfort and effectiveness of this technique.

Acne scarring is an extremely common complication of acne and can be cosmetically disfiguring and have significant negative psychological impact. There is as yet no single appropriate and effective treatment for acne scarring and combination treatments are often required.

Depending on the type or appearance of the scars, different treatments (modalities) may be proposed by your surgeon. These may include surgical excision, subcision, fillers, laser resurfacing, dermabrasion, fractional laser resurfacing etc.

Icepick Scars
Icepick scars most common type of acne scar. These are very often narrow, sharp and deep. They give the appearance that the skin has been pierced with a sharp instrument or icepick. They may appear as a deep, open pore; and usually extend into the deep dermis layer.

Dermabrasion and laser resurfacing are often ineffective at dealing with this type of scar as these scars are often too deep. They usually develop from a cyst infection or after an inflamed blemish works its way to the skin’s surface. In the process skin tissue becomes destroyed, leaving these column-like scars.

One method that we find particularly effective for the treatment of ‘ice-pick’ scars or ‘pitted’ scars is the method of chemical recon­struction of skin scars (CROSS) or TCA CROSS.


This technique is the precise and focused spot application of TCA (trichloracetic acid) into each ‘pitted’ or ‘icepick’ acne scar, avoiding the non-scar areas of normal skin. The resurfacing response that occurs inside the depression stimulates collagen production increases dermal volume, restructuring the dermal elements within the skin, and this eventually causes the scar to rise up (effacement) and close.

In our hands, this technique has been suc­cessful is treating facial acne scars (especially atrophic ice-pick scars) and damaged or dilated pores. The degree of improvement depends on the number of applications and between 2 to 6 courses of treatment may be required.  Studies demonstrate good improvement after three to six courses in more than 90% of cases.

The technique is safe with few significant complications. Healing is more rapid than conventional full-face medium to deep chemical resurfacing.

It is important to have this procedure performed by a doctor with experience in this technique, as this is very much a procedure that requires expert technique to avoid complications such as burns, prolonged healing, pigmentation etc, that can result from applying too much chemical, or applying it inaccurately. Dr. Jonathan Lee performs this procedure under magnification with specialized instruments.

How is the TCA CROSS procedure performed?

After cleaning and priming the skin, TCA is applied, very precisely into each ‘pitted’ acne scar with a special applicator. This produces a white ‘frost’ on each acne scar, which disappears in 20 to 30 minutes. A mild redness may persist for several hours after the procedure, and an ointment is applied at regular intervals for the first week to aid in healing. Sun avoidance and use of sun protection is advised, during healing.

Are TCA CROSS treatments for Acne Scars painful?

The TCA CROSS procedure is relatively painless. There may be slight discomfort, described as a ‘biting’ sensation’ when the chemical is applied, and this lasts only for a few minutes. During the healing phases, there is no discomfort or pain.

What kinds of Acne Scars are suitable for CROSS treatments?

TCA Cross can be used on all skin types, and is especially useful and effective at treating ‘ice-pick’ or pitted acne scars. TCA CROSS alone can be effective as a single method of treatment for light ice-pick acne scars, or other mild to moderate acne scar types. But more often, it is used in combination with other treatments such as laser resurfacing or selective scar excision or subcision, in the treatment of acne scars and improving overall skin texture.

How many treatments are required?

TCA Cross can take one to several treatments depending on the severity of your acne scar case.  Between 2 to 6 treatments may be required.

An interval of 4 to 6 weeks between the first few treatments is required, to allow the skin to heal, remodel and rejuvenate. You are likely to see continued improvements for several months after a treatment.

For an example of CROSS treatment watch:

TCA CROSS is a safe and highly effective procedure of removing deep acne scars, and patient satisfaction is high. It is virtually painless, has acceptable downtimes, and patients see results very quickly. It may be used alone or in combination with other acne treatments depending on the severity and type of acne scars that you have.

To see if you are suitable for this treatment, and to have an effective treatment plan designed and tailored specifically to your needs; Call us for an appointment at THE AESTHETIC STUDIO, SINGAPORE. (Tel: +65 6440-1200 / +65 67371100)



Acne Treatment with Blue Light is Safe, Gentle and Effective

BBL Blue Light for Acne : Advanced, Effective and Perfect for sensitive skins.


Acne vulgaris (or acne) is a chronic inflammatory disorder of the sebaceous gland present in the skin. Acne is a common term for comedones and milia (blackheads and whiteheads), papules (pinheads), pustules (pimples) and nodules. Large nodules are sometimes called “cysts” or “boils”, and the term nodulocystic is used to describe severe cases of inflammatory acne. Cystic acne affects deeper skin tissue than does common acne and typically appears on the buttocks, groin, armpit areas, chest, neck and back. Sometimes acne cysts may develop on the face. Scarring may develop if the lesions are not adequately or appropriately treated. In addition, there is a significant negative psychological effect on patients and severe acne may seriously affect the self-esteem and quality of life.

Does Acne occur only in teenagers?
Acne is more common in the age group of 13 – 30 years but it may occur or persist even beyond this age limit. Males are more frequently affected than females.

What is BBL Blue Light Treatment for Acne? (BBL acne phototherapy)

The Sciton® BBL Blue Light (420nm) technology is one of the most effective acne therapies available today. Utilizing the short wavelengths in the blue-light spectrum, this treatment painlessly destroys the propionibacterium acnes bacteria on the skin surface and in the sebaceous glands, killing the bacteria that cause Acne. It diminishes active breakouts, allows faster healing of the skin and prevents future breakouts.

Does it work on all types of acne?
BBL Acne Phototherapy works on mild to severe inflammatory acne and is ideal for treating the redness associated with mild to moderate acne and cystic acne.

How many treatments are required?

Results are seen within three to four weeks. A typical treatment regimen consists of a series of treatments delivered twice a week over a 4-week period, or until the breakouts are under control. Each treatment takes about 10-15 minutes. Our doctors will recommend the correct duration and timing of your treatments based on your skin’s condition.

As a guide, 3 treatments can potentially result in a 70% improvement in acne, and by 6 treatments a 90% improvement can be achieved.

How does Blue Light Treatment differ from other acne treatments?

The Sciton® BBL Blue Light (420nm) technology is one of the most effective acne therapies available today. In many cases, utilizing this treatment method can help our patients avoid the need for aggressive oral medications or long-term antibiotics.

BBL Blue Light treatments are gentle enough for the treatment of Acne in patients with sensitive skin and atopic dermatitis. It is a safe and effective solution for patients who are unable to tolerate harsh drying topical products or procedures, or who are too sensitive for aggressive laser treatments, as well as patients who are intolerant to oral medications.

BBL Blue Light treatments can be further enhanced by combination with specially selected light chemical peels, suitable patients.

” BBL Blue Light Acne Treatments are effective yet gentle enough even for sensitive skins and patients with concurrent Eczema and Atopic Dermatitis.” (Dr. Jonathan Y. Lee)

Sciton BBL Blue Light treatment for Acne (presented by Dr. Greenberg):


Sciton BBL Blue Light for Acne is available now at The Aesthetic Studio.

Call (+65) 6440-1200 for enquiries and to schedule your consultation.

For more information on BBL Blue Light treatments as well as other treatments for Acne, check out our website:

For more information on the technology behind Sciton’s BBL Treatments for Acne:

The problem with Acne Pimples | The Aesthetic Studio Clinic Singapore

ACNE (Acne Vulgaris) which includes blackheads, whiteheads and also deeper acne cysts and nodules, is not only a medical problem, but can deeply affect the psychological well-being of those affected. And unlike other cosmetic problems, affects young males and females in equal proportion.

Psychological effects can result in:

  1. Reduced Self-Confidence and Self-Esteem
  2. Social withdrawal from friends and social events
  3. Rebelliousness and repressed anger
  4. Over-compensation with preoccupation with skin and outward appearance; or
  5. Total lack of care towards their appearance
  6. Negative Self-Image and Poor body posture

The male hormone testosterone plays a significant part in seborrhoea and problem skin, and therefore affects males more than females. As many as seven out of ten young men are affected acne, seborrhoea and pimples. Females can sometimes benefit from taking the oral contraceptive pill to improve their hormonal balance and clear their acne, but this would not be an option in young men whose sexual development may be affected.

Isotretinoin (Roaccutane/ Accutane) is an oral medication (tablet) that is sometimes prescribed for recalcitrant Severe nodular cystic acne that does not respond to topical treatments. It has many significant potential unwanted side-effects that include liver dysfunction, psychiatric disturbances and the development of fetal abnormalities (requires caution when used in women of child-bearing age).

Broad spectrum Oral Antibiotics such as tetracycline, erythromycin or minocycline are sometimes used in severe cases of acne, but may not be suitable for all patients.  Tetracycline for example may cause staining of teeth in very young patients and may also not be taken by pregnant women.

Topical (applied to the skin) Medications remain the mainstay of treatment for most patients suffering from Acne. These include Topical Antibiotics, Retinoids, Benzoyl Peroxide, Salicyclic Acid, Sulfur Preparations and Azelaic Acid, among others.

Retinoids (Retin-ADifferinIsotrexin and Tazorac etc) are Vitamin A derivatives that improve acne by normalizing the lifecycle of follicle cells and aids in the generation the new cells that restore the dead ones. Vitamin A provides a temporary boost in the production of collagen and can give the skin a more young-looking appearance.

The most suitable prescription acne treatments has to be individualized and is determined by various factors including skin type, type of acne, occupational needs, sun expected sun exposure, lifestyle, gender, age etc. This is best determined after consultation with an experienced doctor.

At The Aesthetic Studio Clinic and Surgery, patients will undergo a through consultation and skin examination by our doctors to determine the best plan for each individual patient. These plans may include optimizing their skin care regimen (Cleanser, Toner, Moisturiser, Sunblocks), Microdermabrasion, Specialized Chemical Peels and Laser or Blue light Treatments. Our goals for treatment are the rapid control of Acne pimples, improving the skin quality, long term maintainence of skin clarity and preventing disfiguring scars.


Acne and Pimples not only causes temporary disfigurement (pigmentation, marks, cysts, blackheads), and behavioral problems in teenagers and young people, but if left untreated or inappropriately managed will cause permanent scars and textural irregularities of the skin.

Both Color changes and Textural changes can be distressing. The Textural irregularities associated with Acne Scars are often classified as rolling, ice-pick, shallow or deep box-car type scars depending on their appearance, and often these multiple scar types will co-exist. Treatment of Acne Scars therefore often require a combination of treatments including:

  1. Ablative Skin Resurfacing (MicroLaserPeels, Laser Fractional Resurfacing, Dermabrasion)
  2. Non-ablative Resurfacing
  3. Excision and Subcision (release of scar tethering)
  4. Dermal Fillers
  5. CROSS (chemical reconstruction of skin scars)
  6. Techniques for treating Color changes (redness or pigmentation).

At The Aesthetic Studio Clinic and Surgery, Our doctors will design a treatment plan tailored to individual needs, lifestyles and budget – geared towards delivering safe effective results in the shortest possible time. (e.g Patients who cannot afford long down-times can have a plan based on multiple non-ablative treatments).

Read more about our various Acne and Acne Scar treatments, in more detail, in our future posts.

Whether you are troubled by Active Acne or old Acne Scars treatments, make an appointment with our Doctor and find out how our treatments can help you! (For Appointments, call: +65 6440-1200)

The Aesthetic Studio Clinic & Surgery, Singapore.

Aesthetic Medicine and Surgery Singapore

Whether you’ve been thinking of enhancing your natural beauty and features, or refreshing your appearance and erasing the years…

At The Aesthetic Studio, we are dedicated to helping you look and feel your best, quickly, safely and comfortably.

We are a medical aesthetic clinic dedicated to bringing you a comprehensive range of clinical-grade products, technologically advanced equipment, and the most innovative up-to-date non-invasive and minimally invasive procedures for the face and body.
We want you to feel empowered, reassured and confident on your journey towards realizing your aesthetic ideals. We listen to YOUR needs and desires because we believe YOU ARE UNIQUE – your body, your lifestyle and your definition of beauty are unique to you. Our treatments are individually customized and tailored to your personal requirements.

The Aesthetic Studio is led by Consultant Surgeon, Dr. Jonathan Y. Lee, who brings together his many years of reconstructive surgical experience, dedication to patient care, love for cosmetic medicine and the science of beauty.

Including acne scar treatments, dermal fillers and Botox® for rejuvenation and facial contour enhancements, laser and light-based skin treatments, non-surgical facelifts, hair removal and body contouring treatments; we ensure our treatments are safe, proven and effective.

Your comfort, safety, trust and satisfaction are our priority. Our friendly attentive professional staff aim to ensure that your every encounter with us is a positive experience. We use the most up-to-date technologies to deliver clinically proven, pain-free cosmetic treatments with little or no downtime.

For your convenience and privacy, our cozy facilities are located in the heart of the City (at Mount Elizabeth Medical Centre, Orchard Road) and in the east (at Parkway East Medical Centre). Our facilities are accredited by the Ministry of Health Singapore.

Call us now for an appointment (+65 6440 1200) and have all your Aesthetic concerns answered!

Read more about us and our services on our website:

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