Chemical reconstruction of skin scars

The use of high-strength TCA (65-100%) for acne scarring has proven to be an exciting new application of TCA. In this technique chemical reconstruction of skin scars (CROSS technique) showed significant improvement. Specifically high-concentration TCA is focally apphed to depressed or ice-pick scars and pressed hard with the wooden end of a cotton tip applicator. This induces a localized scar to occur, which over time effaces the depressed scar. Typically this requires five or six courses of treatment spread out over intervals of weeks to months. 

Lee JB, Chung WG, Kwahck H, Lee KH (2002) Focal treatment of acne scars with trichloroacetic acid chemical reconstruction of skin scars method. Dermatol Surg 28 1017-1021... 

Fabbrocini G, Cacciapuoti S, FardeUa N, Pastore F, Monfrecola G (2008) Cross technique chemical reconstruction of skin scars method. Dermatol Ther 2LS29-S32... 

Chemical Reconstruction of Skin Scars (CROSS) Technique... 

Figure 10.14 CROSS with 100% TCA using syringe with fine needie for eniarged pores on the nose (A) before and (B) after four courses and two months after the last treatment. (From Whang SW, Lee KH, Lee JB, Chung KY. Chemical reconstruction of skin scars (CROSS) method using a syringe technique. Dermatol Surg 2007 33 1539-40. With permission from WIley-Blackwell)...

Dermatological Surgery 35 1134—1135 Kim FU, Kim TG, Kwon YS et al 2009 Comparison of a 1,550 nm erbium-glass fractional laser and a chemical reconstruction of skin scars (CROSS) method in the treatment of acne scars a simultaneous split-face trial. Lasers Surgical Medicine 41 545-549... 

The level of improvement can vary with regard to different diseases and individual patients. With training and experience, one will be able to select the most apjjropniate peel type(s) to address a patient s specific skin condition. For example, a patient with ice-pick acne scars can expect only mild improvement in the scars even if skin texture is remodeled. Conversely, a patient with isolated box car scars can obtain a significant improvement with focal application of TCA at 50-90% to individual scars. This technique called TCA CROSS (chemical reconstruction of skin scars) can produce more than 70% improvement of visible scars with homogeneous tightening of the skin. 

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