CROSS treatment of acne scars with trichloroacetic acid

Safoora Aamir, M. Ali Rafique Mirza, Zafar Iqbal


Objective To establish efficacy and safety of medium depth spot peeling with 35% TCA in atrophic and rolled acne scars, in Asian skin (Fitzpatrick skin type III to IV).


Patients and methods The study was carried out in the Department of Dermatology Sheikh Zayed Hospital form September 2009 to April 2010. Patients with rolled or atrophic acne scars who presented to skin or plastic surgery outdoor were enrolled in the study. After taking informed consent and counseling, the enrolled patients were put on prepeel regimen of topical application of 4% hydorquinone and tretinoin for 2 weeks. 1 to 3 spot peeling sessions, with 35% TCA, were carried out depending on severity of scars. Prepeel and postpeel photographs were taken.


Results Nine patients with acne scars were enrolled in the study. The average age was 24 years. Total of 22 peeling sessions were done. Five patients had good, 4 had excellent and 1 patient had fair improvement. None of the patients had postinflammatory hyper- or hypopigmentation, scarring or keloid formation.


Conclusion 35% TCA spot peeling in rolled and atrophic acne scars is safe, effective and affordable treatment in patients with Fitzpatrick skin type III to IV.



TCA, CROSS treatment, acne scars

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