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Original Article
CROSS treatment
trichloroacetic acid
of
acne
scars
with
Abstract
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.
Key words
TCA, CROSS treatment, acne scars.
Introduction
Acne is one of the most common dermatological
conditions affecting 80 to 90% individuals in the
12-24 age group.1 Treatment is tailored
according to the severity of acne. If left
untreated, few cases with severe acne can lead to
permanent scarring which is one of the most
Address for correspondence
Dr. Safoora Aamir, Assistant Professor,
Department of Dermatology,
Federal Postgraduate Medical Institute &
Sheikh Zayed Hospital, Lahore
Ph# 0300 4248549
Email: safooraamir@yahoo.com
180
181
19/F
26/F
30/M
18/F
18/F
24/F
38/F
21/M
20/F
Rolled
Rolled
Rolled
Atrophic
Rolled
Atrophic
Atrophic
Rolled
Rolled
1
2
3
3
3
2
2
3
3
% improvement
Clinician
>50
>50
>75
>75
>75
>50
>75
>50
>50
% improvement
Patient
50
50
75
75
50
50
50
25
50
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