The Use of Chemical Reconstruction of Skin Scars (CROSS) Method With Trichloroacetic Acid (TCA) for Atrophic…

Cohort studyThe Journal of clinical and aesthetic dermatology· Jun 2026

The Use of Chemical Reconstruction of Skin Scars (CROSS) Method With Trichloroacetic Acid (TCA) for Atrophic Scars: A Comprehensive Review on Application Techniques, Adjunct Therapies, and Complications.

Scott Stratman, Helen He

DermatologyCohort studyTreatmentQ2IF 1.5

TCA CROSS method shows high improvement rates for atrophic scars.

The Use of Chemical Reconstruction of Skin Scars (CROSS) Method With Trichloroacetic Acid (TCA) for Atrophic Scars: A Comprehensive Review on Application Techniques, Adjunct Therapies, and Complications.

Scott Stratman, Helen He

The Journal of clinical and aesthetic dermatology · Jun 2026 · Q2 in Dermatology

Background

Atrophic scars have a significant psychosocial and functional impact on quality of life.

Purpose

To evaluate the methodology, indications, efficacy, and safety profile of the trichloroacetic acid chemical reconstruction of skin scars technique in atrophic scarring and to compare trichloroacetic acid chemical reconstruction of skin scars outcomes to other therapeutic modalities and assesses its adjunctive use.

Methods

A PubMed literature search was performed for clinical studies evaluating trichloroacetic acid application in scar management; inclusion criteria focused on studies using the chemical reconstruction of skin scars technique published after 2002.

n = 937 patients

50%

Results

50%

to 80%

percentage of patients whose indented scars got better with treatment

n = 937 patients

More results

34 publications (20 clinical trials, 4 comparative/cohort studies, 4 case series, 2 case reports, and 4 expert opinions) met eligibility criteria.

Trichloroacetic acid chemical reconstruction of skin scars was primarily used for ice pick and boxcar acne scars, but it was also used for varicella and leishmaniasis scars.

More results

Application techniques varied, with fine-gauge needles and paintbrushes enabling more precise delivery.

Multiple sessions yielded greater improvement, and higher trichloroacetic acid concentrations increased the risk of complications.

“

Conclusion · 1 of 2

Trichloroacetic acid chemical reconstruction of skin scars is a safe, effective option for treating atrophic scars.

Conclusion · 2 of 2

Methodical application and multimodality approaches optimize patient outcomes; further research should address technique standardization and efficacy across diverse skin types.

The Use of Chemical Reconstruction of Skin Scars (CROSS) Method With Trichloroacetic Acid (TCA) for Atrophic Scars: A Comprehensive Review on Application Techniques, Adjunct Therapies, and Complications.

The Use of Chemical Reconstruction of Skin Scars (CROSS) Method With Trichloroacetic Acid (TCA) for Atrophic Scars: A Comprehensive Review on Application Techniques, Adjunct Therapies, and Complications.

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