Skin
scars remain a therapeutic challenge to dermatologists. Over the past several decades, numerous surgical techniques have been used to improve the appearance of
scarring. The objective of this study is to evaluate the efficacy of a local application of a (50%) concentration of
trichloroacetic acid (TCA) for the treatment of atrophic
acne scars (grade 3 in Goodman classification), as opposed to the higher (90%) TCA concentration used in previous studies, in order to reduce adverse local effects. The primary goal was the resolution of
acne or
chickenpox scars. Secondary goals were physician and subject assessments of
scar improvement. Fifty percent TCA was applied locally to atrophic
scars in five patients. Three patients had treated
scars on the face and two patients had treated
scars on the back. Wooden applicators were used to apply TCA locally and the treatment was repeated at 4-week intervals for a total of three sessions. Digital photographic analysis of lesions supported clinical observations. Histologic examination was performed only on two samples of patients with treated
scars on the back. Clinical examination revealed cosmetic improvements in both depth and appearance of skin
scars. We believe that the 50% TCA CROSS can be an effective technique for the treatment of atrophic
scars.