Comparing the Use of 80% Trichloroacetic Acid and 50% Trichloroacetic Acid for the Treatment of Ice Pick Acne Scars

Abstract

BACKGROUND Chemical reconstruction of skin scars (CROSS) using high concentration trichloroacetic acid (TCA) is a safe, effective, and low-cost treatment for ice pick acne scars. OBJECTIVE To compare the efficacy and effectiveness of the CROSS technique using 50% TCA and 80% TCA for treating ice pick scars. MATERIALS AND METHODS A nonrandomized, single-blinded, and self-controlled clinical trial was undertaken. Four CROSS sessions were conducted using 50% TCA on the left hemiface and 80% TCA on the right hemiface. The E′ chelle d'Evaluation Clinique des Cicatrices d'Acne (ECCA) acne grading scale was used to assess the scars pretreatment and posttreatment. Complications were evaluated after each session. RESULTS Thirty-one patients participated in our study. Significant differences were found between pretreatment and posttreatment ECCA scores (p < .0001) on both hemifaces. Scores were significantly lower on the side treated with 80% TCA; however, there was no statistical significance in mean ECCA score differences (pretreatment minus posttreatment) between the 2 treatment sides. The adverse events were more serious on the sides treated with 80% TCA. CONCLUSION The CROSS method using TCA was well-tolerated and effective for treating ice pick acne scars. Less severe complications were associated with 50% TCA, whereas efficacy was the same as 80% TCA.