Immediately after treatment:
- Right after treatment with the CROSS technique, the skin will sting or burn. The skin in the treated area may become red and/or swollen. The treated scars themselves will be white or have a “frosted” appearance.
- After treatment, the doctor may prescribe an antibiotic that will need to be applied until crusts form on top of the treated scars.
- No dressings are necessary after treatment with the CROSS technique.
Days and weeks after treatment:
- In the days after treatment, if your doctor has prescribed an antibiotic, you will need to apply it to the treated scars until crusts form.
- Crusts will form on top of the treated scars 1-3 days after treatment. These crusts will shed spontaneously in 5-7 days.
CAUTION: Detaching the crusts may increase the likelihood of side effects such as skin coloration changes (hypo- or hyperpigmentation). Instead of detaching the crusts yourself, wait for them to fall off on their own.
- It is important to avoid sun exposure and apply sunscreen for 1 month after the treatment.
- You may use make-up to camouflage skin redness and other side effects while your skin heals.
Longer term:
The most common long-term complications of treatment with the CROSS technique are persistent skin redness (erythema) and skin coloration changes, especially skin darkening (hyperpigmentation).
References
- Levy LL, and Zeichner JA. Management of acne scarring, part II. A comparative review of non-laser-based, minimally invasive approaches. Am J Clin Dermatol. 13(5), 331-340 (2012).
- Kontochristopoulos G, and Platsidaki E. Chemical peels in active acne and acne scars. Clin Dermatol. 35(2), 179-182 (2017).
- Lee JB, Chung WG, Kwahck H, and Lee KH. Focal treatment of acne scars with trichloroacetic acid: chemical reconstruction of skin scars method. Dermatol Surg. 28(11), 1017-21 (2002).
- Bhardwaj D, and Khunger N. An Assessment of the Efficacy and Safety of CROSS Technique with 100% TCA in the Management of Ice Pick Acne Scars. J Cutan Aesthet Surg. 3(2), 93-6 (2010).
- Agarwal N, Gupta LK, Khare AK, Kuldeep CM, and Mittal A. Therapeutic response of 70% trichloroacetic acid CROSS in atrophic acne scars. Dermatol Surg. 41(5), 597-604 (2015).
- Ahmed R, Mohammed G, Ismail N, and Elakhras A. Randomized clinical trial of CO₂ LASER pinpoint irradiation technique versus chemical reconstruction of skin scars (CROSS) in treating ice pick acne scars. J Cosmet Laser Ther. 16(1), 8-13 (2014).
- Khunger N, Bhardwaj D, and Khunger M. Evaluation of CROSS technique with 100% TCA in the management of ice pick acne scars in darker skin types. J Cosmet Dermatol. 10(1), 51-7 (2011).
- Nofal E, Helmy A, Nofal A, Alakad R, and Nasr M. Platelet-rich plasma versus CROSS technique with 100% trichloroacetic acid versus combined skin needling and platelet rich plasma in the treatment of atrophic acne scars: a comparative study. Dermatol Surg. 40(8), 864-73 (2014).
- Dalpizzol M, Weber MB, Mattiazzi AP, and Manzoni AP. Comparative Study of the Use of Trichloroacetic Acid and Phenolic Acid in the Treatment of Atrophic-Type Acne Scars. Dermatol Surg. 42(3), 377-83 (2016).
- Ramadan SA, El-Komy MH, Bassiouny DA, and El-Tobshy SA. Subcision versus 100% trichloroacetic acid in the treatment of rolling acne scars. Dermatol Surg. 37(5), 626-33 (2011).
- Uptodate.com The management of acne scars. Available from: https://www-uptodate-com.eresources.mssm.edu/contents/management-of-acne-scars?source=search_result&search=management%20of%20acne%20scars&selectedTitle=1~27#. Last retrieved: 26 September 2017.