CROSS Technique (TCA Cross)
Results
Side Effects

“CROSS” stands for “Chemical Reconstruction Of Skin Scars.” A chemical peel, usually trichloroacetic acid (TCA), is applied directly on the area of the...

“CROSS” stands for “Chemical Reconstruction Of Skin Scars.” A chemical peel, usually trichloroacetic acid (TCA), is applied directly on the area of the acne scar in order to maximize the effects of the chemical peel and to spare the surrounding skin. During application, the chemical peel is either (1) applied by pressing hard for a few seconds, using a sharpened wooden applicator, until a white frosting appears, or (2) injected directly into scars. TCA concentrations greater than 50% increase the efficacy of the peel because of increased thickening of the skin and collagen production.

This procedure is normally repeated 4 times in 2-week intervals.

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August 14, 2025
Phenol CROSS vs TCA: My Results
I’ve dealt with deep icepick and boxcar scars for years and have tried multiple treatments, including TCA CROSS. While TCA did give me some improvement, it always felt like the results hit a ceiling. I looked around the internet after my third TCA and I came across phenol-based CROSS and decided to give it a try. It actually worked WAY better. My deepest icepicks actually leveled out and I don’t notice the scars anymore. Some things that I found when doing some research were that phenol penetrates deeper into the scar tissue than TCA, which means it can trigger more collagen remodeling in the more stubborn scars. I actually booked a consultation and the provider Dr. Hazany also mentioned that phenol tends to cause less surface irritation while still targeting the base of the scar. That combination sounded promising, so I decided to go through with a treatment. The procedure was actually a pretty simple one, there was phenol solution applied directly into each scar using a fine applicator. My skin kind of frosted immediately at the treated spots. Compared to TCA, I didn’t feel as much stinging or burning. If I had to describe it, it felt like little microdroplets of warm water. I think that phenol based CROSS is a good option for people that have super deep scars like how I did.
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Finding a Doctor

The right dermatologist can make a big difference to your patient experience and the success of your acne treatment plan. Here are the steps to find a dermatologist who is a good fit:

  1. Use the search feature on the American Academy of Dermatology website to look for board-certified dermatologists in your area, and filter the search results for doctors with a special interest in treating acne.
  2. Read online patient reviews of any dermatologists you are considering and ask people you know whether they have any experience with these dermatologists.
  3. Do your research and go to your first appointment with questions prepared.
  4. Listen to what your gut feeling tells you once you see a dermatologist in person. If you are not completely comfortable, try a different dermatologist.
Find a Doctor Using The American Acacemy of Dermatology Website

Finding a Doctor

Only a select few plastic surgeons specialize in acne scar revision surgery. Be certain to find a provider who specializes in acne scar repair and who is passionate and experienced in this area.

Be sure to:

  • Look at before and after photos, the more the better, especially patients with similar scarring to your own.
  • Be realistic about results. Look for improvement, not a cure.

Questions to ask a potential scar revision specialist:

  • Are you board certified? Be certain that they are board certified.
  • How long have you been performing these procedures? Normally, the more experience the better, however, some younger surgeons may be more on top of the latest procedures.
  • Can I speak to some of your other patients? Ask for references for several patients who had similar scarring and speak to them about the process and their satisfaction with results.

Red flags:

  • Their story changes: As you discuss different treatment options, if they tend to change their mind easily, or agree with whatever you say, consider this a red flag. A confident, experienced surgeon will possess strong, unwavering opinions.
  • Your gut tells you "no": Trust your gut. If you just don't feel that the doctor is the right fit, trust that and move on. On the other hand, if you feel they are the perfect specialist for you, trust that feeling.
Find a Doctor Using the American Society of Plastic Surgeons Website