Percutaneous collagen induction versus full-concentration trichloroacetic acid in the treatment of atrophic acne scars

Dermatol Surg. 2011 Feb;37(2):207-16. doi: 10.1111/j.1524-4725.2010.01854.x. Epub 2011 Jan 26.


Background: Percutaneous collagen induction (PCI) promotes removal of damaged collagen and induces more collagen immediately under the epidermis. The chemical reconstruction of skin scars (CROSS) method is a focal application of full-concentration trichloroacetic acid (TCA) to atrophic acne scars. The CROSS method has the advantage of reconstructing acne scars by increasing dermal thickening and collagen production.

Objective: To compare the safety and efficacy of PCI and the 100% TCA CROSS method for the treatment of atrophic acne scars.

Materials and methods: Thirty participants were randomly equally divided into two groups; group 1 underwent four sessions (4 weeks apart) of PCI, and group 2 underwent four sessions (4 weeks apart) of 100% TCA CROSS.

Results: Acne scarring improved in 100% of patients. Scar severity scores improved by a mean of 68.3% (p<.001) in group 1 and a mean of 75.3% (p<.001) in group 2. The difference in the degree of improvement was not statistically significant between the groups (p=.47).

Conclusions: PCI and 100% TCA CROSS were effective in the treatment of atrophic acne scars.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acne Vulgaris / complications*
  • Acne Vulgaris / pathology
  • Adolescent
  • Adult
  • Caustics / administration & dosage*
  • Chemexfoliation*
  • Cicatrix / etiology
  • Cicatrix / pathology
  • Cicatrix / therapy*
  • Dermabrasion*
  • Female
  • Humans
  • Male
  • Treatment Outcome
  • Trichloroacetic Acid / administration & dosage*
  • Young Adult


  • Caustics
  • Trichloroacetic Acid