Single Session Treatment of Rolling Acne Scars Using Tumescent Anesthesia, 20% Trichloracetic Acid Extensive Subcision, and Fractional CO2 Laser

Dermatol Surg. 2017 Jan:43 Suppl 1:S70-S74. doi: 10.1097/DSS.0000000000000895.


Background: Successful treatment of acne scars is challenging. Many modalities have been used with marginal success.

Objective: The authors describe a combination of a superficial chemical peel, subcision, and fractional carbon dioxide (CO2) laser resurfacing in a single-treatment session as a novel treatment approach for rolling acne scars.

Methods: A total of 114 patients (75 women and 39 men) with predominantly rolling acne scars were treated with a 20% trichloracetic acid chemical peel, subcision with a novel dissecting instrument, and the CO2 laser under tumescent anesthesia. This was a retrospective, uncontrolled, unblinded study.

Results: The mean improvement after a single treatment was 2.9 on a scale of 1 to 4 with few complications. Ninety percent of the patients were satisfied with their final result and desired no additional treatment.

Conclusion: The combination of a trichloracetic acid 20% chemical peel, subcision, and fractional CO2 laser resurfacing combined with tumescent anesthesia is both safe and effective in the treatment of rolling acne scars.

MeSH terms

  • Acne Vulgaris / complications*
  • Administration, Topical
  • Adult
  • Anesthesia
  • Chemexfoliation / methods*
  • Cicatrix / etiology
  • Cicatrix / surgery
  • Cicatrix / therapy*
  • Cosmetic Techniques
  • Dermatologic Agents / administration & dosage*
  • Female
  • Humans
  • Laser Therapy / methods*
  • Lasers, Gas
  • Male
  • Retrospective Studies
  • Treatment Outcome
  • Trichloroacetic Acid / administration & dosage*


  • Dermatologic Agents
  • Trichloroacetic Acid