New Advances Combining the Chemical Reconstruction of Skin Scars (CROSS) and Subcision

Introduction

Minor acne scarring occurs in up to 95% of acne cases, and 22% of these patients are affected with a more significant and psychologically disturbing degree of scarring (as reported by Layton et al., 1994). Various treatment modalities are used for reconstructing and improving the appearance of acne scars, including dermabrasion, punch excision, punch elevation, dermal fillers, microneedling (with/without radiofrequency), subcutaneous incision (subcision), and chemical and laser skin resurfacing (ablative and nonablative). The chemical reconstruction of skin scars (CROSS) technique significantly added to this armamentarium of options by allowing physicians to treat boxcar and icepick scars in all skin types, with little downtime required and small risk of complications (especially postinflammatory hyperpigmentation). The challenge many patients still face is that their physicians rely on resurfacing options alone instead of using combination therapies to treat their different types of scars.