Chemical reconstruction of skin scars therapy using 100% trichloroacetic acid in the treatment of atrophic facial post varicella scars: A pilot study

Abstract

Context:Chickenpox (varicella) is a common viral disease caused by Varicella zoster virus. Facial atrophic scars after varicella infection are not uncommon and pose a cosmetic problem. Like atrophic scars of other aetiologies, they are a difficult condition to treat. There are not enough references in the literature regarding efficient treatment of post varicella scars. High strength Trichloroacetic acid (TCA), which is known to cause dermal collagen remodelling, was used to treat varicella scars in the present study.Aims:The study was undertaken to assess the efficiency of Chemical Reconstruction of Skin Scars (CROSS) technique using 100% TCA in the treatment of atrophic facial post varicella scars. Settings and Design: Open label, pilot study.Materials and Methods:A total of 16 patients with atrophic facial post varicella scars were treated by focal application of 100% TCA solution by pressing down upon the scar surface by a toothpick (CROSS technique). Total 4 sittings were given at 2 weekly intervals and the results evaluated after 3 months of follow-up. Statistical analysis was carried out using Fischer's exact t-test.Results:All of the 13 patients who completed the study showed good clinical improvement, with 69% patients grading the response as excellent (>75%) improvement, whereas the rest 31% patients reporting good (51-75%) improvement. No significant complications were seen in any patient.Conclusions:CROSS technique using 100% TCA is a safe, cheap and effective therapy for the treatment of post varicella scars.

Late-Onset Complication of Fillers: Paraffinoma of the Lower Eyelids Clinically Mimicking Xanthelasma

“…Depth of coagulation necrosis is determined by the concentration and number of repetition of TCA11. Repetitive use of higher concentration of TCA can affect up to reticular dermis12, so some authors suggested to choose TCA concentration proportional to the severity of target lesion when treating xanthelasma13. TCA peel is a simple, straightforward, and non-surgical treatment option for xanthelasma, and it could show similar benefits for paraffinoma.…”

Novel use of trichloroacetic acid in deep heel fissures

“…A higher concentration of trichloroacetic acid (>50%) causes coagulation necrosis up to the reticular dermis resulting in a localised wound that heals with secondary intention. 2 We utilised this attribute of trichloroacetic acid for the treatment of deep heel fissures [Figure 1]. The sharp end of a wooden toothpick was used to apply trichloroacetic acid (100%) to the opposing margins of the fissures till a faint white frost was achieved.…”