Efficacy of 100 % TCA (Trichloroacetic Acid) in the Treatment of Atrophic Facial Post Varicella Scars

Abstract

Background: Atrophic facial scars from varicella can affect confidence and quality of life. Among treatments, 100% TCA peels show encouraging results in improving skin texture and scar appearance. Although international evidence supports their effectiveness, local data are limited. This study aims to evaluate TCA peel outcomes in our population. Objective: Assessment of therapeutic outcomes of 100% TCA CROSS application in treatment of atrophic facial post-varicella scars Methods: After approval of synopsis and permission from ethical review committee, one hundred (100) patients form both the genders with age between 10-40 years presenting with post-varicella atrophic facial scars falling under Goodman Grade III or IV were included. All participants provided informed consent in written form. These patients were treated by CROSS using 100% TCA every fortnight for 4 sessions. Study variable was outcome of treatment which was assessed 3 months after the last session and was graded as excellent (3 grades decline from baseline), good (2 grades decline from baseline) and fair (1 grade decline from baseline) depending upon final Goodman Grade.   Results: The patients had a mean age of 25.4±7.7 years, mean scar duration of 3.5±1.5 years and 10.2±4.5 scars. Overall, 45% were married. Excellent outcomes were observed in 71% and good in 29%, with no significant differences across subgroups based on age, gender, marital status, scar duration, or number. Conclusion: The use of 100% TCA for CROSS was found safe and effective approach for managing atrophic facial scars following varicella. Most patients demonstrated excellent improvement after four treatment sessions, confirming TCA CROSS as a practical, well-tolerated option in routine dermatological practice.