Recovering from CROSS: What to Expect?

by Dr Wan Chee Kwang
October 7, 2024

While superficial acne scars fade over time, deeper ones can be more challenging to remove. CROSS (Chemical Reconstruction of Skin Scars) treatment is a common and effective option for those struggling with such scars.

This article will explore how CROSS works, and what you can expect when recovering from this treatment. By understanding the different stages of healing, you can better prepare for your journey to smoother, clearer skin.

Understanding CROSS Treatment

What is it?

CROSS treatment, or Chemical Reconstruction of Skin Scars, is a specialised dermatological procedure for treating depressed acne scars. The method involves applying a high-concentration chemical directly to the scarred area, usually trichloroacetic acid (TCA).

How it helps with acne scars

CROSS treatment is effective for boxcar, icepick and small scars. These types of scars are notoriously difficult to treat with conventional methods like laser therapy or microneedling.

A small amount of TCA is directly applied to the depressed acne scars using a fine applicator, such as a toothpick or fine brush. The acid creates a controlled chemical reaction within the scar tissue, initiating the body's natural healing response.

This healing process releases growth factors that stimulate collagen production, new blood vessel formation, and skin regeneration, gradually refining the texture and appearance of acne scars.

Immediate post-procedure

Immediately after the CROSS treatment, you may observe redness and swelling in the treated areas. These are normal reactions as the skin responds to the chemical application. The treated scars may appear white or frosted, indicating that the acid has penetrated the skin. Frosting typically lasts for a few minutes to an hour.

Your doctor may apply a soothing ointment or moisturiser to the treated areas to minimise discomfort and protect the skin. Do not touch or pick at the treated areas to prevent infection and ensure optimal healing. 

You may also be advised to apply a gentle sunscreen to protect the skin from UV damage, as the treated areas will be more sensitive to sunlight.

First few days

In the first few days following the CROSS treatment, you may still experience redness, swelling, and tenderness in the treated areas. The skin will likely begin to scab or crust over as healing progresses. Scabbing is a normal part of the recovery and is not a cause for concern.

During this time, keep the treated areas clean and moisturised. Avoid harsh skincare products, such as exfoliants or retinoids, which irritate the skin. Instead, use a mild cleanser and a hydrating moisturiser to soothe the skin.

1 to 2 weeks

As you move into the 1 to 2-week mark, the scabs or crusts will begin to flake off, revealing new, healthy skin underneath. The treated areas may remain slightly red or pink, but this discolouration will gradually fade.

You may start to notice some improvement in the appearance of your acne scars, though the full effects of the treatment may not be visible yet.

Continue using gentle skincare products and sunscreen to protect your healing skin.

2 to 4 weeks

By the 2-4 week mark, most of the initial redness and scabbing should have subsided, and the treated skin will keep improving in texture and appearance. The skin may still be slightly sensitive, so continue using gentle skincare products and avoid any activities that could irritate the skin, such as excessive sun exposure or vigorous physical activity.

During this time, the collagen production stimulated by the CROSS treatment will continue to work beneath the skin's surface. While you may notice some improvement in the appearance of your acne scars, it is essential to remember that the full results of the treatment can take several months to become apparent.

Long-term healing (1-3 Months)

Over the next 1-3 months, your skin will remodel as new collagen is produced and the treated scars gradually fill in. During this period, you may see dramatic improvement in the skin's texture, with acne scars becoming less noticeable over time.

Being patient during this phase is essential, as the healing process can take several months. Most patients require multiple CROSS treatments for their scars to clear. During the recovery period you may notice that the redness around your scars still persists. You need not be worried about this as it’s part of the healing process of your skin.

In some cases, combining CROSS with other acne scar removal treatments, such as radiofrequency microneedling or laser therapy, may enhance the overall effectiveness of scar reduction. Your doctor may also use growth factors, which make wounds close up faster and better, to improve the safety profile and effectiveness of your CROSS treatment.

Tips for smooth recovery

For a smooth recovery and to optimise results from your CROSS acne scar treatment, follow these tips:

  • Follow your dermatologist's aftercare instructions
  • Keep the treated areas clean and moisturised
  • Avoid sun exposure
  • Avoid picking at the scab
  • Be patient for gradual results

Acne scar treatment in Singapore

CROSS acne scar treatment is a targeted and effective solution for those struggling with atrophic scars. While the recovery process requires patience and care, the results can be the even skin you’ve always desired..

At 1Aesthetics, we specialise in various acne scar treatments, including the CROSS method, to help you achieve smoother skin. Our experienced doctors will personalise treatment plans to address your unique skin concerns.

We invite you to schedule a consultation with us if you're considering CROSS or other acne scar treatments in Singapore.

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