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Objectives: We do have different peelings from superficial AHA-peels to middle deep with TCA in different concentrations until deep peel with phenol. It is a fact and widely accepted that deep peels with phenol are more effective than superficial peels with AHA or low-concentrated TCA. This presentation will show other parameters which play a entirely important role in penetration and therfore result and risk of complication respectively.

Introduction: The effect of peeling does not only depend on the used solution such as AHA, TCA or Phenol. The penetration of the peeling solution is responsible for the result you want to achieve but also the risk of complication. So the question arrises where to use which solution for best results with minimum risk of complications.

Materials / method: The effect on each peeling - be it superficial or deep - is destruction of the skinlayer, exfoliation followed by inflammation causing long term collagen synthesis. Depending on the aggresivity of the solution the penetration is deeper. However the penetration is not only dependent to the solution only but also to the technique beeing used. Futher making the proper indication is probably the most crucial and most difficult point in peeling treatments.

Results: Before any peeling, the doctor must make a clear diagnosis for the choice of the appropriate peeling solution. The mode of action of the different peeling solutions should be understood entirly and the technique must be carried out mach standardised methods. Follow-up and aftercare are almost more important than the peeling treatment itself.

Conclusion: Peelings are of most efficient but also relied - depending on the depth of peeling - to a non-negligible downtime or complication rate respectively. Unlike the general opinion the penetration of the peeling solution and therefore the expected result is not depended to the solution itself alone but to the technique of application the pre- and post care of the patient.

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Objectives: The Chemical Reconstruction of Skin Scars (CROSS) technique was first
described in 2002, with some variations in its technique and concentration. The presentation will review the literature on this technique in postacne scarring. The personal experience of the author in patients of skin type IV will be presented.

Introduction: Postacne atrophic scars such as icepick ones remain present even after fractional laser sessions and must be approached specifically. TCA CROSS technique is a method using concentrated TCA to induce collagenization of those scars. It is an easy and affordable office precedure.

Materials / method: In this presentation how to perform the procedure with 70% TCA, what to avoid and the outcome and follow-up of patients with skin of color will be shown. Combining the procedure with other modalities whether in the same session with modified Jessner peel or in a later on session with microneedling will be presented.

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