Introduction <p>The CROSS (Chemical Reconstruction of Skin Scars) technique employs high concentrations of trichloroacetic acid (TCA). This study aimed to compare the efficacy, safety, and tolerability of the CROSS technique using 70% and 100% TCA.</p> Methods <p>A total of 40 patients were randomly assigned to two equal groups of 20: the first group received 70% TCA, while the second group was treated with 100% TCA. Both patient-reported outcomes and researcher assessments were utilized to evaluate treatment success. The intensity of the burning sensation experienced during the procedure was quantified, and the duration of the frosted appearance was recorded.</p> Results <p>The mean age of participants was 27.07 ± 5.48 years in the 70% TCA group and 23.5 ± 2.9 years in the 100% TCA group. No significant differences were observed between post-treatment scores provided by patients and researchers. However, within the 100% TCA group, treatment efficacy was significantly greater for icepick scars than for boxcar scars. Additionally, crusting durations were significantly prolonged in the 100% TCA group.</p> Conclusion <p>No significant differences in overall efficacy were observed between the two treatment groups. Notably, the crusting time following the procedure was longer in the group treated with 100% TCA.</p>