Why are Ice Pick Acne Scars So Hard to Treat?

asked 1 year ago by VJSerina in Providence, RI
Latest answer by Michael B. Lyons, MD, FACS
Question viewed 872 times
Tags: age 25-34, cheeks, Duac, ice pick scar

I began suffering from adult acne around age 29 and am now 32 with some improvement due to a combo of low dose doxycycline and Duac. As a result, I now have ice pick scars on my cheeks. I have read some of the posts from the docs regarding treatment and it appears that the only successful treatment is punch excision followed by resurfacing and even this only gives a 30% improvement. Why are these scars so difficult to treat and why hasn't an effective method been developed as of 2011?

6 answers to Why are Ice Pick Acne Scars So Hard to Treat?

All acne scars are difficult to treat

Yes, acne scars are very hard to manage but I believe I have a ton of experience treating them by combining silicone micro injections for large holes and CROSS TCA treatment for the small ice picks. Like anything, the two things you need to find in a provider is the physician with the right technique but also with the experience level to get the great results. CROSS can be very effective when done well and very dangerous in unskilled hands. best, Sam Lam Dallas,... more

Samuel Lam, MD
Dallas Facial Plastic Surgeon

Acne Scar Treatments

Acne scars are a challenge to physicians to treat due to the varied depths of the scar, area of the body that the scar is present in, and the skin type. Ice pick scars can be into the deepest layers of the dermis (the second layer of the skin). This area is a veritable "no man's land" as far as predictability of outcome. Hence the numerous treatments so far stated in this column. My experience has included some of all the above except using silicone. My most favorable... more

Michael B. Lyons, MD, FACS
Mobile Facial Plastic Surgeon

Ice pick scars do quite well with punch grafting and a few dermabrasions.

Ice pick scars are annoying to have but they do respond well to punch grafting and a few dermabrasions all done under local anesthesia for about $350 per scar.

David Hansen, MD
Beverly Hills Dermatologic Surgeon

Treatment of ice pick acne scars

Acne scars could be categorized into three broad categories, shallow, medium and deep( also known as ice pick scars). The goal of treatment is to reduce the visibility of the scar. The scars cast a shadow on underlying skin and can appear darker. The idea is to shallow out the scar and remove the shadow effect. The treatment approaches are different for each of the type of scar. Shallow scars generally respond more favorably to medium to deep... more

Joseph Shvidler, MD
Tacoma Facial Plastic Surgeon

Why Are Ice Pick Scars Hard to Treat?

Hi VJ. The reason ice pick scars are generally difficult to treat is because they are deep. The deeper a scar resides in the skin, the more difficult it is to revise. This is why punch excision is often recommended for this type of scar because by "punching" out the tissue, the practitioner can get to the bottom of the scar, thereby removing all the hard fibrous tissue that surrounds it and is underneath it. Many resurfacing options, including CO2... more

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon

Ice-pick acne scar treatment

A more conservative approach to treating ice-pick scars is the TCA-cross method, whereby a chemical peel solution such as TCA is applied to the scar to cause localized tissue injury and the formation of new collagen to help fill in the scar over time.

Bryan K. Chen, MD
San Diego Dermatologist

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