I have several deep ice-pick scars, most notably one on my chin and two on my nose. My understanding is that punch excision or TCA-cross method maybe the best treatment options. However, when I went to one prominent Manhattan derm, he tried to convince me to do Fraxel. It is also my understanding that this kind of laser won't do much for this type of scar. Any advice on choosing a term/ plastic surgeon is much appreciated! I want to save everyone's time and avoid numerous consults :-)
Advice for Choosing Doctor to Treat Ice-pick Scars?
Doctor Answers 3
Ice pick scars and how to treat them
I have heard that fraxel has not improved many people's acne scars. I've seen many patients that have had this also with minimal improvement. Ice pick scars are very difficult to treat. TCA seems to work the best but the recovery can be trying. Deep fx can help pull the deeper tissue and make them so they are less deep. But I think for me ice pick scars are better treated with TCA CROSS method. After they get closer to the normal skin level I would then do a multilayered approach to further improve the scars.
I'd recommend fillers actually
I very rarely suggest patients do punch excisions for acne scars. It re-injures the site, possibly causing more harm, and requires that your physician go wider and deeper than the icepick scar to remove it. An easier and better treatment for icepick scarring is usually to fill those in with dermal filler (like Restylane). Even though it will have to be repeated probably yearly, the effect is so much better and has so many less problems that re-injuring the skin. I always recommend board-certified physicians. The nose, in particular, is not a good place for punch excisions!
Ice pick scars
I agree that TCA CROSS or punch excision is typically the best approach for ice pick scars. Lasers do not work well for ice pick scars in my opinion. The key is to go to someone experienced and who is skilled in many different techniques so that treatment can be tailored specifically to you.
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