Best Treatment for Ice Pick Acne Scars?

Punch excision followed by a laser such as Fraxel re:pair which is a fractionated CO2 laser device is a reasonable strategy for ice-pick type scars in Fitz type I and II (lighter) skin types. I would caution you that in darker skin types, the risk of pigmentary problems is high. Lasers alone for acne scars in general are not that helpful, and much less so for pitted acne scars. Fillers while helpful for rolling scars, spoon-shaped scars, are usually not appropriate for ice-pick scars... more

Ice pick scars are characterized by punctate deep scars that are usually caused by deep cystic acne. These scars are difficult to resurface with laser or chemical peels because the base of the scar is deep with very steep sidewalls. The most effective treatment has remained punch excision with suturing despite many advances in lasers and chemical peels over the years. Fraxel may diffusely improve the overall quality of the skin but there is no clinical evidence to support the claim that... more

I use a combination of subcision, laser resurfacing, deep chemical peeling to improve these scars. There are many variations with each technique that can be used to treat these scars. But you need a lot of experience and some out of the box thinking to really get the results. You can see my results on my website which represents what I can do. Below is a video showing one of our techniques. see video

Ice pick scars are very deep and and difficult to treat. Fraxel Repair laser and eMatrix work the best in my hands to treat ice pick scars. If you have extremely oily skin, it may be necessary to put you on isotretinoin (generic Accutane) for one week before the treatment and for one week following the treatment to to facilitate better healing without as much oil in the pores. eMatrix can be used to do touch up treatments as necessary.