Best Treatment for Ice Pick Acne Scars?

What is the best treatment for ice-pick acne scarring? I am interested in doing Fraxel Re:pair, and maybe punch excision beforehand but would like more input.

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acne scars ice pick scar

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6 Doctor Answers | Asked by daniel in California

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You have a few good options 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 and Punch Excision

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

TCA CROSS works for ice pick acne scars.

For deep ice pick scars, I use TCA - CROSS, a technique which involves spot peeling with TCA 50% or 100%, applied at the base of the scar using a blunt, but fine probe. Results typically start showing around 6 to 8 weeks, with more improvement over 3 - 6 months, and it works fine even in darker skin, which is the type I predominantly get to treat. A test area targeting say, 5 to 10 lesions, should always be treated before going onto a larger area. This technique does have a downtime of... more

Fraxel For Acne Scars

Thank you for your question. At my practice, I have gotten excellent results for scarring with Fraxel. This treatment eliminates irregular skin discoloration, and stimulates new collagen production, tightening the skin without prolonged recovery. After a series of 2 to 4 Fraxel treatments, the cumulative cosmetic improvement is near more aggressive lasers, but unlike more aggressive lasers, redness and swelling eliminated within 2 to 4 days after each treatment. Fraxel is outstanding for... more

Ice pick scars are hard to treat

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

Philip Young, MD

6 reviews

Bellevue Facial Plastic Surgeon

I like Like Fraxel Repair and eMatrix for treating Ice Pick Scars.

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.