Can chemical peels help with ice pick and rolling acne scars?

Acne scars are usually characterized within the subtypes of atrophic, hypertrophic, pigmented, or inflammatory. These subtypes of acne scars can be visually discerning in ambient light and can cause significant cosmetic concerns. Indented and atrophic scars require a combination approach to stimulate collagen and elastin, thereby smoothing contour and uneven skin. These are usually combined with lasers and depigmentation protocols to reduce inflammatory hyperpigmentation (Melarase AM and Melarase PM). Our Hidef protocols for acne scars include fillers such as Sculptra, Juvederm, Radiesse, and Restylane to improve deep acne scars; Vascular lasers to reduce inflammation and post-inflammatory redness and erythema; Fractional lasers to smooth contour and collagen; and Fractional RF to stimulate production of collagen within atrophic scars. Textural improvement and superficial scarring can be improved with Cosmelan peels, TCA Cross for ice-pick scars, deep chemical peels, and fractional CO2. We offer a personalized approach to your combination of scars and a formal evaluation with consultation is recommended to help you achieve your final results. Our plastic surgery office offers subcision and combination TCA Cross to help reduce deeply pitted scars. In terms of pigmentation and skin resonance, we recommend daily use of Melarase AM and Melarase PM coupled with Retinoid creams to achieve brilliant skin.

Best,
Dr. Raffy Karamanoukian
Realself100 Surgeon

Generally I would encourage you to wait a full year after completing the course of accutane before considering and type of chemical peel and then only if oil production in the skin has returned to normal.  For the most part, chemical peels are only modestly helpful for acne scars especially in young people.  Direct acne scar surgery with subcision and possible fat grafting is more reliable but this depends on the individual scar.  The Cross method has been successful for given individuals but I have also seen some terrible scars caused by peelers who did not really understand the limitation of this method.  I think extreme caution in appropriate for that approach.  I also have patients with acne scars who get hyaluronic acid fillers as a volume option which does not require much down time and are very pleased with this approach.  Let your face recover from the accutane and get several opinions before proceeding.

Chemical peels rarely are of any value in treating acne scars.  The gold standards for ice pick scars are dermabasion (NOT micro dermabrasion) or fractional CO2 laser resurfacing.  These may be don alone or in combination with surgical removal of some of the scars first.

Thank you for your question. Although chemical peels are an option in treating acne scars, they are associated with significant downtime and potential complications in certain skin types, considering very deep peels have to be performed to resolve acne scarring. As of today, the treatment of choice for acne scarring is a radiofrequency micro needling device such as Infini or non-ablative fractional laser resurfacing. These are done in a series of treatments, are safe for nearly all skin types, and can achieve very significant improvement in deep acne scars.