How Do I Get Rid of Ice Pick Scars?

Hello, I am a 28 year old half asian/half hispanic female with medium olive skin tone. I have a scar on my left cheek....not too deep but I think it is probably an ice pick type of scar. I have several of them in the same location on my cheek.

My question is that I have been doing the aramis for collagen production and med-lite treatments for dark spots left behind from old acne and have not really seen much results. I really hate the ice pick scars I have on my left cheek but the rest of my face is fairly decent.

I was wondering if it would be wise to have the fraxel light treatment done in just that one area of my face? I have also been reading about punch excision and graphs and subincision and really don't know which route would be best for me and my ethnicity. Any suggestions? Thank you.

Doctor Answers 10

Ice Pick scars and Hispanic/Asian skin

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When you have a darker complexion special care in the choice of treatment and lasers must be addressed.  I would recommend punch graft followed by eMatrix from your description. It is vital to consult a dermatologist with expertise in lasers and scars with your skin type.  Best, Dr. Green

Fraxel and punch graft options

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Fraxel can be used on darker skin, but there does need to be a good pre- and post-treatment protocol to prevent pigmentation. Your dermatologist can discuss this at your first consultation. In addition, a procedure using a tiny punch tool can remove the deeper scars, then you can get Fraxel or dermabrasion for enhanced results.

Sun avoidance is essential, and multiple sessions of Fraxel will be needed, but youcan get significant improvement of these types of scars.

Good Luck!

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 reviews

Ice-pick scars

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For a few scattered ice-pick scars, excision can be a great option. When followed up by a resurfacing treatment such as fractional CO2 laser skin resurfacing, dramatic improvements can occur. Sometimes a small amount of filler can be helpful as well. Additionally, a medical grade skin care regimen can be customized in order to achieve optimal results and help with any inflammatory pigmentation issues.

A consultation with a physician specializing in facial aesthetics can be very helpful to formulate a customized a treatment plan.

All the best,

Matthew Richardson, MD
Frisco Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

TCA CROSS or punch excision

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The answer lies in the method, not the actual treatment or device. Ice pick scars are best treated with TCA CROSS or with surgical punch excision.

For a detailed review, watch the video in the web reference below. 
All the best

Dr Davin Lim 
Laser Dermatologist

Icepick scars

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Thank you for your question and for sharing your concerns with us. Your approach is very reasonable. I would recommend that consider a direct excision of an icepick scar. It will certainly help create a flatter scar. Afterwards, you can consider lasers to help blend it in to the background. The right laser for you would depend on your skin type.  With asian skin, I am finding a lot of success with the Venus Viva to help blend in the scar to the background.

TCA CROSS works for ice pick scars

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TCA (100% or lesser concentrations) works well for ice pick scars. TCA is typically delivered to the base of the scar, and works by building up collagen to fill out the scar. The procedure is painless and results start showing by 4 - 6 weeks, though complete healing and return of skin colour to normal may take more time. It does have a downtime of about 1 -2 weeks though. The results are quite good in fair skin, though it works well for darker skin as well.

Improving deep ice pick acne scars

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Acne scars vary in terms of pigmentation, contour, and depth to width ratio. In most cases, scar revision can improve the appearance of scars. Ice pick scars can be improved by excisional microsurgery to remove the scar depth. This is usually performed in an outpatient clinic setting.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Punch excision or grafting for ice pick scars

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Ice pick scars are holes that travel nearly the full thickness of the skin.

In my opinion, the best option is to do a punch excision and close small scars, and graft (not graph) larger scars.

There is NO WAY to fill them as a solution. So I don't think you should spend your money on collagen. Fraxel will not work. Dermabrasion, laser resurfacing, or ablative lasers will also not work.

I hope this helps.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Ice pick acne scars

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There are several lasers that can possibly improve the collagen under the ice pick scars, but with your skin, you have to be careful with peels and other ablative lasers. Sometimes, excision and closure can help, and sometimes fillers can be a nice, temporary way to elevate the ice pick component.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Fraxel For Acne Scars

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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 fine wrinkles, mild skin laxity, irregular pigmentation, acne scars, surgical scars, enlarged pores, stretch marks, age spots and Rosacea. It can be used safely on the face, neck, hands, arms, and chest.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.