Fraxel and punch graft options
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.
TCA CROSS or punch excision
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
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.
Ice Pick scars and Hispanic/Asian skin
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
TCA CROSS works for ice pick scars
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
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.
Punch excision or grafting for ice pick scars
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.
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.
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.