Can microdermabrasion get rid of sunken scars,like ice pick scars and boxcar scars? And will it help eliminate freckles?

Acne scar treatments require precision and attention to detail. There are several types of acne scars, including atrophic, hypertrophic, PIH hyperpigmented, and hypopigmented scars. Depending on the types of scars you have, our office can recommend a Hidef treatment protocol that can recontour existing scars and reduce complexion irregularities. The results are simply life-changing.

As a general rule, we recommend fillers, subcision, acne surgery, RF ablation, and laser ablation to help with atrophic scars. Hypertrophic and keloid acne scars require pulsed dye laser and IIT SC. PIH scars require chemical peels, Melarase creams (AM and PM) and laser.
If you have ice-pick scars, we recommend RF ablation and TCA Cross.
Best,
Dr. Karamanoukian
Realself100 Surgeon

Microdermabrasion is a great treatment to kick start skin that is in desperate need of exfoliation, as a routine maintenance treatment for healthy skin or a preparatory treatment for some laser treatments.  However, microdermabrasion is not an effective treatment for ridding of sunken scars, ice pick scars,  or box car scars. These scars are most effectively treated utilizing acne scar subcision,  fractional laser resurfacing(non-ablative or ablative) or a combination of the two. Be mindful that when opting for non-ablative resurfacing, a series of 3-6 treatments are best for yielding optimal results. Laser treatments that target pigmentation coupled with a home care lightening regimen will be most effective in addressing the freckles. As always, be diligent with your sunscreen!

Microdermabrasion is a relatively light, noninvasive procedure to exfoliate the outermost layers of the skin.  While its a great treatment, and at our practice, we often combine it with a variety of topical treatments to improve skin texture and pigmentation.  That said, the type scarring that your describe (ice-pick and boxcar scarring) will not show significant improvement with microdermabrasion.  Depending on your skin type and the extent of your scarring, there are a variety of other options available, including laser skin resurfacing, subcision, punch grafting, and injection of fillers.  Freckling would probably best be treated with an IPL or laser treatment, or a chemical peel, again depending on your skin type. 

You may see some mild improvement with your scarring and freckles, although IPL or BBL photo rejuvenation for the freckles, and laser resurfacing with an ablative fractionated laser such as a Profractional for the scarring would be far more effective (since deeper).

Microdermabrasion is a great topical treatment to smooth out your skin and treat mild acne.  However, it will do nothing for ice pick scars and freckles.  The best treatment for these types of scars and freckles is the Fraxel laser.  The 1927 wavelength of the Fraxel will remove all of the hype pigmentation.  The 1550 wavelength will treat the scars but will take 4 to 5 treatments depending on the depths of your scars.  Please find a board certified dermatologist with a great deal of experience with lasers for the best results.