Most effective treatment for Ice-Pick Acne Scars? (photo)

I am 34 and finally want a smooth face. My acne is not active, very mild (blackheads, occasionally) I use retin-a cream .05% nightly and hope its working. My budget is not big and can afford little downtime. I would like to use a treatment that also has skin tightening (for my emerging nasal labial folds. My neck also has a "chicken-skin" texture- any treatment that can do it all? Any suggestions would be greatly appreciated! Thank you

Doctor Answers 4

Treating Ice Pick scars

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The scars on your face have are "ice pick" and unfortunately topical creams will only hep the acne but not the scars.  If you are having emerging nasolabial folds then an injection of Restylane would be best at your age and at the depth of the folds.  The scars can be treated with Fraxel laser at the 1550 setting or eMatrix laser. Skin tightening can only be done with Thermage, BBL, or eMatrix.  Perhaps the best choice for you might be to have the eMatrix laser since both skin tightening and acne scar treatment can be performed simultaneously.  An in office consultation is really the only way to give a clear analysis of the situation.  Please consult a board certified dermatologist with experience in acne scars and cosmetic treatments.

Acne Scar Treatments

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Topical creams alone will not help your scars.  It may improve the texture and color of the skin but not the valleys and the ice picks.  I suggest going to a laser expert as you prob need a combination of lasers, TCA-CROSS (chemical peel type treatment for deep scars), possibly surgical removal of bigger scars, and/or microneedling.  You want to go to someone who is an acne scar expert and who does this daily.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Juvaderm for acne scars

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Ice pick scars are tough.

In general, the best treatment for ice pick acne scars is punch excision and closure. That, however, can be tedious, time consuming and expensive. Lasers in general do not do as well with ice pick scars.

Injectable fillers can do surprisingly well for acne scars, including sometimes ice pick (And some of your scars do not appear to be true deep ice pick type scars).These treatments are relatively easy with minimal downtime and much less expensive than surgery. The only downside is they are temporary and may have to be repeated after a year.

Find an physician experienced with treating these challenging type of acne scars-

Mark Hamilton, MD
Indianapolis Facial Plastic Surgeon
4.8 out of 5 stars 50 reviews

The CROSS Technique & Microneedle Resurfacing Work Well For widespread Ice Pick Scars

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The CROSS Technique, which instills full strength TCA directly down the shaft of the pit scars, is on effective technique for treating them. Radiofrequency treatments using a fine epilating needle can likewise be used in this way.

Microneedle Resurfacing (aka medical microneedling, skin needling, dermal rolling and needle dermabrasion) is another effective method for smoothing the skin surface and improving overall skin tone and texture. Both procedures are quick and easy to perform and are relatively inexpensive. In my experience, lasers, and even fraxel lasers, have proven disappointing (not to mention expensive), appearing to be supported far more by device manufacturer marketing hype than hard science.

For more information on any of the above procedures, you can check out the archives of Be sure to seek consultation by a board certified aesthetic core physician with experience and expertise in treating acne scarring. 

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

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.