Best treatment for ice pick acne scars? (photo)

Hi. Are my ice pick acne scars deep? They are ice pick scars, right? Aside from TCA cross, which other treatments will provide significant changes in them? Will TCA peel or microneedling work on them? I've been to 3 dermatologists already; 2 suggested microneedling while the other advised chemical peel. Help, please? Thanks!

Doctor Answers 5

TCA then laser resurfacing

Deep ice pick scars, and narrow box car scars can be treated with TCA CROSS peels, mixed scars, rolling, and atrophic scars treated with fractional devices such as Fraxel, fractional lasers, and INFINI radiofrequency. Atrophic scars (depressions) can be treated with either fat grafts, or with HA dermal fillers. Tethered and anchored scars are best treated with surgery. In your case, TCA will be my choice, followed by erbium laser. 

Video below shows how I perform TCA CROSS. Web reference better as it explains in depth. 

The majority of patients will have a collection of different scar types, and hence a tailored treatment METHOD will be best. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars.
All the best,
Dr Davin Lim
Laser, surgical & aesthetic dermatologist
Brisbane, Australia


Brisbane Dermatologist
4.7 out of 5 stars 61 reviews

Dark Skin and Acne Scars and eMatrix

I have every modality in my office from microneedling to PRP to Fraxel to eMatrix but with your type of scars and skin type yo should look into an expert who does eMatrix.  Best, Dr. Green

Acne scars in darker skin

I would consider TCA Cross or Infini. Do at least 3-4 treatments and see what success you will have. I don't believe microneedling is as good as these 2 solutions.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

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In my opinion, you have mid and superficial level acne pits. I do not believe that you have ice pick scars. As you mentioned, TCA cross and micro-needling are the two treatments that are commonly used to treat your condition. Multiple treatments may be necessary. Because of your skin tone, pre and post treatment with bleaching creams is suggested. You probably will need multiple sessions. Hope this helps. Good luck.

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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.