Management of Ice Pick Scars
Hello and thank you for the question.
In review of your photographs, I would utilize a bifurcated approach to treat the ice pick acne scars. Specifically, I would suggest a Total FX treatment of the affected area primarily. This will provide effective resurfacing to the scarred area. Additionally, I would suggest a series of 4-6 Derma-roller treatments, commencing 1 to 2 months following the fractionated laser treatment. Keep in mind, the benefits of these procedures will take months to appreciate. You will see continued improvement of your skin well beyond the 12 month mark.
Glenn Vallecillos, M.D., F.A.C.S.
Ice pick scars respond well to aggressive Fraxel Repair Laser treatments.
I have good success with agressive Fraxel Repair Laser Treatments. Occarionally I will also add Extensive subcision, a procedure that may cut through and release some of the deeper pits.
Most of your scars look more like superficial saucer-like scars, rather than ice-pick scars which tend to be a bit deeper, bound down and with sharp angled walls to the scar. It's possible that the ice-pick scars do not show up as well in the photo. The clinical exam would give a clear indication as to whether they're saucer-like or ice-pick like. Depending upon this, we could determine the best treratment options. Also, an important factor is how much down-time you could tolerate, etc
Options for saucer-like scars include soft tissue fillers like Juvederm or Resytlane or dermabrasion or laser resurfacing. Ice-pick scars are best handled by excising and closing the scars or excision the scars and putting small grafts in each one (depends on the size). After healed the area would best be treated by resurfacing or dermabrasion of the area.