How Can I Get Rid of Pockmarks Icepick Holes on my Face? I've Tried Everything That I Could Afford!

I never had medical insurance so always had to find my own remedies. but the past several years been seeking more professional treatments like a series of microdermatbration with tactic peels to TCA home peels/microneedle roller with copper peptides among other stuff including collegen creams + all kinds of supplements healthy eating...but nothing seems to fill in the holes like all these treatments claim :( i been more then very patient i used all these things for months/years at a time each.

Doctor Answers 10

Juvéderm® micro injections, TCA CROSS, and fractional ablative laser are all useful

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Sounds like you have wasted a lot of money on ineffective treatments.

Basically, the scarring you describe extends quite deeply into the skin, so there is no cream, simple low strength peel, or superficial treatment like microdermabrasion which will be the least bit useful.

Starting with the simplest treatment, Juvéderm Ultra XC® microinjections [~0.05 ml per injection] using a BD-II 0.3 ml syringe with 31 ga needle can often be helpful. This syringe and very fine needle allow very precise extrusion of the Juvéderm® into the upper and mid dermis, filling the scar and to some extent stimulating the production of new collagen. I find it most satisfactory to partially correct each scar, then wait a month or longer and go over my patient's face again, injecting a bit more Juvéderm® wherever it is needed. Several cycles of treatment may be needed to reach optimal correction. This approach also works well for some other scars, for example chickenpox scars and some scars resulting from injury or mole removal. It is best to do this under oblique lighting so the scars are properly visualized, and pre-treatment photos are vital to assess respoonse to therapy.

I prefer Juvéderm® to Resylane® because Juvéderm® is a homogenous gel which flows very smoothly through the 31 ga needle, and stays where it is put after injection; in contrast with Retsylane® which is a slurry of particles and is somewhat less smooth to inject. I prefer Juvéderm® to other homogenous gels because I have the greatest confidence in Allergan's technical competence, manufacturing standards, and integrity compared with other filler companies.

Next, we have TCA CROSS technique, where tiny amounts of trichloracetic acid 90% [TCA] are careully applied to the scar to stimulate collagen remodelling and collagen production. Half a dozen cycles of treatment must be done, and this must be performed by a physician who can identify appropriate scars, handle TCA 90% safely, and manage complications if they arise.

Finally, fractional ablative laser [I like and use the Cutera Pearl Fractional laser], when properly used at appropriate [DEEP] parameters can produce dramatic and long-lasting improvement, often after a single treatment. You have to plan ahead for Pearl Fractional [or other] fractional ablative laser treatment, because your face will be VERY red [like a sunburn] for about 5 days after the treatment, then usually quite pink for 2-3 weeks after that.

Non-ablative lasers and Intense Pulsed Light [IPL] are completely useless for deep scars of the kind that you describe, so don't waste your time and money on that.


Best wishes,




Niagara Falls Dermatologic Surgeon

Microneedling can help with icepick scars

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Micro Needling works well on these scars but the results will vary depending on what size roller your treatment is performed with. I’ve had some amazing results with 1.5mm and 2mm high quality rollers. In addition you may like to try a Fractional laser and/or fillers such as Juvederm to fill in any remaining scarring.

Acne Scarring:TCA, Fillers,LASER, Excision

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Acne scars are some of the most difficult scars that we treat in facial plastics.  Home remedies just aren't enough.  Sorry, you need a real doctor...

I typically use a combination approach of laser treatments, strong chemical peels in the scar itself and/or direct excision if necessary for deep scars.  Flatter, broader scars are sometimes amenable to fillers.  Skin type, downtime, type of scars and finances all play a role in determining what treatments are right for you.  Good luck, Hannah Vargas, Kansas City

Hannah Vargas, MD
Kansas City Facial Plastic Surgeon
4.8 out of 5 stars 48 reviews

Ice pick scars

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Ice pick scars are the most difficult type to treat, and often require multiple modalities to get satisfactory correction. Which modalities are you should be custom tailored to your individual needs, which includes your skin type in the exact type of ice pick scarring that you have. 

I often employ combinations of ablative laser resurfacing, such as CO2, TCA CROSS, microneedling, injected PRP, and subcision. Subcision requires an expert to do it properly and thoroughly, as it is similar to undermining during a facelift, but is an essential aspect of the treatment plan. 

To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.

Cameron Chesnut

#realself500 Physician

Cameron Chesnut, MD, FAAD, FACMS
Spokane Dermatologic Surgeon
4.9 out of 5 stars 121 reviews

Ice pick scars

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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.

TCA CROSS or punch excision

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Ice pick scars are actually one of the easiest and most predictable scars to treat, as they respond to v high strength TCA (100%)- don't try that at home ! Another method is to use a punch excision to totally excise the scar. 
The skill of acne scar revision lies in the METHOD of revising scars, and never a machine.Scars need to be mapped, scar types identified, and specific treatments are applied to specific scar types. 

All the best

Dr Davin Lim 
Laser Dermatologist
BRISBANE, Australia. 

Ice Pick scars and treatment with Lasers such as Fraxel and eMatrix and injections such as Restylane

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Ice pick scars are very difficult to treat since they are so deep and all of the topical treatments that you have utilized do not go deep enough to have any effect.  I would consult a board certified dermatologist who has expertise with Fraxel and eMatrix for the best cosmetic results.  You might also benefit from injections of the deeper scars with Restylane or Sculptra.  Best, Dr. Green

Ice pick scars can be improved but they are difficult and require multiple treatments

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I would start with TCA deep chemical peels. I would then do a multilayered approach with co2 resurfacing and working form the deeper layers.

Philip Young, MD
Bellevue Facial Plastic Surgeon

Punch excision is the answer!

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The best way to treat ice pick holes from acne scarring is punch excision. This is a technique that can be done in the office that directly removes the ice pick hole and replaces it with a fine line scar. Don’t give up hope. There are good options!

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

TCA CROSS can help ice pick scars

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TCA CROSS involves the use of 90% TCA placed carefully into the icepick scars that will bore a hole through the icepick scar and then allow for healing, remodeling the architecture of the ocepick scar.  This will not remove the scar, but may help remodel it that I believe is then amenable to other procedures like fractionated laser resurfacing, that it would otherwise not respond to.

Daniel I. Wasserman, MD
Naples Dermatologic Surgeon

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.