Which treatment options would help minimize the appearance of ice pick scars? (photos)

Question

Hello. I already had two treatment with: Lumenis Encore fractional CO2 laser and don’t see much result. I will have 3 more treatments. But it is a more effective solution to remove my ice pick scars. I’m willing to do whatever is necessar.

Nelson Lee Novick, MD · Answer

TCA CROSS, which I have been performing for over twenty-three years has a nearly a quarter of a century long track record for safety and efficacy for treating ice pick scars in all skin types. The latter cannot be said of the relatively expensive, here-today-gone-tomorrow fraxel laser and other gizmo treatments. So, I am not at all surprised that you have had little result from your fraxel treatments so far. You would be wise to consider consulting with a board certified cosmetic dermatologist to explore TCA CROSS.  Hope this helps and best of luck.

Randal Haworth, MD, FACS · Answer

Ice pick scars, which are deep and narrow scars that resemble small, deep holes, can be challenging to treat. Several treatment options may help minimize their appearance:

1. **Laser Therapy:** Fractional laser treatments, such as CO2 or erbium lasers, can stimulate collagen production and improve the texture of the skin.

2. **Microneedling:** This procedure involves creating tiny punctures in the skin to promote collagen formation, which can help improve the appearance of ice pick scars.

3. **Chemical Peels:** Certain chemical peels, especially those containing trichloroacetic acid (TCA), can help resurface the skin and reduce the visibility of scars.

4. **Dermal Fillers:** Injecting fillers into the depressed areas can help raise the skin's surface and minimize the appearance of ice pick scars temporarily.

5. **Subcision:** This involves breaking the fibrous bands beneath the skin that tether it down, allowing the scar to rise to the surface.

6. **Punch Excision:** This surgical method involves removing the scar tissue and suturing the wound closed.

Best of luck !

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Yixiu Zheng, MD · Answer

Best is subscion with Agnes precision microneedling then Scarlet RF microneedling. We have a treatment package especially designed for those concerns.

Roya Rakhshani, MD · Answer

Hello;Everyone's response to treatments vary. In my practice I use Lasergenesis and picogenesis, and RF microneedling with good success. But it takes up to 6 sessions of Laser treatment to achieve good results.

Kurren Gill, MD · Answer

Agree with all the great options below. Would also add a newer device called AGNES RF, which delivers targeted radiofrequency energy beneath the skin surface to address scarring/acne scarring. You may need 2-4 rounds of this treatment for a final result you are pleased with, and each time it is paired with radiofrequency microneedling with a device called Scarlet. Very minimal downtime, short and tolerable procedure with topical and/or local numbing injections.

Which treatment options would help minimize the appearance of ice pick scars? (photos)

Answers (6)

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