Ice pick scars are deep, narrow scars that can result from severe outbreaks of acne. People wishing to minimize the appearance of these scars usually need to see a dermatologist, as over-the-counter and natural remedies are generally ineffective.
Ice pick scars are deep V-shaped scars that are usually less than 2 millimeters wide. They often look as if a sharp object, such as an ice pick, has punctured a hole into the skin. Some ice pick scars have the appearance of a very dilated pore.
In the United States, medical insurance generally does not cover treatment for ice pick scars, which can limit a person’s ability to treat them. Treatment of ice pick scars may also require multiple sessions or a combination of therapies.
In this article, we discuss some of the available treatment options for reducing the appearance of ice pick scars. We also cover causes and tips for preventing ice pick scars.
Punch excision is a technique that involves removing the top few layers of skin covering an ice pick scar. Dermatologists do this using a punch tool that is similar in size to the scar. They usually also use a local anesthetic to numb the person’s skin.
After removing the skin over the scar, the dermatologist will use stitches to close the resulting wound. Punch excision tends to leave behind a thin scar, but this is usually less noticeable than the original ice pick scar.
Dermatologists typically recommend punch grafting for deeper ice pick scars. The procedure involves removing the skin from the scar and replacing it with a skin graft.
The dermatologist takes this skin from another part of the person’s body, such from behind the ear.
TCA CROSS is a technique that involves using trichloroacetic acid (TCA) for the chemical reconstruction of skin scars (CROSS).
During the procedure, a dermatologist stretches the affected skin, then applies a small amount of high-concentration TCA to the scar, which damages the epithelial layer of skin.
As the wound heals, new collagen fibers form inside the scar, helping to reduce its appearance.
TCA CROSS can cause a mild, temporary burning sensation, but anesthesia is usually not necessary.
According to a 2015 review, a single session of TCA CROSS can improve the appearance of ice pick scars by around 25%. People can also undergo two or three additional sessions at intervals of 2–4 weeks.
Radiofrequency therapy is a relatively new technique for treating ice pick scars and is generally safe and effective for all skin types and colors.
The procedure involves using high-frequency radio waves to tighten and smooth a person’s skin, which can help reduce the appearance of scars.
Microneedling, which is also called collagen-induction therapy, is a technique that involves damaging the skin to promote collagen production.
During this procedure, a dermatologist gently applies a needle-studded device over the acne scars. The device creates small holes in the skin, which produce new collagen fibers as they heal. This collagen formation helps reduce the appearance of the ice pick scars.
Many people experience some swelling or bruising after the procedure, and this can last for several days.
Following other treatments, a dermatologist may also recommend resurfacing procedures to further reduce the appearance of ice pick scars.
Resurfacing therapies involve removing the skin over and around the scars to encourage the growth of new, healthier skin cells.
Laser skin resurfacing is one of the most common resurfacing techniques that dermatologists use to treat ice pick scars. The procedure involves using monochromatic light to deliver thermal energy to the scar, which stimulates the production of collagen and elastin.
According to a 2015 review, scarring may occur in around 95% of people with acne. Although any type of acne may cause scarring, it is generally more likely to occur in people who develop severe acne.
Risk factors for acne scarring include:
- having inflammatory acne lesions, such as cysts and nodules
- delaying or not receiving treatment for inflammatory acne
- picking, popping, or scratching acne pimples and lesions
- having a close relative who has acne scars
Severe or inflammatory acne can penetrate the skin deeply, which can damage the skin and the underlying tissues. The body heals this damage by producing collagen and elastin.
If the body makes too much or too little collagen, it can cause scarring. Pitted scars, such as ice pick scars, can develop when the body does not produce enough collagen. If the body produces too much collagen, raised scars can form.
It is not always possible to prevent acne scarring. However, the best way to reduce the risk of scarring is to treat all acne outbreaks and to take steps to prevent future outbreaks.
A person can often treat mild acne using over-the-counter products and medications. People with more severe acne should discuss treatment options with a dermatologist.
Steps that can help prevent future outbreaks of acne include:
- avoiding picking, popping, scratching, or touching acne lesions
- continuing treatment even after acne clears
- cleaning the skin gently by avoiding vigorous scrubbing and harsh soaps or cleansers
- regularly washing the hair with shampoo, particularly if the hair is oily
- using oil-free and noncomedogenic skin care products and cosmetics
Ice pick scars are small, deep scars that can develop following severe outbreaks of acne. Over-the-counter products and natural remedies are generally not effective treatments.
However, a number of professional treatments can help reduce the appearance of ice pick scars.
The best way to reduce the risk of ice pick scars is by treating acne outbreaks promptly and avoiding picking or popping acne lesions. Practicing good skin hygiene can help prevent future acne outbreaks, which also reduces the risk of acne scarring.