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  5. Ice Pick Acne Scars: Causes, Treatments & Prevention

Is your acne leaving scars and hyperpigmentation even after recovery? These acne scars can be of different types - boxcar, ice pick, rolling, hypertrophic, and keloid scars. Among these, ice pick scars are one of the most prominent and severe types of acne scars.

Ice pick scars appear like minute and deep punctures on your skin and disrupt the skin’s smoothness. Read on to learn why ice pick scars form and how to treat them.

What Are Ice Pick Scars?

Ice pick scars are a type of atrophic acne scars [1] commonly formed by severe cystic acne. These are usually narrow (≥2 mm in diameter), punctiform, and deep scars that appear on your cheeks.

Usually, this type of scar has comparatively smaller apertures and a deeper infundibulum forming a ‘‘V’’ shape [2]. Ice pick acne scar is the most common type of atrophic acne scar. Approximately 60% – 70% of total scars are of ice pick type [3].

Ice pick acne scars are very tough to remove due to their peculiar shape. The scar removal treatments can be time-taking; and often require persistent, aggressive, and costly treatment.

Why Do Ice Pick Scars Form?

Usually, ice pick acne scars are caused by inflammatory acne like cysts and papules that penetrate deep into your pores. If you puncture your acne or leave your comedones untreated, that can form an ice pick scar.

Compared to other acne scars, ice pick scars are narrower and more profound. They look like narrow, pitted shapes in the skin and for such a unique shape, these scars are often more noticeable to the naked eye. Severe acne can form a deeper spot, damaging your collagen. So, it becomes difficult to cure ice pick scars naturally.

Ice pick acne scars can occur on different parts of the face, including your nose, forehead and upper cheeks. To cure acne scars, you must consult your dermatologist at the earliest to find the most suitable ice pick scar treatment option for you.

Did You Know?

Ice pick acne scars can be up to a few millimeters deep, extending into the skin's second layer. Such an appearance of the scar makes skin look like it was pierced by an ice pick or other sharp instrument. This is the reason behind the name of the scar.

Is An Ice Pick Scar Deep Or Superficial?

Ice pick acne scars are deep and narrow scars. These result from inflamed and infected acne caused by deeply clogged pores. Ice pick acne scars have steep sides forming a 'V-shaped puncture into your skin.

What Does An Ice Pick Scar Look Like?

Visually, ice pick scars look like tiny cavities over the cheeks, nose, or forehead. They have a small aperture but can extend up to a few millimeters deep into your skin. Usually, the scars are less than 2 millimeters wide and look just like tiny punctures on smooth skin.

What Treatment Options Are Available To Treat Ice Pick Scars?

Ice pick acne scars are too deep to cure naturally over time or through traditional home remedies. But you can consult your dermatologist for the best option based on your skin type and the intensity of your ice pick scars.

1. Punch Excision

According to a study on Effective Treatments of Atrophic Acne Scars, punch excision is one of the most efficient treatments for ice pick acne scars. In this scar treatment process, surgeons use a small cookie-cutter-like tool to cut out the scar and then the opening is stitched or glued together and allowed to heal.

While this method also leaves a tiny scar in place of the depression, it is almost invisible. The new scar will be smaller, without any surrounding skin discoloration. Also, it will be at level with the surrounding skin, making it less noticeable than the original ice pick scar.

2. Punch Grafting

Some dermatologists consider punch grafting the best solution for ice pick acne scars [4]. Here surgeons remove the scar and replace it with a skin graft from an inconspicuous place, like behind your ears. This treatment method raises the level of the scar and matches it with the surrounding skin.

Punch grafting is guaranteed to fill the deep and narrow acne scars, but you may have to go through multiple grafts for a single scar. Also, it is considered more suitable for treating large or intense ice pick scars. Like punch excision, this grafting method leaves less noticeable scars than the original.

Note :

Punch excision and punch grafting are commonly done by facial plastic surgeons. They use local anaesthesia to numb the particular area of the procedure [5].

Shot of cosmetologist making mesotherapy injection with dermapen on face for rejuvenation

3. Microneedling

This method is also known as collagen induction therapy[6]. Here plastic surgeons use a tool with multiple fine needles to puncture the skin's top layer (epidermis). As a result, numerous microscopic holes are created on the skin that help to peel the epidermis and mid-dermis.

It triggers the production of collagen and elastin. You can observe a result within 6 to 12 weeks after the treatment. Compared to other ice pick scar treatment costs, this one is relatively affordable. Microneedling also has less risk of side effects.

4. Microdermabrasion

This is a kind of skin resurfacing treatment where dermatologists use tiny crystals or a diamond-tipped handpiece on skin to gently remove the epidermis. As a result, a smoother and toned skin is revealed, which minimizes the appearance of acne scars.

5. Laser Resurfacing

This is a standard treatment for scars where dermatologists use high-frequency laser rays on the targeted area. The procedure removes the skin layers and stimulates collagen and elastin production. So, your skin layers regrow and offer you improved skin with an even tone.

However, the depth of ice pick scars may make laser resurfacing or dermal fillers unsuitable. So, check with your dermatologist, as these measures are often not able to completely remove the ice pick scar.

Comparison of skin before and after laser resurfacing

6. Hyaluronic Acid Injections

In some cases, dermatologists also suggest hyaluronic acid injections to treat pitted acne scars like ice pick scars. It can be an effective treatment, but there is a drawback. The fixation will not be permanent, and the effects of hyaluronic acid injections can disappear in about a year.

7. Chemical Peels

Chemical peels are another popular option to reduce the appearance of acne scars by removing the skin's epidermis. Different chemical peeling substances contain various chemicals, like glycolic acid, trichloroacetic acid (TCA), alpha hydroxy, etc. Most of the chemicals can be harsh to your skin, making it red and irritated.

SkinKraft Tip:

Most scar removal treatments have potential side effects, such as burns, irritation, redness, skin peeling, skin bleaching and even changes to skin texture. People with darker skin types have a higher risk of suffering from the side effects of scar removal. So, always consult your dermatologist about the probable side effects of your chosen treatment measure.

8. OTC Creams

As ice pick scars are pretty deep, over-the-counter creams or ointments are not strong enough to treat them. But you can use OTC options to maintain healthy skin. This will help to distract attention from scars and also reduce the risk for future acne outbreaks and scarring.

9. Natural Remedies

Natural remedies are usually not very effective in treating ice pick acne scars. But there are some ingredients like honey, cinnamon, rosehip oil, and witch hazel that you can apply to your skin as DIY masks.

These can help to decrease discoloration and improve overall skin texture. Though these ingredients would not be able to remove the deep pits, they are soothing and can improve the appearance of your skin.

How To Prevent Ice Pick Scars?

  • Take the help of a dermatologist to cure comedones as they appear, as they can cause ice pick scars.
  • Avoid picking, popping, scratching, or touching acne.
  • Clean your skin gently and avoid vigorous scrubbing that can worsen your acne lesions.
  • You must wear sunscreen before going out to prevent skin darkening that can make your acne scars more visible.
  • Keep your skin well-hydrated to enhance the healing process of your skin.
  • Use oil-free and noncomedogenic cosmetics and skin care products.

Frequently Asked Questions About Ice Pick Scars

1. How Long Do Ice Pick Scars Last?

Ice pick acne scars are like deep pits in the skin, damaging the epidermis and sometimes the dermis. They don’t fade away with time, and you will need to take the help of your dermatologist to reduce their visibility.

2. Will Ice Pick Scars Go Away?

No, these acne scars do not go away by themselves. You need to consult a dermatologist and consider different treatment procedures to reduce them visibly.

3. How To Hide Ice Pick Scars?

You can use a concealer to hide acne scars. For more effective and permanent solutions, consider the skin treatments listed above. You can also consider punch elevation, chemical reconstruction, dermal fillers or laser therapy to make those scars less visible.

Wrapping Up

  • Ice pick scars are deep, V-shaped acne scars with tiny apertures.
  • These stubborn scars don't recover over time.
  • These scars are too deep to cure with OTC creams or home remedies.
  • You need to consult your dermatologist to make those scars less visible through surgical procedures, laser therapy, or chemical peeling.