Acne is embarrassing, but the deep, steep-sided ice pick scars that it often leaves behind, giving your face a poked look are just as embarrassing. If ice pick scars are bothering you, then this article is for you. We’ll give you a run down of everything you need to know about ice pick scars, including what causes them and how you can treat them.
What Causes Ice Pick Acne Scars- Ice Pick Scarring
According to the UK National Health Service, ice pick scars are small, deep holes in the surface of your skin that make it appear as though it has been punctured with a sharp object. Such scars normally extend into the subcutaneous layer of the skin. They are typically the result of a more severe case of acne known as cystic acne.
Ice pick scarring usually begins as a mild form of acne referred to as a comedone. You might hear some people refer to it as a whitehead or blackhead. A comedone results when sebum, the oil secreted by the sebaceous glands combine with dead skin cells in the follicles of your skin resulting in their blockage.
Once the follicles get blocked by the comedone, bacteria begin to multiply inside it. the body responds by sending white blood cells into the affected area as a way to fight the infection. As white cells build up, pus forms and the combination of bacteria, white blood cells and sebum often bursts into the surrounding tissues leading to further irritation and inflammation.
As inflammation continues in the area of the skin surrounding the acne lesion, pressure may also continue to build up. With enough pressure, the inflammation is then pushed deeper into the skin resulting in more serious types of acne known as cysts or nodules.
As the American Academy of Dermatology notes, the cyst or nodule formed can burst if the pressure is not relieved, resulting in further skin tissue damage. When this happens, the structure and production of collagen in the affected tissues is disrupted leading to inadequate collagen and fibrin.
Consequently, the scar tissue formed as a result of the inflammation sinks into the skin. This explains the sunken, poked appearance of the ice pick acne scars that makes the skin look like it has been pricked with a pin.
How to Get Rid of Ice Pick Acne Scars
Now that we have discussed what causes ice pick scarring, it might interest you to know how to get rid of ice pick acne scars.
Well, unlike hypertrophic and keloid scars, ice pick scars extend into the subcutaneous layer of the skin which makes treating them a challenge. Only a handful of options can effectively be used to get rid of this class of scars including punch excision, laser resurfacing, dermabrasion and dermal fillers. We have discussed them in more details in the next section.
Ice Pick Acne Scar Treatment – Treatment for Ice Pick Acne Scars
Ice pick scars are the most common marks left behind by more severe cases of acne, that is, cystic acne and nodules. They can be filled up naturally with collagen, but that might take six months or longer and some deeper ones might not heal completely.
So, what are some of the ice pick acne scar treatment that you may resort to? Well here are a number of them:
Punch techniques (excision and grafting)
Ice pick scars respond well to punch techniques and so does boxcar scars. Both punch excision and punch grafts are surgical treatment options.
Punch excision is used in treatment of mild ice pick acne scars whereby the scar is first removed surgically before sealing the remaining wound. Once the wound has healed, a smoother and more even skin is left behind, but as with any surgical operation, a small scar is often left. Other treatments such as laser and dermabrasion can then be used to get rid of the scar.
Punch grafting is on the other hand preferred for treatment of deeper ice pick scars whereby the scar is first removed surgically before filling the remaining wound with a graft of skin extracted from another area of the skin, usually the back of the ear.
It deserves a mention at this point that ice pick scar treatments are regarded as cosmetic procedures and are typically not covered by most health insurance policies. You should thus talk with your insurance company first.
It is also important to have a realistic expectation; the scars may not heal away completely but an improvement of 50 to 75 percent is possible.
Laser treatment: Surgical removal of ice pick scars (punch grafts and excision) remain the most effective treatment and as many as 15 to 20 scars can be removed in a single session. Laser treatments are often used alongside punch techniques. Laser treatment is in such cases done for 6 to 12 weeks after surgical removal of ice-pick scars.
Ablative laser treatment (e.g. carbon dioxide and erbium laser equipment) involves the removal of the upper surface layers of the skin using laser light in order to stimulate a new growth of smooth skin.
Non-ablative laser treatments such as Fraxel however work by targeting the dermis directly whereby they stimulate the growth of new collagen. This helps in repair of the tissues damaged by the scarring process.
The “Cross” method is also often used to treat ice pick scars. This is basically speaking a chemical reconstruction of the scars that works by stimulating the growth of collagen. This then helps to fill the depressions that give the skin the pitted appearance.
After having your skin cleansed, the dermatologist will apply a strong chemical peel (TCA 50% or 100%) to each scar using a fine, but blunt probe.
This often takes less than half an hour. Numerous treatment sessions (usually 5–6) may be required. It is however important to be realistic with your expectation since it might take as long as 1 year to achieve optimum results.
Ice Pick Acne Scar Removal – How to Remove Ice Pick Acne Scars
We hadn’t been focusing so much on ice-pick scars until one of our valued readers sent us an email asking us to “please provide me with information on the options available for removal of ice-pick scarring”.
Punch techniques (that is punch excision or punch grafting) is always a safe bet, but TDA-CROSS can as well be helpful. The best thing is to talk to your dermatologist about the most suitable option for you.
How to Fix Ice Pick Acne Scars without surgery
If the thought of the scalpels and syringes that click in our mind when mulling over surgical procedures scares the hell out of you, then you might want to know how to fix ice pick scars without surgery.
Well, other than punch excision and grafting which remain the most effective treatment options to date, you can always go for TCA-CROSS which essentially uses a strong chemical peeling agent to promote new growth of collagen in the skin. The new collagen then helps to fill pitted depressions commonly associated with the ice pick scars.
Results typically show in 6 to 8 weeks with more improvement over the next 3 to 6 months. It might however take as long as 1 year to see optimum results, so you need to be patient.