Ice-Pick Scars
What are ice pick scars?
Ice pick scars are a deep, narrow and pitted acne scar type. They are a type of atrophic scar, and comprise the majority of atrophic acne scarring, 60-70%.
They are deeper and more narrow than boxcar, atrophic, rolling and other acne scar types. Since ice-pick scars are so deep, they are one of the most difficult to fully treat with at-home methods and even with professional methods due to their severity.
Ice-pick scars are known for being narrow pitted indents in the skin, and due to their depth they are often very obviously noticeable.
Pitted scars are a type of Ice-Pick scar.
Why do ice-pick scars form?
Ice pick scars are usually caused by severe acne, such as cysts and papules that occur deep in your pores.
Ice-Pick Scar Treatment
- Microneedling: Microneedling for acne scars can be at home derma-roller and it can also be done in a professional clinic.
Microneedling works by stimulating the skin’s healing and collagen production response so it starts repairing the microneedled areas.
Microneedling is done not only to heal acne scarring and other types of scarring on the skin, many people without scarring use it on healthy, non-damaged skin as an anti-aging treatment because it stimulates collagen production and can be used to reduce fine lines and wrinkles.
An important part of microneedling after-care is putting a collagen stimulating and healing ingredient such as Vitamin C serum for acne scars, or Copper Peptides for acne scars, on your skin after microneedling. This is because microneedling opens up the skin so it is ready to receive healing ingredients deeper into the skin, making the ingredients and the microneedling more effective.
Microneedling has been found across studies in a Literature Review by the International Journal of Women’s Dermatology using the PubMed, Medline, and Embase databases, in addition to reviewing the bibliographies of relevant articles, to be an effective treatment for collagen production, skin repair and particularly reducing the appearance of acne scars.
It has been found to be one of the most effective treatments to improve the appearance of acne scarring across numerous studies, and at-home microneedling is the one I have seen the most results with personally, out of all the treatment options I have tried.
I like to put a light layer of copper peptide cream on my skin at night after micro-needling, and each night as part of my skincare routine, and then each morning I wash off the copper peptide cream and put a light layer of Vitamin C serum on my skin. The Vitamin C serum is clear and gives skin a nice glow, which is why I like wearing it each morning, and the copper peptide cream is bright blue which is why I like using it at night.
The two creams can’t be layered on top of each other at the same time because the copper peptides oxidize the Vitamin C making it ineffective.
- Fillers: The Journal of Clinical Aesthetic Dermatology’s paper discusses the different acne scar treatment options and explains that scar filler is an one that can be used to lessen the appearance of scars.
Injectable fillers can be used to lift the soft tissue under the scar, this is the most effect in soft atrophic rolling or boxcar scars as opposed to ice-pick, but you can consult your dermatologist to categorize your scars and determine the best mode of treatment for you.
Filler can be injected in different ways including serial punctures, linear threading, fanning and cross-hatching, deep bolus, and superficial micro-droplet injections. There are some common side effects that include infection, pain, erythema, lumps, swelling, and abscess formation. Fillers are usually not permament, the different types of acne scar filler are temporary, semi-permanent, and permanent.
Temporary fillers: Last around a few months, meaning you have to go in to get treatments every time the filler dissolves.
The Journal of Clinical Aesthetic Dermatology explains how temporary fillers work, “The injection of hyaluronic acid fillers (HAF) stimulates collagen production by fibroblasts, augmenting soft tissue and improving the quality of the overlying skin.89–91 Biphasic HAFs comprise cross-linked HA particles suspended in a lubricating non-cross-linked HA gel, which allows passage through a fine needle.”
There are also semi-permanent and permanent filler options available, however permanent fillers can have adverse effects that end up requiring their complete removal.
- Punch excision and punch elevation: Punch excision is indicated for icepick and boxcar scars. Punch elevation is best suited for treatment of broad boxcar scars without underlying fibrosis.
Punch excision is only performed by a professional dermatologist so you can meet with yours to see if it is a fit for your scarring and situation.