What is the best acne scar treatment for ice pick scars?

Hi Xiu Lian,

Ice pick scars have a very narrow top and go deep. Because of that, traditional laser techniques are ineffective at targeting the depth of these scars to promote scar remodeling.

More effective methods include non-surgical options such at TCA Cross - the use of minute amounts of very strong TCA Acid deposited at the depth of the scar to promote collagen remodeling and scar resurfacing. When the scar has become less deep, subsequent laser sessions can further promote proper resurfacing.

Quicker, more invasive options include punch excision of these scars. Here, the scar is excised and the wound closed. Treatment is more definitive and quicker, though more invasive.

Improvement of scars in general from lasers/peels/radiofrequency typically have a quoted improvement of 50-70 % after 4-6 months of treatment, though improvements of up to 80-90% are possible.

While surgical removal of scars do provide better results, the final result will also depend on the healing of the wound left by the closure of the excision.

Do feel free to arrange a proper consult for a more thorough discussion on your needs and expectations on the issues you have.

Best Regards,
Dr Shane Tan

I agree with my colleagues who have expertly answered your question. I personally treat my patients with ice-pick scars using a multi-modality approach. Combining various treatment modalities will yield synergistic results while keeping costs low.

Treatment options include:

1) TCA Cross (high concentrations)

2) Subscision

3) Fractional ablative lasers (high settings)

Hope this helps.

Cheers,

Dr David Deng

Hi,

Deep ice pick scars are hard to treat because of the narrow passage. I am not a fan of punch excision because it may make the scar worse (and it often does) simply because scarring patient may in itself have poor healing abilities and why gamble some so uncertain to create a worse scar.

Cross TCA may be a possible option but the healing takes quite long and in some cases might actually make it worse.

Fractional CO2 laser is more conservative and results may be less than the above.

My suggestion is often to try something more conservative before trying more risky and aggressive treatment. However, if cost is a concern, you may then take the risk of doing the more aggressive treatments.

And no you cannot get 100% recovery for any of the treatment and for any scars. It is extremely unlikely.

There are several effective treatments for ice pick scars:

• TCA Cross
• Subcision
• Fractional CO2 (high settings)
• Punch excision

80-90% improvement for ice pick scars is possible after several treatment sessions.

There isn't a single best treatment for ice pick scars. I usually combine several treatments for ice-pick scars as this gives the best results.

I suggest that you consult with a doctor who specialises in acne scar removal so that you get the most results from each treatment.

Read this article to find out more on acne scar treatment costs in Singapore.

Hope that this helps!

Warmest regards,

Dr Justin Boey