Ice Pick Scars: Facts, Causes, and Treatment

Nobody likes having to deal with damaged skin. Statistics show that an alarming number of people suffer anxiety and depression as a result of this. Also, the risk attributed to these psychosocial disorders scores 8.1, 11.8, and 0.4 respectively. This record is for every 1000 person-years as recorded in a study.

The same could also happen to others when diagnosed with ice pick scars.

This skin condition leads to many pit-like depressions forming on your skin. It happens when the collagen compound found in your skin gets destroyed. This may likely occur when you suffer from active acne.

The scars formed have a V-shape. They look as if someone punctured holes in your skin several times using an ice pick. On occasion, the scars may also appear like exploded pores.

Now, treating ice pick scars is not a walk in the park and may require intensive care. That’s why you have to act with speed when you suspect that you might have the problem.

So, what causes ice pick scars and how can you prevent them? Let’s read on and find out.

What are ice pick scars?

This is a type of acne scar that forms on your skin when your collagen gets damaged. Ice pick scars leave your skin with entrenched pits that have wide tops that taper toward the bottom. The scars create what look like narrow tracts that are about 2mm or less.

Among acne scars, ice pick scars appear to be the most severe of them all. And as a result of this, treating ice pick scars through home remedies is a difficult task. It’s next to impossible actually. And that is also the same fate you will meet with OTC drugs.

Sadly, there’s no effective insurance cover that can help you get treatment for ice pick scars. This may limit your options of treatment in the long run. But even so, you still have to get diagnosed early to stop things from blowing out of control.

Other types of acne scars

There are other types of acne scars besides the one we’re focusing on today. Some of them fall under atrophic scars while others fall under the hypertrophic category.

Atrophic scars refer to those scars that create a depression on your skin. A hypertrophic scar refers to a scar that forms raised lesions on your skin.

According to Dr. Delot at Apexskin, the most common form of acne scars are atrophic. They include:

Boxcar Scars

Boxcar scars are a type of atrophic scars that also leave visible depressions all over your skin. Unlike ice pick scars, Boxcar scars tend to have a wider base at the bottom that doesn’t taper.

They form what looks like oval or round-shaped dimples that could be either shallow or deep.

Rolling Scars

This type of scarring is also classified under the atrophic category. Rolling scars form wider depressions (4-5mm) than what you will observe in ice pick scars. The depressions are, in most cases, shallow and have an undulating look.

The scars create rising and falling folds due to the abnormal attachment of collagen.

Hypertrophic Scars or Keloids

Unlike the 3 other types of acne scars, a hypertrophic scar creates elevated lesions instead. This happens when you get an increased collagen concentration on your skin.

The difference between hypertonic scars and keloids is that the former remains inside the wound’s margin whereas the latter grows beyond it.

What causes ice pick scars?

From observations made on several acne scar patients, there appear to be at least 3 main reasons. They control whether you have an increased or reduced risk of developing ice pick scars.

They include:

1. Your skin’s healing process

The way your skin heals plays a huge part in determining whether you will get acne scars. For instance, if your skin scars more easily, then there is a chance you will develop ice pick scars.

2. Genetics

Like many other conditions, developing acne scars is also affected by genetics. If you come from a line that has a history of acne scarring, then you’re also likely to get ice pick scars. If not, then you have little chance or might still get it due to the other reasons for ice pick scars.

3. Inflammation

The inflammation on your acne also has a role in saying how bad your scars could get. Severe acne inflammation tends to dig into the depths of your skin. When that happens, then the acne lesions will have a higher risk of developing ice pick scars.

Important: Ensure that you treat acne lesions as fast as you can to prevent the problem from taking root.

4. Disturbing acne lesions

Disturbing acne lesions can lead to the development of terrible ice pick scars. The way through which you may unknowingly do this includes squeezing or picking your acne lesions.

It’s normal to get the urge to pop acne bumps to release the pus trapped inside. However, if you go at it for long and use the wrong method, then you’ll get ice pick scars as a result.

5. Smoking

Smoking also increases the chances of scarring even without all the above factors. Scientists record that the elements found in tobacco worsen the symptoms of acne. 

6. Age

Acne is a condition more linked to teenagers as they go through the adolescent phase. That is when they experience physical changes that include the development of pimples in some cases. If these pimples or any other type of skin damage gets disturbed, then scarring may occur.

Despite this fact, acne is also known to affect adults who have already surpassed adolescence.

How to treat ice pick scars

Like all other types of acne scarring, ice pick scars also need to undergo 2 levels of treatment.

The 1st stage aims to make the depressions flatter by reducing the deepness of the scars. The 2nd stage aims to decrease the chances of your skin getting discolored from the process in stage 1.

Before diving into any form of treatment, it’s very important to consult with a dermatologist. They can help you understand all the pros and cons of each of the procedures involved.

Stage 1 treatment

Some of the main procedures used to flatten ice pick scar pits include:

a. Punch Grafting

Leading dermatology journals suggest that punch grafting is the best method of treating ice pick scars.

The process involves first removing the scar tissues causing the deformation. Afterward, they’ll use skin grafts taken from the back of your ears to fill up these areas. This procedure has shown greater success in covering narrow and entrenched ice pick scars.

The only downside to it is that you may need close to 20 grafts to cover one scar. Also, the treated area may become more raised than the unaffected skin surrounding it.

b. Punch Excision

The Punch Excision method involves cutting the ice pick scars out of your skin. After the initial cutting, your skin is then stitched up from every side.

Now, though this procedure also shows high success levels, you may have to deal with scars afterward. Also, it does not offer an effective treatment for discoloration, so, you may need resurfacing.

c. Punch Elevation

This process involves removing an ice pick scar’s center and reattaching it at a higher level. Normally, the reattachment’s done on the same level as your healthy skin to achieve flatness.

d. Dermal Fillers

Dermal filler is also a popular way of raising depressions caused by ice pick scars. In this procedure, a substance gets injected into your skin to push the floors of the scars upwards. These may be hyaluronic acid, collagen wrinkle fillers, and synthetic wrinkle fillers.

e.   Chemical Reconstruction of Skin Scars (CROSS)

In this procedure, trichloroacetic acid (TCA) gets injected in high concentrations of 70 – 100% into your skin. Due to this high concentration, an inflammation follows which causes your skin to produce collagen. The new collagen in return works to decrease the scar’s depth.

When using CROSS, you’ll have to go for several sessions to get its full benefits.

Stage 2 treatment

The main procedures involved in the 2nd stage treatment of ice pick scars include:

a. Laser resurfacing

Through ablative laser therapy, the upper layers of your skin can get removed using high light energy. This procedure is normally aimed at reducing the effects of discoloration that may arise from the scars. Despite that, you still stand a risk of developing further scarring.

On the other hand, nonablative laser therapy seeks to improve wrinkles and your skin tone. This happens when the laser stimulates the production of collagen.

Worth noting, laser treatment may have some side effects on you. Some of them are:

  • Blisters
  • Swelling
  • Enduring redness
  • Sun sensitivity
  • Skin color changes

b. Dermabrasion

Dermabrasion involves using an abrasive tool that has a rough end to ‘polish’ your skin. This rough end could be a serrated metal wheel or a wire brush.

During the procedure, the tool gets moved quickly over your upper skin to remove the epidermis. As this happens, the damaged surface of the ice pick scars is also removed in the process. The final appearance is smooth skin with lesser scar pits visible.

Although dermabrasion offers a candid relief from ice pick scars, it doesn’t last for long. So, you have to keep going back to redo the procedure every once in a while. Also, the treated area may turn pinkish for about 3 months.

Important: Dermabrasion may aggravate your condition if you have eczema. It may also cause your pores to enlarge or acne to flare up further. If you suspect an infection brewing, then treat it immediately with antibiotics or visit your dermatologist.

c. Chemical Peels

Chemical peeling uses high concentrations of salicylic acid or glycolic acid to remove your skin’s outer layer. This helps your body to reduce the effects of discoloration that may arise from ice pick scarring.

Alpha hydroxy chemical peels are much quicker but have a temporary effect.

Note: Ensure that only an accredited practitioner carries out this procedure on you. Any flaw to the process and you might suffer severe consequences.

d. Microneedling

Microneedling uses many fine-pointed needles to make numerous holes in your skin. These microscopic holes can go as far as the mid-dermis and encourage peeling of the skin. This promotes the production of elastin and collagen that helps restore your skin’s balance.

In most cases, you may start seeing results anywhere from 6 to 12 weeks.

Many people love micro needling because it is a far much cheaper option compared to the rest. The best thing with it, again, is that it does not come with a lot of side effects. The most that patients have reported is only some slight bruising.

Do over-the-counter creams work?

No, they fully won’t. Take for example agents like hydroquinone – they only fix discoloration and not the deep pits formed by ice pick scars. The same also goes for all the other bleaching agents meant for corrective cosmetology.

My advice would be that you should only use OTC drugs as part of your skincare routine. At least that way you’ll reduce the risk of developing ice pick scars in the future.

What about natural remedies?

Natural or home remedies still don’t have any advantages over OTC medication. They only work best when also combined with other prescribed treatment methods.

Nonetheless, some natural products can help you fight off discoloration. These include:

  • Witch hazel
  • Honey
  • Rosehip oil

These remedies may also improve your skin’s texture but not the deep pits of ice pick scars.

Safety measures after treatment

To avoid the side effects that you may get from the treatment of ice pick scars, you should:

  • Consult with your doctor before using any cosmetic product to prevent a reaction.
  • Avoid going out into the sun as the exposure can increase irritation or worsen the redness.
  • If you’ve had herpes before, take antiretroviral drugs to reduce the chances of viral infections as you heal
  • Always check in with your dermatologist and stick to the appointments made.

How to prevent ice pick scars

To reduce the risk of developing ice pick scars, MedicalNewsToday suggests that you should:

  • Avoid squeezing, touching, or popping acne lesions
  • Avoid scrubbing your skin using force
  • Avoid harsh facial cleansers or soaps
  • Follow through with your acne treatment even after the lesions vanish
  • Use non-comedogenic and oil-free skincare cosmetics or products only
  • Use sunscreens when stepping out into the sun


Most cases of acne scars rarely heal completely, but you can reduce their appearance. You can overcome the effects of ice pick scars if you practice enough patience and dedication. Depending on the level of seriousness, a dermatologist can help you decide on the best cause of action.

All in all, you must ensure that you treat any signs of acne with promptness. It will help you avoid future blowups.

Have you had to deal with ice pick scars before? How was your journey? Did you find an effective treatment plan? Feel free to share with me in the Comments Section below!

At The Animascorp, we offer practical, real-life tips and inspiration to help you live better. From decorating and gardening advice, to entertaining and home repair how-tos.

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