Ice Pick Scars – Causes, Symptoms & Treatment

Ice Pick Scars – Causes, Symptoms & Treatment


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Acne breakouts can be extremely annoying, even when they finally go away, because they sometimes leave unattractive scars and hyperpigmentation on the face. Dealing with facial acne is especially challenging since they can create visible permanent damage that can affect your self-esteem.

Ice pick scars, in particular, are one of the most difficult to treat, because they are deeper and oftentimes leave a more noticeable texture. 

In this article, we explain what ice pick scars actually are and how dermatologists usually treat them.

What are ice pick scars?

Ice pick scars are a kind of severe acne scar that appears to be deeper than typical acne scars. They usually occur when acne (usually cystic) erupts and the skin does not heal properly, leaving a pitted scar, resembling a tiny crater on the face or a very dilated pore.

They are quite common, and ice pick scars can be unflattering on anyone. Since ice pick scars are considered to be more severe and difficult to treat through natural methods or simple acne scar creams, professional help is often recommended.

Why do people get ice pick scars?

Ice pick scars are a pretty common type of scar. While some people are more likely to develop this kind of scar, it usually occurs when the acne penetrates the skin deep enough to damage the skin tissue.

When this happens, an acne eruption can leave a hollow space on the skin that will require more collagen to heal. This is even more likely to happen when the pimple is popped or picked.

What causes ice pick scars?

Acne comes in different forms and sizes. When an acne becomes inflamed and infected, it is likely to leave a deeper scar. When this happens, skin tissue is destroyed, making it more difficult to repair.

When the collagen is not enough to completely repair the skin damage, ice pick scars can start to develop. They are also most likely to develop when the acne is inflammatory, cystic, or if the acne is picked or popped forcibly.

When the collagen is not enough to repair the skin damage, a pit is formed and a prominent scar becomes visible. The longer you leave the scar untreated, the more time it might take to heal. This is why it is important to seek treatment for your ice pick scar as soon as possible.

Are some people more prone to them?

Some people are naturally prone to acne scarring. This is usually caused by genetics or the lack of collagen production. Ice pick scarring is also more likely to occur on the cheeks or areas on the face where the skin is thinner and more fragile.

Although some people are more likely to develop cystic acne or ice pick scarring, there are still ways to prevent it such as the following:

  • Not scrubbing the face, especially with active acne
  • Not picking on the affected areas
  • Avoiding strong cleansers
  • Avoiding touching the face
  • Not consulting a dermatologist

Basically, disrupting the skin barrier makes it harder for the skin to repair itself when scarring occurs. To prevent noticeable skin damage or acne scarring, use mild skin care products and refrain from touching the affected areas.

If you want to make sure you follow the skin care routine that fits your needs best, talk to your dermatologist about it. They can run a quick assessment of your skin and prescribe products and procedures that match your skin type, goals, and budget.

How do dermatologists diagnose the condition?

Ice pick scars are quite easy to spot through its appearance. You can check your scars yourself or you can visit a skin expert or dermatologist for a more accurate diagnosis and treatment.

Dermatologists often take a look at how the scar forms. How the scar appears often indicates what type of scar it is. Ice pick scars look as if they were punctured by ice picks. They are narrow, v-shaped, and about 2 millimeters in width. From afar, they can look like tiny craters or enlarged pores. They mostly occur on the cheeks and even on the nose or forehead.

Since not all people with ice pick scars share the same skin type, certain medications might not work for everyone the same way. This is why it is important to remember that before you pick out OTC acne scar treatments by yourself, you should consult a dermatologist for a proper diagnosis first. Oftentimes, wrong products can only worsen your skin condition. 

How do dermatologists treat ice pick scars?

There are different ways dermatologists can treat ice pick scars. Since treating ice pick scars naturally at home can be very difficult, dermatologists usually suggest a specific treatment that fits your skin type or the severity of your scarring.

Punch Excision

Punch excision refers to the acne scar treatment method where the ice pick scar is cut out and then closed from all sides through stitches. This method is performed by a facial plastic surgeon. It is considered to be one of the most effective treatments for ice pick scarring, although this may still leave a thin scar after healing. Since the scar is less noticeable than the much wider ice pick scar, most consider this negligible.

Punch Grafting

Punch grafting is considered by most dermatologists to be the best ice pick scar treatment. This is usually recommended for very deep ice pick scars. Similar to punch excision, this method is also performed by a facial plastic surgeon and requires local anesthesia for the entire procedure.

During this method of treatment, the scar is taken out and filled in by skin grafts from behind the ear. Although it sounds simple and straightforward, this procedure can take up to multiple grafts just for one scar. It is time-consuming and may require several visits, but the results are more natural except for a tiny scar, similar to the punch excision procedure.


Microneedling is also known as collagen induction therapy. During this treatment, dermatologists use fine needles to puncture the surface or top layer of the skin. The punctures induce the production of collagen and elastin that help heal the scar.

Because microneedling is not as invasive as punch excision or punch grafting, results may be gradual and complete skin repair may take several microneedling sessions.


Microdermabrasion is the acne scar treatment where the epidermis or the top layer of the skin is “sanded down” to reveal a smoother and toned skin. This lessens the appearance of the scars. 

Since microdermabrasion only deals with the skin’s surface level, this treatment is only usually recommended for shallow scars. 

Laser Resurfacing

Laser resurfacing is also a common kind of acne scar treatment that involves the top layer of the skin or the epidermis. In this procedure, dermatologists use high-frequency laser rays on the affected area to remove skin layers and stimulate collagen and elastin production as the skin grows back. This results in less noticeable scarring.

Hyaluronic Acid Injections

Hyaluronic acid injections are fillers meant to treat pitted scars or ice pick scars temporarily. They plump and lift the affected area, significantly reducing the appearance of the ice pick scars. However, just like other common fillers, this treatment needs to be repeated after a couple of months to a year, depending on the severity of the scar and the intensity of the treatment.

Chemical Peels

Chemical peels are a faster way to exfoliate the skin, which encourages newer skin cells to develop. This helps minimize the appearance of the pitted acne scars including ice pick scars.

There are different types of chemical peels and not everything works for every skin type. It may be too harsh or abrasive to the skin when you decide on a chemical peel without professional help. To learn more about which chemical peel treatment works for your skin best, it is important to consult your dermatologist first, so you do not damage your skin barrier and worsen your condition.


OTC creams are also a popular and affordable alternative to treat acne scars. Some dermatologists may prescribe topical ointments to aid the healing process of acne scars. However, these creams may not be strong enough to treat deep, ice pick scars on their own.

Other natural remedies

Ice pick scars are just too deep to treat with normal creams, ointments, and home remedies. However, there are natural remedies that help improve skin health and support your existing medications. 

Eat a healthy diet

Add anti-inflammatory foods to your diet to boost your skin health and aid the healing process. Foods that improve the skin include:

  • Foods rich in antioxidants (broccoli, spinach, carrots, potatoes, avocados, pumpkin, etc.)
  • Foods rich in Omega-3 fatty acids (mackerel, salmon, flax seeds, chia seeds, etc.)

Apply tea tree oil to acne

The earlier you treat your acne, the less likely it will leave a large scar on your skin. To help prevent acne growth, apply tea tree oil to the affected area. According to research, tea tree oil is an effective ingredient that prevents bacterial growth and inflammation.

Clean your face, but do not overwash it

Do not forget to regularly wash and clean your face. This prevents clogging of your pores and bacterial infection that can worsen the acne. It is important to remember, however, to not overwash your face as well.

Overwashing strips your face of its natural oils and leads to more breakouts. As a general rule, dermatologists and skin experts recommend washing your face up to two times a day. If you need to wash your face more than twice in a day, be sure to moisturize to prevent drying and skin irritation.

Lastly, be careful not to pick or pop your pimples. This can create trauma to the skin and make the scar more visible. This can also lead to bacterial infection and a larger scar.

What if medical treatments don’t work?

Ice pick scars are deep and usually the hardest kinds of acne scars to treat. Since it is more difficult to heal, some medical treatments might not work right away. Healing may take time and patience.

If medical treatments do not work on your ice pick scar immediately, talk to your doctor or dermatologist about it. There can be several factors why you’re not seeing the results that you were hoping for. 

In most cases, healing is gradual and results may appear months after your last treatment. Since skin takes time to grow, it is important to be patient. Observe how your skin and scar are responding to treatment. Some ice pick scars heal faster than others because of their depth or severity.

If you want to be more precise about your observations, take a photo of your skin every day and check for any improvements (or the lack of it).

Ice pick scars can be treated and you should seek medical attention if you have these kinds of acne scars on your skin.

Acne scars, especially the deep pitted ones, can be debilitating to a person’s self-esteem, and they can be tricky to treat. While some acne scars eventually lighten or go away on their own, some are more stubborn and require medical help. The deeper scars, in particular, cannot be treated by topical ointments or creams alone.

Fortunately, the field of medicine has gone a long way and there are multiple treatment options available for different kinds of skin types and scarring. Whether you’re looking to treat shallow scars or deep, pitted ice pick scars, a dermatologist can help you figure out the best treatment option that fits your needs and budget.

Acne and acne scars are perfectly normal and it’s nothing to be ashamed of. However, you don’t have to live with noticeable acne scars either. To get the best permanent or semi-permanent treatment for acne and acne scarring, contact your most trusted dermatologist right away.

Skin Cancer Specialists Dermatology focuses on skin treatments including acne or ice pick scars, so you can regain confidence in your own skin.

About the Author greenadmin

Stanislaus Okwor is the Chief Editor @

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