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What to Know About Ice Pick Scars

Medically Reviewed by Dan Brennan, MD on April 15, 2021

Ice pick scars are acne scars that have a sunken or pitted appearance. These scars leave the skin looking like it was punctured by a tiny ice pick. Although acne is most common among teenagers, it affects people of all ages.

The Appearance

When pores on your skin become clogged, a common skin condition called acne erupts. Ice pick scars are left after acne is cured.

Visually, ice pick scars can appear like tiny craters over the cheeks. They are narrow deep scars and less than two millimeters wide, and they look as if a sharp object like an ice pick has punctured a hole in your skin. 

The Causes

Across the globe, acne is one of the most common skin disorders treated by dermatologists. While it most often affects adolescents, it is not uncommon in adults and can also be seen in children.

Skin and the tissue beneath it are damaged by outbreaks of acne because the breakouts penetrate the skin deeply. Your body tries to repair the damage by producing collagen. When too little collagen is produced, ice pick scars develop and leave behind noticeable pits or depressions in the skin.

As acne begins to heal, certain people are more prone to developing ice pick scars. In addition to genetics playing a role, the risk of getting acne scars increases if you have inflammatory acne, if you delay treatment, or if you pick/squeeze/pop acne.

The American Academy of Dermatology suggests several skincare habits that will decrease your risk of getting acne scars:  

  • Don’t scrub your skin
  • Don’t pick, pop, or squeeze acne
  • Don’t use abrasive or astringent cleansers
  • Avoid repeatedly touching your face throughout the day
  • Avoid the sun and stay away from tanning beds
  • Don’t wear hats or tight headbands
  • Don’t wait to consult a dermatologist

The Treatment

Products containing benzoyl peroxide and salicylic acid are effective treatments for ice pick acne scars. You can also now purchase the topical retinoid, like Differin®, over the counter at a pharmacy and use it as directed.

Successful medical procedures used for treating ice pick scars include the chemical reconstruction of skin scars (CROSS) using high concentrations of trichloroacetic acid. Here, the chemical is placed on each ice pick acne scar using a toothpick.

Other treatment methods include laser treatments, fillers, punch excision, punch grafting, and chemical peels. These treatments can be performed by dermatologists or dermatologic surgeons.

Early treatment. Early treatment can prevent psychological stress that often accompanies ice pick scars. Catching acne early can clear skin and prevent acne from getting worse. You may need to make prevention part of your daily ritual to prevent acne outbreaks, but that may be a better option than dealing with the stress of permanent acne scars.

Acne is often dismissed as a transitory condition prevalent in adolescents, that will go away on its own. Treatment of ice pick scars is often delayed, particularly in male individuals, even though early intervention can mean the difference between a permanent scar and a more treatable one.

Emotional effects. If you have ice pick scars from acne, be aware that the skin condition can affect more than just your appearance. Over time, acne can take a toll on your well-being and emotional health. Dealing with ice pick acne scars can cause low self-esteem, anger, frustration, anxiety, and poor self-image. Often, there are feelings of loneliness and depression that lead to a decreased quality of life.

Ice pick scars are particularly stressful because they often occur on the cheeks of the face and are characterized by narrow pitted shapes in the skin. These shapes are often more noticeable to the naked eye and are not covered up well with makeup.

Expected Result. With time and persistence, most treatments can reduce the size and visibility of acne scars. Many scars fade and become barely noticeable. This is not the case with most ice pick scars. Due to the depression in the skin, treatments that help other acne scars fade or diminish over time are not as helpful.

WebMD Medical Reference

Sources

SOURCES:

American Academy of Dermatology: “Acne Scars: Diagnosis and treatment,” “Acne Scars: Overview,” “Emotional effects of acne: Acne can affect more than your skin,” “Acne: Who gets and causes.”

Cleveland Clinic: “Acne.”

International Journal of Women’s Dermatology: “How Acne Bumps Cause the Blues: The Influence of Acne Vulgaris on Self-Esteem.”

Journal of American Academic Dermatology: “Guidelines of care for the management of acne vulgaris,” “Self-esteem and body satisfaction among late adolescents with acne: results from a population survey.”

Journal of Clinical Aesthetic Dermatology: “Effective Treatments of Atrophic Acne Scars.”

Journal of Cutaneous and Aesthetic Surgery: “An Assessment of the Efficacy and Safety of CROSS Technique with 100% TCA in the Management of Ice Pick Acne Scars.”

Mayo Clinic: “Acne: Symptoms and causes.”

Medscape: “Acne Vulgaris.”

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