While there are numerous treatments for superficial and deeper acne scars, the most difficult scar to treat is the "ice pick" scar. The method of treatment for ice pick scarring addresses each scar individually and can be a costly endeavour.
What Are Ice Pick Scars?
Acne scarring is the result of the body's attempt to address injury to the skin--in the case of acne scarring, the inflammation caused by excess oil, bacteria and dead skin cells that clog the follicles. According to the American Academy of Dermatology, it is impossible to predict what type of scar will result from acne, but the most severe forms of scarring are left behind in the wake of nodulocystic acne. "Ice pick" scars are notably the most difficult type of scar to treat and are considered a true type of acne scar by the AAD. Ice pick scars present as deep, jagged impressions in the skin that are similar to chickenpox scars.
Punch Excision & Grafting
Ice pick scars are addressed by a method called punch excision, which is performed by a dermatologist or plastic surgeon. This procedure involves using a device to "punch" out the scar down to the layer of subcutaneous fat. The hole left behind afterward can be sutured back together, or in the case of a larger ice pick scar, a small piece of skin may be grafted to the site.
What About Punch Excision Scarring?
There will be a slight scar line after punch excision. But this scar is far less noticeable than the ice pick scar itself. After punch excision or grafting, dermabrasion or laser resurfacing can be used to blend in the skin graft or scar line with the rest of the skin.
Cost of Punch Excision
The cost of punch excision depends on the number of scars that require treatment; however, treating one ice pick scar costs around £32.
Why Not Dermabrasion?
Dermabrasion is the most popular way to reduce acne scarring. This technique is performed by a dermatologist who uses a device with rapidly-rotating wire brushes to resurface the skin. This treatment can sufficiently reduce the appearance of other types of depressed acne scars, but it will often cause ice pick scars to become more noticeable.