What is the best treatment for ice pick acne scars?

Part of: Acne

Ice pick scars are narrow and deep, so superficial resurfacing alone usually does not reach the full depth of the scar. One of the best-studied options is TCA CROSS: high-strength TCA placed precisely inside the scar, not a peel of the whole face. A small study in skin types IV and V showed a clear improvement in most patients after four spaced sessions. But this is a small study, and high-strength TCA is a medical procedure that can cause darkening, lightening or a wider scar if used incorrectly.

Key numbers

  • 3 of 30 — Temporary pigment changes

Is 100% TCA always best?

No. Comparison studies did not find that the higher strength clearly works better, while it was linked to longer crusting and more severe side effects. So the higher number is not automatically the better treatment.

When is punch excision a better fit than TCA CROSS?

Some very deep ice pick scars, or scars with a clear wall, may suit a small surgical procedure such as punch excision better. The choice depends on the scar's shape, width, depth and skin tone, not only on calling it an ice pick scar.

Key takeaways

  • Ice pick scars need a deep, targeted treatment more than superficial resurfacing.
  • TCA CROSS works in small studies, but a higher concentration is not always better.
  • High-strength TCA is not a home treatment because of the risk of burns, pigmentation and scarring.

Acne Scars: Choose the Treatment by Scar Type

Medical references

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