How To Treat Ice-Pick Scars

Ice pick scars are one of the most common types of acne scarring, and although they can be challenging to get rid of, there are plenty of treatment options that will help improve their appearance.

This type of scarring is named after how it looks, which is similar to an ice pick puncturing the skin.

Ice pick scars are most commonly caused by acne, but other injuries to the skin can also trigger this type of scarring to form.

In this article, we will discuss how ice pick acne scarring develops, how to distinguish them from other types of acne, and some treatment and maintenance options that can help improve their appearance.

How Do Ice Pick Acne Scars Develop?

Ice pick acne scars develop as a result of deeper acne breakouts, such as cysts and nodules that have remained on the skin for a longer time.

Deep cystic acne can damage the tissue beneath the visible skin layer. Sadly, as we continue to lose collagen with age, the collagen production isn’t significant enough to fill up the indentations created by this type of inflammation.

So when we don’t have enough collagen to fill up these spots, we are left with noticeable pits and depressions in the skin.

Additionally, our bodies will try to heal the injury, but due to not being able to produce enough collagen, a complex chemical reaction will sometimes form fibrous bands, which anchor down that area of the skin, pulling the scar even deeper.

The deeper the scar, the more tissue is lost, and therefore, the more noticeable it will be.

What Do Ice Pick Acne Scars Look Like?

Ice pick scars are narrow and deep.

They are easily noticeable by their narrow pitted shapes that look like the skin has been pricked with a needle.

Ice pick scars can range in size from very small to large, and this type of scarring most commonly occurs on thicker areas of the face such as the cheeks and chin but is rarely found in areas such as the forehead and temples.

How Are Ice Pick Acne Scars Different Than Other Types of Acne Scars?

The main difference between ice pick acne scars and other types of acne scarring is their depth and appearance.

Other types of acne scars such as rolling and boxcar scars are more shallow but wider, while ice pick scars are narrower but go deeper into the skin.

The appearance of ice pick scars also sets them apart from other types of acne scarring.

Ice pick scars have a jagged,  punched-out appearance while other types of acne scarring may appear as box-like or rolled depressions in the skin or raised bumps, such as hypertrophic or keloid scarring.

How to Treat Ice Pick Acne Scars?

The best treatment for ice pick acne scars can be determined after considering a couple of factors, including the depth of the scar and the area where it’s found.

Since ice pick acne scarring is relatively narrow, you can’t really tell how deep it goes, which is why a combination of treatments is usually advised before it’s determined which one works best and continuing with a few more sessions.

Deeper scarring in larger areas of the face will surely require a combination of treatments, and therapy is likely to last longer because the skin will need time to heal and recover between treatments.

With all that said, here are the best treatments for ice pick acne scars:


Microneedling, also known as collagen induction therapy, is a minimally invasive procedure that involves using tiny needles to create controlled micro-injuries in the skin.

This helps stimulate the body’s natural production of collagen and elastin, which can help fill up the indentations in the skin and improve the depth and appearance of ice pick scars.

Microneedling is the best treatment for both deep and shallow ice pick acne scars, and although deeper scarring will need more sessions than superficial scars would, most people get permanent results after four to six treatments.

Laser Resurfacing

Laser resurfacing is a more invasive treatment that uses powerful beams of light to improve the appearance of ice pick scars by heating the tissue and stimulating collagen production.

This treatment can be quite effective, but it comes with a longer recovery time as the skin will need to heal from the injury caused by the laser.

Laser resurfacing is usually done in a series of treatments spaced out anywhere from four to eight weeks apart, and most people see significant improvement after two or three sessions.

Laser resurfacing is the best treatment for red or pigmented ice pick scars that go deeper into the skin.


Subcision is a surgical procedure that involves inserting a needle into the skin and manually breaking up the fibrous bands that are anchoring down the ice pick scars and pulling them deeper into the skin.

This helps release the scar tissue, which can help significantly improve the scar’s appearance.

Subcision is usually done in a series of treatments four to six weeks apart, and most people see significant improvement after two or three sessions.

However, this treatment is likely to cause some discomfort that includes initial bleeding, swelling, and bruising that can last up to a week.

Subcision is the best treatment for ice pick scars that are tethered down by fibrous bands and appear sunken in.

It’s also a treatment that’s usually recommended to people who have a combination of boxcar, rolling, and ice pick acne scarring.

Punch Excision

Punch excision is a surgical procedure that involves removing the ice pick scar with a punch biopsy tool.

This tool makes a small incision around the scar, which helps remove it along with a small margin of healthy skin around it.

The area is then stitched up, and the healing process begins.

Punch excision is the best treatment for ice pick scars that are relatively deep.

However, it’s important to note that this treatment can cause some scarring when used on larger areas, which is why it’s only recommended to people with fewer ice pick scars in smaller areas.

Additionally, punch excision requires some downtime as bruising is likely to occur and can last up to a week post-treatment.

Dermal Fillers

Dermal fillers are injectable treatments that can help improve the appearance of ice pick scars by filling them up with hyaluronic acid that will help plump up the skin and make the scarring less prominent.

One of the advantages of fillers is that they are quick and easy to get, and most people see immediate results after one treatment.

However, the drawback of fillers is that the results aren’t permanent and will fade away after six to nine months, depending on the quality of the work and the product as well as how fast your body breaks down the substance.

Dermal fillers are usually recommended for deep ice pick scarring in smaller areas.

Chemical Peels

Chemical peels are exfoliating treatments that involve using high-strength acids to shed the top layer of the skin and reveal a smoother and more uniform complexion.

Most people need a series of peels four to six weeks apart to see a significant improvement, and there is usually some downtime associated with this treatment as the skin will be sensitive and more susceptible to UV damage and burning.

Chemical peels are recommended for shallow ice pick scars and are usually combined with other, more invasive treatments such as micro-needling.


Microdermabrasion is another type of exfoliation treatment that uses a high-powered tool to sand down the top layer of skin.

This helps improve the appearance of ice pick scars by reducing their depth and making them less noticeable.

Microdermabrasion is usually done in a series of treatments two to four weeks apart, and most people will see some improvement after four to six sessions.

Microdermabrasion is the best treatment for shallow and pigmented ice pick scarring.

Can You Treat Ice Pick Acne Scars Naturally?

While ice pick scarring can’t be fully treated naturally, some home remedies can help improve their appearance by moisturizing and softening the skin and promoting healing.

Here are some of them:

Rosehip Oil

Rosehip oil is abundant in fatty acids that help moisturize and soften the skin, as well as vitamin C, an antioxidant known for its ability to accelerate collagen production and support skin healing.


Squalane is another oil that’s rich in fatty acids and vitamins that help nourish the skin and promote healing.

It also has the ability to reduce inflammation, which can help the area around ice pick scars look less red and irritated.

Prickly Pear Oil

Prickly pear oil is high in vitamin E and linoleic acid. Both components help nourish the skin and promote healing, and linoleic acid helps the skin retain moisture, keeping it hydrated and strengthening the skin barrier’s function.

Prickly pear oil is also antibacterial, which means it can soothe inflammation caused by conditions such as acne, dermatitis, and rosacea.

Can You Treat Ice Pick Acne Scars With Skincare Products?

Because ice pick acne scars go way deeper than the skin’s surface, not many skincare products can actually help target the root of the issue.

The best face wash for ice pick acne scars depends a lot on the type of scar and skin type of the individual person. Every type of scar and skin type will respond differently depending on the ingredients used in the cleanser.

However, many people have seen improvement in ice pick scarring by using tretinoin, a prescription-strength retinoid that works by increasing cellular turnover and encouraging collagen production.

And while tretinoin alone won’t entirely get rid of ice pick scarring, it can definitely help improve its appearance, especially when combined with professional treatments.

What Makes Ice Pick Scars Worse?

Here are some of the most common mistakes that can actually make ice pick scars worse:

Popping Pimples

Popping your pimples will only further inflame the skin and cause the bacteria to spread in other areas.

Besides that, when squeezing your skin, you might push all that bacteria and cellular debris even deeper, meaning the root of the issue will be even deeper than initially.

This is almost a certain sign that ice pick scarring will form its base deeper into the skin.

Picking at Scabs

Like popping pimples, picking at scabs can also lead to more inflammation and scarring.

Picking at scabs can re-open wounds that have already started to heal, increasing the risk of infection and leading to more scarring.

Dermarolling at Home

While dermarolling isn’t the safest of procedures to do on yourself and is heavily advised against at-home use, it can still offer some benefits, including improving the appearance of ice pick acne scarring.

However, using a derma roller at home can go wrong in many different ways.

Therefore, if you aren’t a professional, it’s best to stay away from this tool because the consequences can be devastating, and some of them include:

  • Spreading bacteria.
  • Exacerbated acne.
  • Exacerbated skin texture.
  • Redness and irritation.
  • Infections.

Originally Published: March 19, 2022

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Analyzed by Simone Sydel

Hi, I’m Simone Sydel, a licensed esthetician and acne expert dedicated to helping others solve their skin issues including acne, eczema, and UV damage. I specialize in testing and reviewing the latest acne treatments and beauty products, offering honest, practical advice for skincare. I’ve helped hundreds of clients clear their skin and my skincare product reviews have been read by several hundred thousand people. Thanks for visiting!

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