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How can I remove or resurface ice pick scars on my face?

Q:

I am  someone who suffers from ice pick facial scarring caused by chicken pox and some pimples.  I have had aggressive dermabrasion, about 5 treatments of fraxel CO2 laser, thermage, countless microdermabrasion treatments, and several other treatments including collagen builders, but nothing is working.  I would so much like to have a smooth face with minimum to no holes or dips!  I know my skin may not ever be picture perfect but these scars are so old and I am tired of feeling like an "alien." Make-up helps but not enough.  In some light the make up looks worse!  I have spent roughly $10,000 or more trying to correct this issue and I still have it.  With technology always improving, is there hope for me?  I am running out of patience and tired of wasting money and getting no results.  Please help!

A:

It looks like you have tried just about every method out there.  Historically, the most effective treatment for "ice pick" scars has been dermabrasion with a wire brush.  Many surgeons do not use a wire brush any more because it takes a lot of experience to handle it well and dermabrasion is not as popular as it was in the past.  Check with a local plastic surgeon to see if they use dermabrasion with a wire brush.  Some dermatologists also offer dermal grafts which are implanted into the depression to smooth out the skin surface.  Based on your comments, however, it seems you might be setting your expectations too high.

Perhaps any improvement you have achieved is about as good as it is going to get.  You should realize that all of your scarring may not be correctable and you should consider lowering your expectations as to what can be accomplished.

Aldo Guerra, M.D.
Scottsdale, AZ

A:

I'm sorry you're going through this. Acne scarring can be very frustrating. Ice pick scars are difficult to eliminate. It is difficult to know exactly how to treat these scars without  an in  person consultation.  

Deep ice pick scars that actually cast a shadow can be excised. This is called micro excision. it can be accomplished with a specialized 18 g "No-Kor" needle which has a top like a tiny scalpel.  This allows a precise excision which is closed with a single tiny suture that is removed about 4 days later to avoid suture mark scars.

P

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