A. Deep ice pick scars are the most difficult acne scars to improve. The pit must be ablated or surgically removed to see a change. There is a procedure called punch and float, which has been around for over 25 years. It is usually followed by dermabrasion or laser resurfacing. Punch and close is also an option, but I have found it works less reliably. I have seen the best results (but not home run results) from a combination of high concentration TCA placed with a sterile toothpick into the pit. The healing takes 1 week. The scab must be preserved because if it is picked out, there will be no change and perhaps even worsening of the scar. I usually combine it with aggressive Fraxel Restore several weeks later. 2-3 rounds of this combo may be needed and a reasonable expectation is 50-70% improvement.
Q. I have red scars on my face from acne that I think look even worse after Accutane (although I have been clear of severe acne now for over one year). What can I do to make them look better so I can be free of make-up?
A. There is no one-answer-fits- all solution to your problem. There are many questions I would ask you and I would need to see if the scars are just red, or are pitted. I would then give you options. I can make a general comment that chemical peels are quite good for most skin types having this complaint. If there is a general ruddiness to the complexion, I tend to go for a series of salicylic acid peels done monthly over 3-6 months. These peels are anti-inflammatory and very inexpensive when compared to Fraxel or Deep FX. This is a great option if you are patient (since it takes months to see the benefit) and if you do not have pitted scars.
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Lupo Center for Aesthetic and General Dermatology
Mary P. Lupo, M.D. - Connect on Linkedin
Our mission at the Lupo Center is to provide patients with innovative, effective and ethical care to make each person look and feel their personal best. To fulfill our goal, we provide state-of-the-art medical, surgical and cosmetic treatments to all patients.
Board certified dermatologist and clinical professor of dermatology Mary P. Lupo, MD has been a leader in the field of non-surgical rejuvenation since 1983. She travels internationally to teach her innovative techniques, and her reputation brings in patients from around the country. She started the first formal residency training program for injectables and peels in 1983 at Tulane Medical School and served as past president of Women’s Dermatologic Society, adjunct professor of dermatology at Tulane and a founder of Cosmetic Boot Camp. Dr. Lupo holds membership in many prestigious dermatology associations, participates in clinical trials for approval of new drugs and devices and acts as an advisor for numerous aesthetic-minded companies.
