Punch Excision for Ice Pick Acne Scars
Ice pick scars are narrow, deep acne scars that extend down into the skin like a tiny pore or pinhole. Because they are deep and tapered, many topical treatments and even lasers can only partially improve them. Punch excision is a minor in-office procedure designed to remove the scar itself and replace it with a small, straight-line scar that typically blends in better over time—especially when combined with resurfacing
What Punch Excision Treats Best
• Ice pick scars (deep, narrow scars)
• Very narrow boxcar scars (small, sharply edged scars)
• Scars that are too deep for laser alone
Punch excision is usually not ideal for broad, shallow rolling scars, which tend to respond better to subcision, filler, or energy-based resurfacing.
How Punch Excision Works
A tiny circular instrument, typically 1–3 mm in diameter, is used to remove the scar down to a controlled depth. The edges are then brought together and closed with a small suture.
1. The scar is precisely removed.
2 . The skin is closed with a very small stitch.
3. The result is a fine line instead of a deep pit.
What to Expect During the Procedure
In-office time: 15–45 minutes depending on the number of scars treated
Anesthesia: local numbing with a small injection
Pain: minimal during the procedure with mild tenderness afterward
Healing Timeline
• Days 1–3: mild swelling and redness; ointment or small bandages used
• Days 5–10: stitches are typically removed
• Weeks 2–6: pinkness fades and the line scar softens
• Months 3–12: continued scar remodeling
Results: What You Can Realistically Expect
• Deep pits become much less noticeable
• Skin texture appears smoother, especially in side lighting
• Best results often come from combination treatment plans
Side Effects and Risks
• Temporary redness, swelling, or bruising
• Mild tenderness or scabbing
• Rare risks include widened scars, infection, pigment changes, or suture marks
Aftercare Basics
• Keep treated areas clean and apply recommended ointment
• Avoid picking, scrubbing, or trauma
• Limit heavy exercise for 24–48 hours
• Use strict sun protection
• Attend follow-up appointments for stitch removal
Schedule a Scar Evaluation
If you have ice pick acne scars, a scar-type evaluation is the fastest way to determine whether punch excision or combination therapy is appropriate for your skin and goals.