Ice Pick Acne Scars: What Causes Them
Ice pick acne scars are those small, deep pits in the skin that look like tiny holes poked by a sharp tool. They stand out because they are narrow and go deep into the skin’s middle layer, called the dermis.
These scars come from severe acne, especially the cystic kind where big, painful bumps form under the skin. When acne gets bad, inflammation digs deep and destroys collagen, the protein that keeps skin firm and smooth. Without enough collagen, the skin over the spot collapses inward, leaving a sharp pit behind. This happens most with untreated or picked-at acne, as the damage stops normal healing.
Picking or squeezing pimples makes it worse. The repeated poking tears deeper skin layers, breaks down collagen, and causes the skin to shrink and form permanent dents. People with hormonal acne in adulthood face higher risks too. Things like menstrual cycles, pregnancy, or conditions such as PCOS lead to deeper cysts that inflame the skin more than teen breakouts do. Adult skin also heals slower, and past sun damage weakens it further, raising the chance of these pits.
The process starts with acne blocking pores, trapping oil, dead cells, and bacteria. White blood cells rush in to fight it, but their enzymes can harm nearby tissue. If the inflammation hits deep and lasts long, collagen production fails during repair, creating ice pick scars. They often show up on cheeks, jawline, or chin where cystic acne hits hardest.
Genetics and skin type play a role too. Some people just make less collagen when healing, no matter the acne type. Severe cases from infections like chickenpox or skin injuries can mimic this, but acne is the top cause.
Sources
https://liniaskinclinic.com/acne-excoriee/
https://www.london-dermatology-centre.co.uk/blog/adult-acne-scarring/
https://slmdskincare.com/blogs/learn/the-5-kinds-of-acne-scars-how-to-treat-each-type
https://www.kins-clinic.com/blogs/what-are-the-main-acne-scar-types-a-skin-friendly-guide-with-treatment-options
https://www.oreateai.com/blog/the-journey-of-acne-scars-understanding-their-formation/2680dcb2bfbfb7caed166aeace40ddc4
https://www.woodlandswellness.com/blog/understanding-depressed-scars-treatments-and-prevention-for-you/
https://www.pristyncare.com/consult/acne-scars-for-years-is-complete-skin-clearance-possible/
https://shi.org/acne-scars/fillers-and-filler-injections/
