Ice pick scars are deep, narrow pits in the skin that look like tiny holes punched by an ice pick. They form mainly from severe acne when inflammation destroys collagen in the deeper skin layers, leaving permanent indentations after healing.
These scars start with cystic or papular acne, where pimples burrow deep into the skin. The acne pore swells from oil, dead skin, and bacteria, breaking the pore wall and spilling contents into nearby tissue. This triggers a strong immune response with white blood cells and enzymes that fight infection but also damage collagen, the protein that keeps skin firm.[5][6][2]
During healing, the body tries to repair the harm by making new collagen. If too little forms, the skin surface sinks, creating atrophic scars like ice pick types. These pits go deep into the dermis, the skin’s middle layer, because the inflammation was narrow but intense.[1][7][3]
Picking or squeezing pimples makes it worse. This extra trauma hits deeper layers, destroys more collagen, and stops proper healing, turning small spots into lasting scars.[1]
Adults get these scars more often than teens. Adult acne tends to be deeper and cystic from hormones, like during menstrual cycles or menopause. Skin heals slower with age, plus years of sun damage weaken collagen, making pits form easier.[3][4]
Other factors raise the risk. Genetics play a part if family members had bad acne. Sun exposure breaks down collagen further. Stress, poor sleep, pollution, smoking, or some medicines slow repair and increase scarring chances.[3][2][6]
Infections like chickenpox or skin injuries can cause similar pits by depleting collagen the same way.[4]
Sources
https://liniaskinclinic.com/acne-excoriee/
https://shi.org/acne-scars/fillers-and-filler-injections/
https://www.london-dermatology-centre.co.uk/blog/adult-acne-scarring/
https://www.woodlandswellness.com/blog/understanding-depressed-scars-treatments-and-prevention-for-you/
https://www.oreateai.com/blog/the-journey-of-acne-scars-understanding-their-formation/2680dcb2bfbfb7caed166aeace40ddc4
https://www.kins-clinic.com/blogs/what-are-the-main-acne-scar-types-a-skin-friendly-guide-with-treatment-options
https://slmdskincare.com/blogs/learn/the-5-kinds-of-acne-scars-how-to-treat-each-type
