Q: I had a severe case of cystic acne which after treatments of accutane left me with severe crater like facial ice pick scars on both my jaws. I am an african american male and have heard due to my color I can worsen the scars with laser surgery. I am at my wits end with this. I need help.
A: Icepick acne facial scars, even in a Caucasian, would not be treated with laser surgery as it could not go that deep. Your skin color is a reason the laser should not be used but is not the main reason.
Icepick scars are treated by excision, sometimes called punch excision, for their removal. This is a technique where they are cut out by small instruments and then closed, trading off a fine line scar that is level as opposed to a deep pitted scar.
This method can be helpful for scar improvement and is usually done in the office under local anesthesia. Based on the number of pitted scars you have, this can be done in a single session or may require multiple sessions.
The concept of performing these small acne scar excisions can be unsettling as one may not be certain that sufficient improvement in scar appearance may be obtained. The best way to answer that concern is to just do a few of the worst ones and judge the results. That will tell you whether this method is helpful and can give one the confidence to do more. (or stop if one is not satisfied with the improvement)
Dr. Barry Eppley