Acne Scar Treatment
Large Pores or Ice Pick Scars?
Many people think they have large pores, but what they actually have are ice pick acne scars.
Large pores are normal openings in the skin where oil is released. They are usually round, shallow, and become more noticeable with oily skin or aging.
Ice pick scars are completely different. They are tiny, deep, narrow holes left behind after acne damages the skin. Because they are so small, many people mistake them for enlarged pores. The difference is that pores can be minimized, but scars need to be repaired.
This is why creams, facials, and pore-tightening treatments often fail to improve these "large pores." They are treating the wrong problem.
The good news is that ice pick scars can be significantly improved with the right procedures, such as TCA CROSS, laser resurfacing, and other scar-specific treatments. The goal is not to erase the scars overnight, but to gradually rebuild the skin so these tiny pits become much less noticeable.
The first step to successful treatment is making the correct diagnosis. What looks like large pores may actually be acne scars.
Large pores can be made less noticeable by reducing excess oil, boosting collagen, and improving skin texture.
Depending on the cause, treatments may include medical-grade skincare, chemical peels, microneedling, laser resurfacing, microtoxin injections and sebum-reducing skin care products.
In my experience, nearly all large pores dramatically improve with CO2 laser spaced 3 months apart till my patient says "I now can go out without makeup."
The toothpick standing on its own demonstrates the remarkable depth of this ice pick scar. A laser alone cannot adequately reach the bottom of such a narrow defect. That's why deep ice pick scars are usually treated first with TCA CROSS, which stimulates collagen from within the scar before any resurfacing procedure.
Ice-pick scars are one of the most challenging types of acne scarring because they form deep, narrow indentations that topical treatments and surface-level procedures cannot correct. When these scars are mistaken for enlarged pores, patients often waste time and money on ineffective treatments. The correct treatment is TCA CROSS first then laser resurfacing to promote true collagen repair and visible improvement.
Ever notice makeup making certain spots look more textured? That's a sign you're dealing with ice-pick scars, not large pores. These scars are too deep for microneedling, peels, or skincare to correct — this type of ice pick scar needs TCA CROSS first, then laser resurfacing to reach the right depth for visible smoothing.
Ready to Get the Right Diagnosis?
Call Dr. Lopez at Rejuvimed to schedule a consultation and find out what you're really dealing with.
559-488-9234Medical Disclaimer: The information on this page is for educational purposes only and does not constitute medical advice. Results vary by individual — no specific outcome is guaranteed. All treatments are performed by or under the supervision of Cynthia M. Lopez, M.D. Before/after photos are of actual patients and are used with consent. Individual results may vary. This website is not intended to diagnose, treat, cure, or prevent any medical condition. Please consult Dr. Lopez directly to determine whether a treatment is appropriate for you.