Punch excision for ice pick scars: before and after

Before treatment, a dermatologist examines the scar's depth, width, location and skin tone, then discusses whether the method suits that scar. The procedure uses local anaesthetic, so the skin is numb while a small circular instrument removes the scarred core. The edges are brought together with a stitch or allowed to heal according to the technique used.

Afterward, mild swelling, tenderness, a scab or a visible stitch can draw attention to the site. Early healing is not the final appearance. The original depression may look shallower, but a small line or spot can remain, and colour changes may take time to settle. Several scars may need separate treatment decisions.

Tell the clinician about medicines, supplements, allergies, previous raised scars, active acne, cold sores and any tendency to develop dark marks after skin injury. Follow the instructions about cleansing, dressings and medicines. Keep the site protected from rubbing and sun while it heals; do not pick a scab or remove a dressing early. Attend any planned stitch removal or review so healing can be checked.

Contact the treating clinic promptly if redness spreads, pain is worsening rather than easing, the area becomes hot, pus develops, bleeding does not stop with firm pressure, or you develop fever. Seek urgent help for facial swelling that affects breathing or vision. A rapidly enlarging, very itchy or raised scar also deserves review.

Ask which scars are suitable, where the closure will sit, how dressings should be changed, when normal skincare can resume, and what options exist if a residual mark remains.