Ice pick scar treatment in Singapore is a common search among adults who have cleared their acne but are still left with deep, pitted marks that makeup cannot fully hide. Many online articles highlight TCA cross peels as a “must-do” for these scars, but Asian skin has unique considerations, and newer combinations like subcision with PDRN (salmon/trout DNA) injections can often give more impactful and sustainable results with much lesser risks downtime.
What are ice pick scars?
Ice pick scars are narrow, deep, pitted acne scars that look as if the skin has been pierced by a tiny sharp instrument. They are a type of atrophic (sunken) scar and usually arise after severe, inflamed or cystic acne that destroys collagen in the deeper layers of the skin.
Because these scars extend vertically down into the dermis, they rarely respond to superficial treatments like basic facials, mild peels or skincare alone. Effective ice pick scar treatment in Singapore therefore focuses on techniques that reach into the deeper layers and stimulate controlled collagen remodelling from within.
How do ice pick scars form?
When a deep, inflamed pimple forms, the combination of bacteria, oil and intense immune reaction can damage both the surface and the deeper support structures of the skin. As the body heals, it may produce too little or disorganised collagen, leaving a narrow, steep-sided “hole” instead of a smooth surface.
Picking or squeezing pimples pushes inflammation deeper and increases the chance of permanent scarring, especially in patients who are genetically prone to forming atrophic scars. Once established, these scars do not fade on their own, which is why many people eventually search for specialised acne scar treatment in Singapore.
Principles of treating deep acne scars
Modern acne scar management is built on three key principles: accurately classifying each scar type, choosing treatments that target the correct skin depth, and combining modalities for a gradual but more complete result. Ice pick scars, boxcar scars and rolling scars often sit side by side, and each type responds differently.
For deep pits, the goal is to trigger focused wound healing inside the scar, encouraging new collagen to fill and soften the defect over a series of sessions. This can involve chemical methods (such as TCA Cross), mechanical release (subcision) and regenerative injectables or lasers, all tailored to Asian skin sensitivity and pigment risk.
TCA Cross: why it’s so popular online
TCA Cross (Chemical Reconstruction Of Skin Scars) is one of the most talked-about options for ice pick scar treatment. In this technique, a high-strength trichloroacetic acid solution is carefully placed into the opening of each individual scar using a very fine applicator, causing a controlled chemical injury inside the pit.
As the treated area heals, it can generate new collagen and gradually reduce the depth and sharpness of the scar.
Is TCA Cross really suited for Asian skin?
Asian skin (typically Fitzpatrick types III–V) has a higher tendency to develop post-inflammatory hyperpigmentation (PIH) or temporary pigment changes after aggressive procedures. This means that while TCA Cross can be effective for ice pick scar treatment in Singapore, it must be used with extra care in darker skin tones.
Many aesthetic doctors therefore adjust the acid concentration, application technique and treatment interval for Asian patients, and emphasise strict sun protection and pigment-control skincare before and after procedures. The decision to use TCA CROSS should be individualised, based on scar pattern, lifestyle and the patient’s tolerance for potential temporary darkening.
Known side effects and complications of TCA CROSS
Even in experienced hands, TCA Cross is not completely risk-free. Common short-term effects include frosting (whitening), redness, scabbing and temporary darkening around the treated points, typically lasting several days to weeks as the skin remodels.
Less frequent but important complications reported in the literature and clinical practice include prolonged PIH, transient hypopigmentation (lighter spots), widening or distortion of scars, infection and inadequate improvement despite multiple sessions. These risks are particularly relevant in Asian skin, which is why patients should avoid DIY or unregulated treatments and seek a skilled and experienced doctor familiar with ethnic skin responses.
Why our clinic does not use TCA CROSS
At our clinic, most patients have Asian skin types (typically Fitzpatrick III–V), which are naturally more prone to post-inflammatory hyperpigmentation and prolonged redness after strong chemical procedures. While TCA Cross can work for deep ice pick scars, the risks in darker skin – such as burns, scabbing with long downtime of about 7 to 14 days, residual redness, and PIH that may linger for weeks or months- are not always justified, especially for patients with busy schedules or public-facing jobs.
After weighing risk versus benefit, our team has chosen not to offer TCA Cross, and instead to focus on newer options with minimal downtime and a lower side-effect profile which deliver more sustainable and impactful results. These include subcision to release tethered scars, combined with regenerative injectables such as PDRN (salmon or trout DNA) and other collagen-stimulating treatments that support gradual remodelling without repeatedly “burning” the skin surface. This risk management approach prioritises safety and consistency for Asian skin, while still working towards smoother texture and visible softening of deep ice-pick and boxcar scars over time.
Treat deep ice-pick & boxcar scars with precision
Deep ice-pick and boxcar scars require precise, scar-by-scar planning rather than a “one-size-fits-all” acne scar treatment. The ideal approach is to map out each scar type, then selectively apply the right tool. Subcision is an option suitable for tethered depressions, synergistically paired with regenerative injectables to enhance healing and texture.
With this precise strategy, the doctor can minimise the side effects and reduce the overall risk of pigment complications of TCA cross associated with Asian skin. Over time, this targeted method lifts the deepest scars, smooths key shadow-casting areas and improves skin quality, while still keeping lifestyle acceptable for busy patients.
Subcision with PDRN injections: a gentler yet effective option for Asian skin?
Subcision is a minimally invasive technique that uses a special needle to release the fibrous bands pulling a scar down from beneath. By breaking these tethers, the scar can lift, and a small, controlled pocket of injury is created that the body fills with new collagen during healing.
For Asian patients worried about pigment changes from strong acids, subcision often pairs well with regenerative injectables rather than aggressive resurfacing. One increasingly popular choice in Singapore is combining subcision with PDRN injections to encourage smoother, more stable healing in the treated zones.
What is PDRN (salmon and trout DNA)?
PDRN stands for polydeoxyribonucleotide, a mixture of DNA fragments usually extracted from salmon or trout sperm cells that has been used in regenerative medicine. These DNA fragments interact with receptors involved in tissue repair, helping to stimulate cell growth, improve microcirculation and promote collagen synthesis in the treated skin.
In aesthetic practice, PDRN is often described as “salmon DNA” or “trout DNA” injections and is used to improve skin texture, hydration and healing. When combined with acne scar procedures like subcision or RF microneedling, PDRN can support the repair process, reduce inflammation and gradually make atrophic scars appear shallower and less noticeable.
Taking the next step
If deep acne pits are affecting confidence, it is worth having your scars assessed early rather than waiting for them to “fade” on their own. An experienced aesthetic doctor can identify which treatment methods and protocols are best suited for your scars with minimal risk of complications and downtime.
During your consultation, ask about realistic improvement percentages, expected downtime and how many sessions you may need for meaningful results. With a precise, personalised approach to ice pick scar treatment in Singapore, it is possible to soften deep pits, smooth key areas and achieve skin that looks more even and confident in real life and on camera. Book a consultation with our doctors to discuss your concerns, understand your scar pattern.
Eeva Medical Aesthetic Clinic [ Raffles Place MRT ]
20 Cecil Street, #09-06 Singapore 049705
PLUS Building
📞+65 9457 9225