Abstract

Objectives: 1. Nasal ice pick scars are small and deep scars on the nose that are notoriously difficult to treat. 2.Traditional treatment options, such as TCA Chemical Reconstruction of Skin Scars (CROSS) technique and punch excision, have limitations and may not be suitable for all cases. 3. The novel treatment approach using fractional ablative CO2 laser is an accurate yet effective method to treat nasal ice pick scars, as this treatment method allows for the focal treatment of individual nasal ice pick scars while sparing the rest of the face. Introduction: Nasal ice pick scars are a specific type of scarring on the nose that commonly arises from acne vulgaris, as well as self-picking and physical extraction of comedones or hair follicles. These small, deep scars are challenging to treat, with TCA CROSS and punch excision being the current best options. However, TCA CROSS is limited by the likelihood of affecting healthy skin due to nasal curvature whereas punch excision is only effective to small individual scars and may cause anatomical distortion to the relatively small nasal area. Materials / method: Five patients participated in this case series. A fractional ablative CO2 Laser was used to focally treat individual nasal ice pick scars while sparing the rest of the face. A total of three treatments were done every four weeks, with follow-up at week 16. Images were taken prior to treatment and during each follow-up. Results: Follow-up at week 16 revealed that four patients had clinical improvement of 76-100%, 1 had clinical improvement of 51-75%, and none had minimal or no improvements. No severe adverse effects were reported. Conclusion: We propose a novel method to treat nasal icepick scars by utilizing fractional ablative carbon dioxide (CO2) Laser to focally treat individual nasal icepick scars. This novel method allowed us to achieve near complete clearance of nasal icepick scars while minimizing downtime and risk of adverse effects.