Punch excision for acne scars

Under local anaesthetic, a small circular blade the size of the scar (about 1.5–3.5 mm) removes it, and the hole is closed with a stitch. This turns a deep pit into a fine flat line. A laser resurfacing session 4–6 weeks later blends it in.

A few stinging anaesthetic injections, then nothing sharp. Mild soreness for a day or two.

How much downtime: Low — About a week with small stitches; then a fine pink line that fades over weeks.

Cost for that downtime: $100–$300 per scar, or $500–$2,000 per session, usually 1 session, followed by laser 4–6 weeks later.

Is it worth it? Our verdict (4/5): Worth it for deep ice-pick scars, which no laser alone will fix. Best as part of a plan: excision first, then resurfacing.

• Removes deep ice-pick scars that lasers and microneedling can't reach
• Fast: many scars in one session
• Permanent result for each treated scar

• Treat wide rolling scars
• Leave no mark; it swaps a pit for a fine line
• Work alone on widespread scarring; it's a first step

• A visible line or slight indent
• Infection
• Stitch marks if stitches stay in too long

Darker skin tones: Suitable for darker skin; there's some risk of temporary darkening of the line, which usually fades.

Good fit

• A number of deep, narrow ice-pick or boxcar scars
• People planning laser resurfacing anyway

Avoid or ask a doctor first

• Active acne
• Keloid tendency
• Wide, shallow or rolling scars

Typical cost: $100–$300 per scar, or $500–$2,000 per session (USD, varies by city and provider)

Sessions: Usually 1 session, followed by laser 4–6 weeks later

• Dr Asif Hussein (London laser surgeon) — Punch excision
• PubMed research: punch excision acne scars

General information only, not medical advice. Consult a qualified dermatologist.