Ever wonder how icon authors such as Mormegil create their cool looking icons? They typically use programs like Corel Draw (in Mormegil's case) or Photoshop or Illustrator. Once they've created their icon they then use a program to turn them into icons.
One such program: IconDeveloper which has been designed specifically to make it really easy to turn images (or batches of them) into icons and take care of all the rescaling and colorizing and all that for the user.
This article at JoeUser walks users through how easy it is now to create icons.