The short answer
Because depressed scars are almost never one type — most faces carry a mix of rolling, boxcar, and ice-pick scars, and each type responds to a different treatment. The improvement tends to be greater when subcision (to release tethering), TCA cross (for narrow, deep scars), and resurfacing lasers are combined according to a map of your scars.
How are scar types classified?
Rolling scars are broad, gently depressed areas usually caused by tethering — fibrous bands pulling the skin down from beneath. Boxcar scars have sharp, vertical edges like a box; ice-pick scars are narrow, deep punctures. A mix of all three on one face is the norm.
What works for each type?
For rolling scars, subcision to release the tethering comes first. For ice-pick scars, TCA cross — which induces regeneration along the scar walls — is effective. Boxcar scars and surface irregularities are refined with fractional lasers (CO2, erbium, Legato II) and Potenza. Boosters such as Juvelook are sometimes added to support regeneration.
How long should I plan for?
Scar treatment proceeds in stages at 4-6 week intervals, typically planned as 3-6 or more stages. The realistic goal is to make scars less noticeable rather than to erase them, and we build the full roadmap together at your first visit.
First-line treatment by scar type
| Type | Shape | First-line treatment |
|---|---|---|
| Rolling | Broad, gentle depression | Subcision + laser |
| Boxcar | Depression with vertical edges | Fractional laser + Potenza |
| Ice pick | Narrow, deep puncture | TCA cross |
| Mixed | Combination of types | Combination based on a scar map |
Related treatments
Scar Combination Program
Scar Combination Program
Staged treatment designed around your scar types
- ·Acne scars of several mixed types
- ·Those who were not satisfied with a single laser
- ·Those who want a long-term plan for scar improvement
Potenza
Potenza
RF microneedling that treats skin problems at the root
- ·Recurring adult acne and lingering red marks
- ·Enlarged pores and depressed scars
- ·Those who want to manage redness at the same time
Juvelook / Juvelook Volume
Juvelook / Juvelook Volume
A regenerative booster that stimulates your own collagen
- ·Texture concerns such as fine lines, pores, and shallow scars
- ·Those who want natural volume restoration without the feel of filler
- ·Those who prefer gradual change that builds over time
Sources
- 01Methods for the Improvement of Acne Scars Used in Dermatology and Cosmetology: A ReviewJ Clin Med · 2022 · PubMed 35628870
- 02Microneedling as a Treatment for Acne Scarring: A Systematic ReviewDermatol Surg · 2020 · PubMed 31356435
These are the general references used for this guide. They do not warrant the results of treatment at this clinic.
This guide is general medical information and does not replace an individual diagnosis. Please seek an in-person consultation for decisions about your own care.