Rolling, Boxcar and Ice Pick Scars: Understanding the Types

Not all acne scars are the same. The main atrophic (depressed) scar types, rolling, boxcar and ice pick, look and behave differently, and the type influences which treatments are appropriate.

Recognising the type is part of assessment, not something to diagnose from a photo online.

Rolling scars

Rolling scars are broad, shallow depressions with sloping edges that give the skin a gently undulating, wave-like appearance. They are caused by tethering beneath the skin and tend to respond to treatments that stimulate collagen and improve overall skin quality.

Boxcar scars

Boxcar scars are round or oval depressions with more clearly defined, steep edges, a little like small craters. They vary in depth, and shallower ones generally respond better to skin-remodelling treatments than deeper ones.

Ice pick scars

Ice pick scars are narrow, deep and pitted, as if the skin has been pricked with a fine point. Because they extend deep into the skin, they are the most challenging type and often need targeted approaches rather than general resurfacing.

Why type guides treatment

Most people have a mix of scar types, and each responds differently, so treatment is planned individually after assessment. Microneedling, sometimes with exosomes, is one option for suitable scarring, always within the staged Acne Recovery Programme and only once active acne has resolved.

Frequently Asked Questions

Can all acne scars be fully removed?

Scar treatment aims to improve appearance rather than guarantee complete removal, and results vary with scar type and depth. An honest assessment sets realistic expectations.

Which treatment suits my scars?

It depends on your scar types and skin, which is what assessment determines. Most people have a mix of types, so a combined, personalised approach is common.

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