Cosmetic medicine

Acne scarring

Ice-pick, rolling, and boxcar scars after inflammatory acne—combination resurfacing approaches.

Overview

Acne scars form when inflammation destroys collagen, leaving pits or uneven texture. Types include narrow ice-pick scars, broad rolling scars tethered by fibrous bands, and boxcar depressions. The AAD acne scar overview describes why combination therapy is common.

Treating active inflammatory acne first reduces new scarring risk.

Contributing factors

Severe nodulocystic acne, picking lesions, delayed care, and genetic healing patterns all influence scarring.

Treatment options

Fractional lasers and RF microneedling remodel collagen; subcision releases tethered scars; chemical peels help superficial texture; PRP may adjunct healing. Deep ice-pick scars sometimes need punch techniques by dermatology subspecialists.

Skin of color requires careful settings to reduce post-inflammatory hyperpigmentation—often pretreatment with brightening regimens.

What to expect

Expect incremental improvement over a series of treatments, not complete erasure. Sun protection and retinoids at home support results.

Frequently asked questions

Yes—controlling inflammation prevents new scars and improves laser safety.

Most patients need multiple sessions spaced weeks apart; severity and scar type determine the plan.

Yes with appropriate depth, sun avoidance, and sometimes pre-treatment for pigment—your clinician individualizes settings.