Acne Scar Types: Icepick, Boxcar and Rolling, and What Treats Each

Where do the three names come from?

The icepick, boxcar and rolling system was set out by Jacob, Dover and Kaminer in the Journal of the American Academy of Dermatology in 2001. They sorted depressed scars by width, depth and three-dimensional shape, because those features decide which treatment can reach the problem. Later studies have shown that even trained doctors do not always agree on the shape of a single scar, so the names are a working guide, not a precise measurement. What matters is the principle: the shape of the scar points to the method.

What is an icepick scar?

Icepick scars are narrow, deep openings that look like a large pore or a small puncture. They are usually under about 2 mm across at the surface, but they extend vertically into the deep dermis, sometimes further. They often sit on the cheeks.

Because the opening is narrow and the base is deep, surface resurfacing alone tends to do little. Dermatology reviews describe methods that work on each scar individually, such as chemical reconstruction with a high-strength acid applied only inside the scar, or removing the scar with a small punch. A doctor decides whether these are suitable for you after seeing the scars.

What is a boxcar scar?

Boxcar scars are round or oval depressions with steep, well-defined edges and a fairly flat base. They are wider than icepick scars, often a few millimetres across, and can be shallow or deep. They are common on the cheeks and temples.

• Shallow boxcar scars often respond well to collagen-building treatments that soften the edges, such as RF microneedling or fractional resurfacing.
• Deep boxcar scars may need an individual technique first to lift or reshape the base, followed by resurfacing to blend the edges.

What is a rolling scar?

Rolling scars are wide, gently sloping dips that give the skin a wavy look, especially in side lighting. They are caused by fibrous bands that tether the dermis to the tissue underneath and pull the surface down. If you stretch the skin gently and the dip softens, it is often a rolling scar.

Because the cause is underneath, releasing the bands is the key step in many published approaches, a technique called subcision. Collagen-building energy and, in some cases, volume support help the surface stay level afterwards.

Most people have two or three scar types at once, so a good plan uses more than one method and treats in stages.

Matching scar type to treatment

Where does RF microneedling such as Potenza fit?

RF microneedling inserts fine needles into the skin and releases radiofrequency heat at the needle tips. The small channels and the heat together prompt the dermis to remodel and lay down new collagen, which softens the edges of boxcar scars and the slopes of rolling scars. Depth can be adjusted for different areas of the face.

Potenza is one RF microneedling device used for this. It is usually most useful as the base treatment in a course, repeated over several sessions, with other methods added for the deeper or narrower scars that it cannot reach on its own. It does not close a deep icepick scar by itself.

What about red or brown marks?

Flat red or brown marks left after a breakout are not scars in the textural sense. They are colour changes and usually fade or respond to different treatments. Many people have marks and true scars at the same time, and treating them in the right order helps. See red vs brown acne marks for that side of the question.

Why active acne should be settled first

New breakouts create new scars and inflame the skin, which raises the risk of irritation after scar treatment. Most plans calm active acne before starting resurfacing. Our acne treatment page covers that stage, and why the order matters explains the timing.

How many sessions, and how much improvement?

Scar treatment is gradual. Collagen remodelling takes weeks to months, so courses usually run over several sessions spaced weeks apart, and the final result is judged some months after the last one. Improvement is real but partial: the aim is smoother texture and less shadowing, not perfectly flat skin. The number of sessions depends on the scar types, their depth and how your skin heals. If you are visiting Seoul once, a doctor can tell you what one or two sessions can do and what would need follow-up.

FAQ

Plan a visit: send close-up photos of your scars in daylight and side lighting on WhatsApp, LINE, or KakaoTalk, and we will explain which scar types we see and how a plan could look, in English, before you land.