GraysGrays Dermatology

Acne Scar Treatment Combinations by Scar Type

2026-08-11 · Reviewed by the medical director (review date to be posted)

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. Improvement widens only 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 much less noticeable rather than to erase them, and we build the full roadmap together at your first visit.

First-line treatment by scar type

TypeShapeFirst-line treatment
RollingBroad, gentle depressionSubcision + laser
BoxcarDepression with vertical edgesFractional laser + Potenza
Ice pickNarrow, deep punctureTCA cross
MixedCombination of typesCombination based on a scar map

Related treatments

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.

Consultation

Tell us your concern — a board-certified dermatologist will answer with a treatment plan

You don't need to know which treatment you need. It starts with telling us what bothers you.

CallKakaoTalkNaver Booking
ConsultationKakaoTalkLINEInstagram