Cosmetic
Ice-pick, rolling, and boxcar scars after inflammatory acne—combination resurfacing approaches.
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.
Severe nodulocystic acne, picking lesions, delayed care, and genetic healing patterns all influence scarring.
RF microneedling remodels 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.
Expect incremental improvement over a series of treatments, not complete erasure. Sun protection and retinoids at home support results.
