How can I find the best treatment for boxcar acne scars?

I am looking for the best treatment for boxcar scars. What is the best way to sift through the sales fluff and really get the best treatment? I do not have much money to spare so I want to make sure the first option I pick is the best.


F, 34, California

Fortunately, acne scars are treatable, whether they are rolling scars, boxcar scars, or ice pick scars. If you've already done some research and are confident that they are boxcar acne scars, you may already recognize that there are several options for treatment.

Consulting with a board-certified dermatologist will result in the determination of which treatment is best for you and confirm whether your scars are typical boxcar acne scars.

Like rolling scars, boxcar scars are typically shallow but with sharp, instead of round, edges. We’ve had the best results treating these scars using skin resurfacing methods. There are several options for skin resurfacing, such as laser treatment or dermal fillers. Others like chemical peels and microdermabrasion show mixed results. Skin needling and punch excisions are sometimes used, but we steer clear of them at our office in most cases, as they can lead to scarring of a different sort post-procedure. Treatment options vary by individual, severity, skin texture, and scar type.

Each person is different, as is each person's skin cells. The extent of the scarring, deep acne scars/depressed acne scars versus more topical/shallow scarring and the age of the scar, call for different forms of treatment. The good news is that there are now ways to treat the big three of acne scars -- ice pick, rolling, and boxcar.

It's difficult to determine the extent of your scarring without seeing for myself. My best advice is to do your homework and find a good, board-certified dermatologist in your area, ideally someone who specializes in treating acne-related scarring. From there you can determine the best way to approach your situation.

I recognize it can be a difficult decision to make, but depending on your financial situation I suggest that you ideally choose your provider based on their experience, rather than price. Look for board-certified dermatologists or plastic surgeons in your area who specialize in acne scar repair. After consulting with them you’ll learn which treatment makes the most sense for you and then you can talk price.

It sounds like you already know that you have boxcar scars which, for those who don’t know, are typically round or oval depressions with sharp edges. Like ice pick scars, they can give the skin a pitted appearance. The typical treatments offered are dermal fillers or laser resurfacing/laser treatment. Some practitioners will recommend chemical peels or microdermabrasion as both possibilities are less costly and don't require as much downtime. However, they're better for treating discolored scars rather than depressed scars. Punch excisions are riskier, and you could just be trading one scar for another.


If you have a few scars, your doctor may recommend one course of action. If you have a face filled with depressed scars from acne, they'll likely recommend resurfacing the face through lasers or radio frequency technology.

Acne scar treatments are best left to the professionals. In other words, don’t invest in wonderdrug topical skin care potions you see on the Internet or any of those do-it-yourself chemical peels, even more so for use where you have sensitive skin.

After your treatment, and you may require a couple more trips back to the provider in order to produce the best results.

Make sure you avoid sun exposure and closely follow the post-treatment instructions provided to you in order to avoid inflammation.

Lawrence Broder has 1 Acne treatment before & after:

Acne treatment before image performed by Dr. Lawrence BroderAcne treatment after image performed by Dr. Lawrence Broder

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Boxcar scars are caused by acne scarring. Their uneven, pitted appearance can respond well to dermal fillers such as Restylane or Juvederm Ultra Plus, which are injected into the skin to elevate the scar, evening out the depression with the surrounding skin.

Many patients are overjoyed to find that dermal fillers offer instant results. However, results depend on the experience of your injector: It is vital to use a provider skilled in injecting for scarring. In addition, results are temporary, lasting between six months and one year, so regular maintenance injections are needed.

Another more permanent option you may wish to consider is laser resurfacing. Non-ablative, fractionated lasers stimulate collagen production and improve skin tone and texture. They can produce excellent results in certain candidates, but may not be suitable for all skin types. I would suggest you consult with a dermatologist or plastic surgeon who specializes in acne treatment to determine the most suitable option for your budget and aesthetic goals.