 
Acne scars do not all look or behave the same way. Some are wide and shallow, while others are deep and narrow. That is why laser resurfacing for acne scar types should begin with identifying the scar pattern, so the plan targets what you actually see in the mirror.
Rolling, boxcar and ice pick scars are all forms of atrophic acne scars, meaning they sit below the surrounding skin. Each type has a different shape and depth, and that difference affects which treatment helps most. Research in dermatology journals shows that laser treatment can improve many atrophic acne scars, while deeper scars may need a combined plan. Learn more about laser skin resurfacing at PURE.
Key Takeaways
- ✓Rolling and boxcar scars often respond better to fractional laser than deep ice pick scars.
- ✓Most people have mixed scars, so one plan may use more than one approach.
- ✓Active acne should be calm before resurfacing begins.
- ✓Start with an acne scar consultation.
What Is Laser Resurfacing for Acne Scar Types?
Laser resurfacing uses controlled light energy to create small zones of injury in the skin. The skin responds by remodeling and building new collagen, which can lift and smooth depressed scars over time. Fractional treatments are popular for scars because they treat tiny columns of skin while leaving the surrounding skin intact, which supports healing.
The key idea is matching. A plan for acne scar types looks at each scar’s shape and depth rather than treating the whole face as one scar type. For an overview of all options, read treating acne scars: laser, microneedling or chemical peel.
| Scar type | What it looks like | How laser fits |
|---|---|---|
| Rolling | Broad, wave like dips that show more under side lighting. | Fractional laser often helps; tethered scars may also need release first. |
| Boxcar | Wider depressions with sharp edges, shallow or deep. | Shallow to moderate boxcar scars often soften well; deep ones may need combination care. |
| Ice pick | Narrow, deep scars that look like small holes or large pores. | Laser improves surrounding texture; deep scars often need targeted treatment too. |
What Are Rolling Acne Scars?
Rolling scars create broad, wave like dips in the skin. They often look more noticeable under side lighting. A laser treatment for rolling acne scars may improve surface texture by supporting collagen remodeling.
In one study of fractional CO2 treatment for atrophic acne scars, rolling scars showed a stronger response than ice pick scars. Some rolling scars are tethered by bands below the skin, and in those cases laser alone may not fully address the deeper attachment.
How Laser Helps Rolling Scars
Fractional laser resurfacing can be useful when rolling scars are shallow or moderate. Possible benefits include:
- ✓Smoother looking skin and better surface texture.
- ✓Softer scar edges.
- ✓Support for collagen renewal.
- ✓A more even looking complexion.
When Rolling Scars Need More
If a scar stays the same when the skin is gently stretched, it may be tethered. Your provider may then discuss a combined plan. Microneedling is one collagen focused option; see microneedling in Chicago and microneedling vs laser.
What Are Boxcar Acne Scars?
Boxcar scars are wider depressions with sharper edges. Some are shallow, while others extend deeper into the skin. A laser treatment for boxcar acne scars may soften the edges and improve the surrounding texture.
Studies show that boxcar and rolling scars may improve more than deep ice pick scars. A fractional CO2 laser for acne scars may suit some boxcar scars because it creates tiny treatment areas that support the skin’s natural healing and remodeling.
Boxcar Scars and CO2 Resurfacing
CO2 laser resurfacing for acne scars may work well for shallow or moderate boxcar scars. Deep boxcar scars may need another treatment before or along with laser resurfacing. Read about the combination approach in acne scar treatments: PRP, microneedling and CO2.
What Are Ice Pick Scars?
Ice pick scars are narrow, deep scars that extend into the skin. They often look like small holes or enlarged pores. A laser treatment for ice pick scars can improve surrounding texture, but deep ice pick scars may be harder to correct with laser resurfacing alone.
Dermatology reviews often discuss targeted techniques such as TCA CROSS or punch methods for deeper ice pick scars, with laser resurfacing then used as part of a wider plan. The strongest laser is not always the right answer for every scar.
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Why Should Scar Type Be Checked Before Treatment?
An acne scar laser consultation should include a close look at:
- ✓Scar type and scar depth.
- ✓Skin texture and skin tone.
- ✓Active acne and previous scar treatments.
- ✓History of pigment changes and healing history.
Mixed scars are common. One person may have rolling scars on the cheeks, boxcar scars near the temples and a few deeper ice pick scars. That is why treatment may need more than one approach. Read when to consider acne scar treatment to judge your timing.
Skin Tone and Pigment Safety
Laser energy can trigger dark marks in some skin types. Your provider adjusts settings to lower that risk. Our guide to laser for darker skin tones explains the precautions.
Are There Gentler Options for Mild Scars?
For shallow marks and lingering discoloration, a peel may be a good starting point. Compare VI Peel for acne scars and chemical peels for acne scars and dark spots. Curious about comfort? Read does laser scar removal hurt.
How PURE Plans Acne Scar Laser Treatment
At PURE Medical Spa, acne scar treatment begins with identifying your scar pattern. Your consultation helps determine whether your scars are mainly rolling, boxcar, ice pick or a mix. If laser treatment is appropriate, fractional laser resurfacing can be planned around scar depth and skin condition.
Ask whether laser alone is expected to help or whether combination treatment may suit you better. If you still get breakouts, our acne therapy team can help calm them first.
Skincare Around Laser Resurfacing
Post treatment skincare should be simple and gentle. Products to discuss with your provider, available through the PURE skincare shop:
- ✓ALASTIN Regenerating Skin Nectar, a recovery focused option used around aesthetic procedures.
- ✓SkinMedica HA5 Hydra Collagen Water Burst Moisturizer for hydration once your provider approves it.
- ✓ALASTIN HydraTint Pro Mineral SPF 36 for daily protection after healing.
See what to use after microneedling for gentle routine ideas that also apply after many resurfacing treatments.
Visit PURE Medical Spa Across Chicagoland
PURE Medical Spa welcomes you at five convenient clinics in Chicago and the suburbs. Ask our team which location offers acne scar laser treatment and pick the visit that fits your schedule.
PURE Medical Spa Gold Coast (N. Dearborn), Chicago
875 N Dearborn St, Suite 300, Chicago, IL 60610
Book OnlineCall or Text 312.312.7873Naperville 331.283.0440
Frequently Asked Questions
Which laser suits rolling acne scars?
Fractional laser treatments may improve rolling scars. The right option depends on scar depth and whether the scar is tethered below the skin.
Does CO2 laser work for boxcar acne scars?
Fractional CO2 laser may improve selected boxcar scars, especially shallow or moderate ones. Deeper scars may need combination treatment.
Can laser resurfacing improve ice pick scars?
It may improve surrounding texture, but deep ice pick scars often respond less strongly to laser alone and may need targeted treatment.
Which acne scar types respond most to laser resurfacing?
Studies suggest rolling and boxcar scars respond better than deep ice pick scars to fractional CO2 resurfacing.
Rolling vs boxcar vs ice pick scar laser treatment: what is different?
Rolling scars are broad and sloped, boxcar scars have sharper edges and ice pick scars are narrow and deep. Their shape and depth shape the treatment plan.
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Safety note: Laser resurfacing may not be suitable over active acne, skin infection, open wounds or irritated skin. Tell your provider about previous pigment changes, scarring problems, medications and recent procedures. Seek medical care for severe pain, blistering, spreading redness, drainage or worsening swelling after treatment. This article is educational and does not replace a medical assessment.
References
- National Library of Medicine: Fractional CO2 laser with and without PRP in post acne atrophic scars
- National Library of Medicine: Acne scarring: pathogenesis, evaluation and treatment options
