Boxcar scars can develop as a result of acne, or sometimes, chickenpox. Numerous treatments are available to reduce their appearance, such as dermarolling, microdermabrasion, and surgery.
Boxcar scars are also known as craters or pockmarks. While they are not physically harmful, they can cause distress and low self-esteem, particularly when they appear on the face.
Boxcar scars are a type of atrophic acne scar. An atrophic scar is a depressed scar that heals below the normal layer of skin tissue.
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Boxcar scars form when the skin tries to heal after an injury but does not produce enough collagen. Collagen is a substance that helps support the skin, so a lack of collagen causes pitting.
Any type of acne can cause boxcar scars. They sometimes develop following chickenpox, too. Some risk factors make acne scars more likely, such as:
According to the American Academy of Dermatology (AAD), while genetics and other risk factors influence who will or will not develop acne scars, they are not a guarantee. It is not always clear why one person develops scars while another does not.
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There are a variety of ways to try to minimize the appearance of boxcar scars. The method a person chooses may depend on the depth and severity of the scars.
Dermarolling, or microneedling, involves rolling or pressing tiny needles over the skin in order to create small injuries. This stimulates collagen production, which can reduce the appearance of depressed scars.
Chemical peels involve a dermatologist applying acids to the top layer of skin to exfoliate it. This allows new skin cells to grow. It is a form of resurfacing treatment.
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Found that superficial chemical peels effectively treat atrophic scars with relatively few side effects or complications. A 2015 review suggests that five sequential sessions of
Chemical peels can cause side effects, such as pain, redness, or flaking. This is more likely with stronger acid solutions. People may need to follow a special skincare routine while undergoing treatment and wear SPF to prevent sun damage.
Dermabrasion and microdermabrasion are facial resurfacing techniques that involve removing the epidermis, or top layer of skin cells, to encourage new skin cells to grow.
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Laser resurfacing is another type of skin resurfacing that can help minimize the appearance of mild to moderate boxcar scars. There are
Ablative laser treatment can produce more drastic results, with significant improvements after only one treatment. However, there is also a higher risk for infection than non-ablative treatments.
Fillers are skin injections that contain substances to plump up the skin. Depending on the type of filler, it may contain collagen or fat from another part of the individual’s body.
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Fillers can reduce pitting and even out the skin. However, most give temporary results, lasting between 6-18 months. Some types of filler are permanent.
Medical professionals can also remove acne scars surgically. This option is best for those with a small number of scars. There are two types of procedure:
Some people use dermarollers and dermastamps at home. However, it is important to be aware that home kits may carry some risks.
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It can be difficult to sterilize dermaroller needles at home properly. If a person does not sterilize or change the needle head frequently enough, they may be at risk for infection.
The needles that come in home dermarolling kits are also shorter than the ones professionals use and penetrate the skin at an angle. This may mean they do not work as effectively as professional microneedling treatments.
Boxcar scars are not something that requires immediate medical attention, but they can have a significant impact on mental health. If that is the case, people should speak to a doctor or dermatologist about their options.
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There are numerous ways to reduce the appearance of boxcar scars. Minor surgery may help reduce a small number of scars, while procedures such as peels, laser treatment, or dermarolling may reduce more widespread scars.
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But whether your acne scars are raised or sunken, there are several good ways to mask or minimize them — think laser resurfacing, chemical peels and microneedling.
“I’m always amazed at how much healing the skin can do once you get the inflammation under control, ” says dermatologist Amy Kassouf, MD.
Acne is a common skin condition affecting about 80% of those between the ages of 11 and 30 at some point. It can be on your face, chest, back and shoulders. It may seem like the irritation will never go away, but it does. When it goes away, you may be left with acne scars.
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Although it’s not possible to get rid of your acne scars quickly, it’s never too late to treat them. Teenage patients may have to wait until their early 20s before undergoing treatment to make sure there’s little risk of future acne flare-ups.
While there are plenty of over-the-counter products that claim to improve a scar’s texture, color and appearance, there’s no real way to get rid of acne scars naturally and at home. Over-the-counter products may include the following ingredients:
But your best bet is to consult a dermatologist. First, they’ll focus on getting your acne under control. The fewer breakouts you have, the fewer scars you’ll get. And the good news is that not all acne scars are permanent.
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Vascular-specific lasers target blood vessels and can help lighten flat or raised scars that are pink or purple and help flatten raised scars. Doctors often use fractional or carbon dioxide ablative lasers to treat acne scars.
“Afterward, the skin is swollen and red, and may bleed, for up to five days, ” says Dr. Kassouf. “Also, you may need between three and five treatment sessions.”
Laser treatments aren’t just for acne. Doctors use lasers to treat other types of scarring as well, including those from burns, skin cancer and tattoo removal.
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Your dermatologist may apply a chemical solution to your skin. This causes it to blister and eventually peel off, creating new, regenerated skin that’s usually smoother than the old skin.
Peeling typically causes redness, and sometimes swelling and cold sores, for up to seven days. This treatment is also less expensive because you’ll usually only need one treatment session.
Also known as collagen-induction therapy, microneedling uses either a fine-needle roller or pen device to create tiny holes in the top layer of your skin. The procedure stimulates collagen production, which helps improve fine lines and skin texture.
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Redness occurs afterward and typically lasts a couple of days. Most people will need four to six microneedling treatments for best results.
Your doctor may use more than one type of treatment, too, depending on your needs. For instance, they may treat some scars with a laser and others with microneedling.
“When you have damaged skin, no treatment will make it look perfect again, ” states Dr. Kassouf. “But, depending on its severity, an acne scar can diminish by as much as two-thirds after treatment.”
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A round tool is used to completely remove a scar by puncturing the top layer of skin. Then, skin sutures are used to close the area, which should result in a smaller, flatter scar that fades over time.
Another treatment that may be helpful before any of the lasers or peels is called subcision, a procedure that involves releasing a scar that’s bound to the muscle or deeper tissues so that it can move freely again.
This technique, which uses a surgical probe or needle, is used with deeper scars to bring them to the surface to enhance their response to the laser, chemical peel or microneedling.
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Hyaluronic acid fillers like Restylane® and Juvederm® help plump your skin and can smooth out any sunken areas, while collagen fillers like Bellafill® lift the acne scar and can add volume.
Your doctor may also suggest an autologous fat transfer, in which fat from another part of your body is harvested and injected into the acne scar area.
For all varieties of filler, you may experience swelling, redness and discoloration. And depending on what type of filler is used, you may need multiple treatments.
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Similar to laser resurfacing, dermabrasion uses a special tool that creates friction to remove your skin’s top layer. Think about it as a “sander” that smooths your skin.
Once that top layer of skin is removed, a moist dressing will be applied to help it heal, which can take a couple of weeks.
Microdermabrasion is similar to dermabrasion, but typically involves multiple treatments with shorter
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