Quick answer: Ice pick and boxcar acne scar treatment works best as a combination plan, not a single procedure. Ice pick scars are narrow and deep, so they need treatments that reach far below the surface, while boxcar scars are wider with sharp edges and respond well to resurfacing that smooths those edges. At Oxygen Med Spa in Orland Park, plans usually combine fractional CO2 laser resurfacing, microneedling with growth factors from your own blood and chemical peels, spread over several months. Expect clear improvement rather than complete erasure, and plan for multiple sessions.
If you have acne scars, you have probably noticed they are not all the same. Some look like tiny, deep holes. Others look like small craters with sharp walls. Those differences matter, because a treatment that smooths one type of scar may barely touch another.
This guide explains how to tell ice pick and boxcar scars apart, which treatments suit each one, how many sessions to expect and what results are realistic. You can also read more about our acne scar treatment in Orland Park.
Types of Acne Scars: How to Tell Them Apart
Most acne scars are atrophic, which means tissue was lost as the skin healed and the scar sits below the surface. Dermatologists usually describe three main atrophic types.
| Scar Type | What It Looks Like | How Deep It Goes |
|---|---|---|
| Ice pick | Very narrow, deep openings, like the skin was pricked with a sharp tool | Deep and narrow; often wider below the surface than at the top |
| Boxcar | Round or oval depressions with sharp, defined edges | Shallow to deep, with a flat base |
| Rolling | Soft, wave-like dips that make skin look uneven in side light | Caused by bands pulling the skin down from below |
Most people have a mix of scar types, which is the main reason a single treatment rarely gives the full result. A quick way to check at home is to look at your skin in side lighting. Scars with sharp edges are usually boxcar, pinpoint holes are usually ice pick, and soft shadows that change with light are usually rolling.
Why Ice Pick and Boxcar Scars Need Different Approaches
Ice pick scars
Ice pick scars are the hardest type to treat because they are narrow at the top and run deep. Surface treatments cannot reach the bottom of the scar, so improvement comes from treatments that stimulate collagen deeper in the skin over repeated sessions. Some very deep ice pick scars respond best to targeted procedures performed by a physician, and we will tell you honestly if that is the better route for you.
Boxcar scars
Boxcar scars have a flat base and sharp edges. Resurfacing treatments soften those edges so the scar blends into the surrounding skin, while collagen-building treatments help raise the base. Shallow boxcar scars often improve the most. Deeper ones need more sessions and a combination of approaches.
Which Treatments Work for Ice Pick and Boxcar Scars
| Treatment | How It Works | Best For | Typical Downtime |
|---|---|---|---|
| Fractional CO2 laser resurfacing | Creates tiny columns of controlled heat injury that trigger strong collagen remodeling and smooth the surface | Boxcar edges, texture and deeper scarring | Redness and peeling for about a week |
| Microneedling | Fine needles create micro-channels that prompt the skin to build new collagen | Boxcar and rolling scars, and ice pick scars over a series | Redness for 1 to 3 days |
| Microneedling with growth factors | Growth factors from your own blood are applied during microneedling to support healing | Boosting collagen response for deeper scars | Similar to microneedling |
| Chemical peels | Acid solutions remove damaged outer layers and even tone | Shallow scars, texture and dark marks left by acne | From none to several days, depending on strength |
Our comparison of chemical peel vs microneedling vs laser resurfacing goes deeper into how each one feels and heals. If microneedling is your starting point, read our guide to microneedling for acne scars.
Microneedling vs CO2 for Acne Scars
This is the most common question we hear. Both treatments build collagen, but they suit different situations.
- CO2 laser gives a stronger result per session and is especially good at softening the sharp edges of boxcar scars. It has more downtime, and it needs careful settings and sun protection, especially for darker skin tones.
- Microneedling needs more sessions, but downtime is short and it is a gentler option for many skin tones. It works well as a steady, repeatable way to build collagen under ice pick and boxcar scars.
- Combining them often gives the best outcome. Many plans alternate or sequence the two so you get the strength of resurfacing and the steady collagen build of microneedling.
See our skin resurfacing and microneedling service pages for more on each treatment.
What a Combination Plan Looks Like
Every plan is built at a consultation, but a typical combination plan for mixed ice pick and boxcar scarring follows a clear order.
| Phase | Focus | What It Usually Includes |
|---|---|---|
| Prepare the skin | Calm active breakouts and even out tone | Skincare guidance and, where suitable, a lighter chemical peel |
| Build collagen | Lift the base of boxcar and ice pick scars | A series of microneedling sessions, with or without growth factors |
| Resurface | Soften sharp scar edges and refine texture | Fractional CO2 laser resurfacing, with healing time between sessions |
| Refine and maintain | Polish tone and texture | Follow-up peels or microneedling as needed |
For a broader look at options, see our acne scar treatment guide for Orland Park.
How Many Sessions Will You Need?
Acne scar treatment is a series, not a single visit. Microneedling is usually done as several sessions spaced weeks apart, and CO2 resurfacing sessions are spaced further apart so the skin can fully heal and remodel. Deeper ice pick scars usually need more sessions than shallow boxcar scars.
Collagen keeps building for months after each treatment, so results improve gradually. Our microneedling results timeline shows what to expect week by week.
Realistic Results: What Improvement Looks Like
The honest goal is a clear, visible improvement in depth, texture and how scars catch the light. Most people see their scars become shallower and softer, with makeup sitting more smoothly and side lighting looking less harsh. Very deep ice pick scars may improve less than boxcar scars, and complete removal is not a realistic expectation for most people.
- Shallow boxcar scars usually show the most improvement.
- Deep ice pick scars improve more slowly and may need a combined or physician-led approach.
- Results build over several months and continue after your last session.
- Sun protection and good skincare help protect your results.
Who Is a Good Candidate
- Adults with ice pick, boxcar or mixed atrophic scars who want gradual, natural-looking improvement.
- People whose active acne is under control. Treating scars while breakouts continue limits results.
- All skin tones, with treatment choice and settings matched to your skin to lower the risk of dark marks.
- Anyone willing to commit to a series and to daily sunscreen during treatment.
Tell us if you have taken isotretinoin, are pregnant, have a history of cold sores or keloid scarring, or have an active skin infection, so your plan can be adjusted for safety.
Downtime and Aftercare
Microneedling usually leaves the skin pink for a day or a few days. Fractional CO2 has more downtime, with redness, swelling and peeling for about a week. Our CO2 resurfacing aftercare guide walks through the recovery day by day.
- Use a gentle cleanser and the moisturizer recommended after your treatment.
- Avoid active ingredients like retinoids and acids until your skin has healed.
- Wear broad-spectrum sunscreen every day and avoid direct sun.
- Do not pick or scrub peeling skin.
Acne Scar Treatment Cost
Cost depends on which treatments your plan includes and how many sessions you need. Microneedling and peels cost less per session, while fractional CO2 costs more per session but may need fewer visits. Your exact price is confirmed at your consultation. You can compare options on our med spa prices by session page and in our guide to CO2 laser resurfacing cost in Orland Park.
Frequently Asked Questions
Book an Acne Scar Consultation in Orland Park
Oxygen Med Spa has served Orland Park and nearby towns since 2008. At your consultation, we look at your scars in proper lighting, identify each type and build a combination plan around your skin, your schedule and your goals. Learn more about our acne scar treatment.
Visit us at 14360 South La Grange Rd, Unit D, Orland Park, IL 60462, call (708) 229-8800, or contact us online. We are open Monday through Saturday, 10:00 AM to 5:00 PM.
