Laser resurfacing, particularly ablative resurfacing with an Er:YAG or CO2 laser cannot achieve desired results, as Boxcar scars are simply too deep. There is no role for laser therapy for these types of scars.
BOXCAR SCARS – CLEARLY DEFINED AND STEEP EDGES
The name of these scars is often confusing. They are shaped like a box and hence came the name box scar. However, this sounds like boxcar and thus the confusion.
Boxcar scars can be characterized by the presence of clearly defined and steep edges. In this regard they are similar to ice pick scars, however they are much wider. They differ from rolling scars due to their deep steep edge and limited diameter. Due to its complex nature, box acne scars are more difficult to smooth out, or blend to match with the surrounding skin.
Laser resurfacing, particularly ablative resurfacing with an Er:YAG or CO2 laser cannot achieve desired results, as these scars are simply too deep. There is no role for laser therapy or peels for these types of scars.
The reason for the importance in differentiating ice pick from box is because the biopsy punch treatment of ice pick scars is not used for box scars. The larger circle of the biopsy punch in such cases can leave a bunching up of the edges. Instead, for box scars it is best to perform what is called an ellipse excision within the “elective lines of incision” in the face. This means that the scar is located in such a way that it will heal nicely and fade in the future.
Whenever possible, excision of the scar will create the best result. However, the most common treatment for boxcar scars, are dermal fillers. The reason fillers alone are often not successful is due to the underlying and surrounding scar. Such scar tissue is best released with subcision. Fillers can then be injected into the scar, helping to raise depressed areas of the skin, leaving it more even with the surrounding skin surface. Dermal fillers are fast, simple procedures compared to other types of acne scar treatments. Checkout our reviews here.
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