Boxcar Acne Scars

Boxcar Scars

Boxcar acne scars are usually broad, box-like scars that often cast a very deep shadow and are highly visible in low light. These scars are usually found on the cheek or jaw area where your skin is thicker. Because the scarring is so deep, cosmetic makeup is typically little help. Boxcar scars are common for people who have suffered from acne or scar easily.

BOXCAR ACNE SCARS – CLEARLY DEFINED AND STEEP EDGES

The name of these scars is often confusing, so we will compare the different acne scarring below. For now, just remember that boxcar scars are shaped like a box and hence came the name box scar.

Boxcar scars can be characterized by the presence of clearly defined and steep edges. In this regard they are like 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. We’ve seen many patients who have come to us after numerous sessions of laser therapy with little to no change in their scarring. Because of this, Dr. Sadove created the revolutionary treatment for boxcar scarring.

Treatment

Like mentioned earlier, ice pick scars are different from box scars because the Refine biopsy punch treatment of ice pick scars cannot be 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 simply means that the scar is placed in such a way that it will heal nicely and fade in the future. It requires a surgeon who understands the concepts of “elective lines of incision.” When possible, the incision and thus scar would be placed in a wrinkle. The direction of scar placement usually makes all the difference as to its visibility after the healing period.

In many box scar instances, the excision of the scar will create the best result. However, the most common treatment for boxcar scars, are dermal fillers. While dermal fillers can be used, typically fillers alone are often not successful due to the underlying and surrounding scar. The scar tissue is simply too “tight” to allow filling form below by a “filler” material.