Types of acne scars: rolling, boxcar and icepick
Indented acne scars come in three shapes. Rolling scars are broad, wavy dips held down from underneath; boxcar scars have steep edges and a flat floor; icepick scars are narrow, deep pinpoints. Most people have a mix. Flat red or brown marks aren't true scars, and Neoderma matches different treatment to each.
- Physician-led medical spa
- 4.9 on Google (650+ reviews)
- Serving Anaheim since 2001
$50 consultation at Neoderma in Anaheim, CA, credited toward treatment if you proceed within two weeks · Open Mon–Sat
Neoderma's team assesses your skin and matches the treatment to what is actually there, and you get a transparent estimate before any treatment.
Booking opens Neoderma's short request form: under “By skin concern”, pick Acne & Breakouts or Acne Scars & Texture. Their team contacts you to confirm the time and the $50 consultation.
What are the types of acne scars?
A healed breakout can leave two very different things. A mark changes the color of your skin but leaves its surface level. A scar changes the surface itself.
Indented scar
Rolling scars
Broad, shallow, wave-like dips with soft edges, tethered to the tissue below, so the cheek looks undulating rather than pitted.
Matched at NeodermaSecret RF microneedling, the strongest match
Indented scar
Boxcar scars
Wider dips with steep, defined sides and a flat floor, like a small crater.
Matched at NeodermaSecret RF microneedling plus resurfacing; the deepest ones are stubborn
Indented scar
Icepick scars
Narrow, deep pinpoint pits, as if the skin had been pricked with a fine tool.
Matched at NeodermaThe most resistant type: usually a combination or referral-level technique, assessed in person
Flat mark
Red marks (PIE)
A flat pink or red spot where a pimple healed. The surface stays level: it is leftover widened capillaries, not lost tissue, so it isn't a true scar.
Matched at NeodermaTime and daily SPF first, then gentle resurfacing and calming facials
Flat mark
Brown marks (PIH)
A flat brown or tan spot: extra pigment laid down during the inflammation. It is more common, and slower to fade, on deeper skin tones.
Matched at NeodermaPicoWay Resolve, Vi Peel and pigment-regulating skin care
Most acne scars are atrophic, which means indented. When the breakout healed, the skin didn't rebuild all of the collagen the inflammation broke down, and the surface sank where tissue went missing. Raised scars, called hypertrophic or keloid, are the reverse case: too much collagen rather than too little. They are handled differently, and Neoderma always evaluates them in person before treating anything.
How can I tell which type I have?
Use light, not a straight-on photo. Neoderma teaches this check at consultations, and it takes about thirty seconds:
Light from one side
Stand at a mirror with a single light source off to the side, like a window or a lamp. Overhead bathroom lighting flattens everything, so switch it off.
Turn your face slowly
Watch what happens as the angle changes. A flat mark fades from view, because there is nothing there to cast a shadow. An indented scar does the opposite and stands out as the light grazes across it.
Read the shapes
Soft, rolling waves across the cheek point to rolling scars. Small craters with steep sides and flat bottoms are boxcar scars. Tiny, deep pinpoints are icepick scars. Expect to find more than one kind.
A provider will confirm what you're looking at. When treatment starts, Neoderma photographs your skin, so your progress is measured against where you began rather than against memory.
Rolling scars: what helps?
Rolling scars are wide and shallow, with gently sloping edges. Fibrous bands underneath tether the skin and pull it down, which is why a cheek with rolling scars looks wavy rather than pitted. Neoderma matches them to Secret RF microneedling, its strongest match for this type: fine needles deliver radiofrequency energy to a controlled depth, so collagen is rebuilt in the floor of each dip.
Of the three indented types, rolling scars generally respond the most. How Secret RF treats acne scars
Boxcar scars: what helps?
Boxcar scars are wider, with steep, well-defined walls and a flat floor, a little like a crater. Neoderma pairs Secret RF microneedling with a resurfacing treatment for them, and many plans add PicoWay Resolve, which Neoderma uses for pigment and overall texture, in sequence with Secret RF.
Boxcar scars improve with treatment, though the deepest are the slowest to give ground.
Can icepick scars be treated?
They can improve, but they're the toughest of the three. An icepick scar is a narrow, deep pinpoint, as if the skin had been pricked with a fine tool, and the damage reaches far below the surface. That depth is why microneedling on its own tends to do the least for them.
Neoderma's honest line: a meaningful improvement is realistic, but complete correction often isn't. Icepick scars usually call for a combination of in-office techniques or a referral-level approach, and that is something Neoderma assesses in person rather than promising up front.
Do acne scars go away on their own?
Indented scars don't. The collagen is missing, and no serum or brightening cream can fill a dip in the skin; it takes treatment that rebuilds collagen. Even then, the realistic goal is meaningful improvement, not perfectly smooth skin, with the main change showing two to six months after a series.
Flat marks are a different story. Red and brown marks often fade by themselves over months, especially with sunscreen every day, because no tissue was lost. If yours are flat, read red marks and dark spots from acne before you price any scar treatment.
Which treatment matches each type?
Neoderma matches treatment to the scar in front of it. In summary:
| Type | What you see | Matched at Neoderma |
|---|---|---|
| Rolling | Broad, shallow waves, tethered underneath | Secret RF microneedling |
| Boxcar | Wider dips with steep walls and a flat floor | Secret RF plus resurfacing |
| Icepick | Narrow, deep pinpoints | A combination or referral-level technique, assessed in person |
| Mild texture | Roughness and faint unevenness rather than true dips | Exceed microneedling |
| Brown marks (PIH) | Flat brown or tan spots | PicoWay Resolve, Vi Peel, pigment-regulating skin care |
| Red marks (PIE) | Flat pink or red spots | Time and daily SPF, then gentle resurfacing |
Neoderma's own acne scar guide covers the same ground in its own words. For what each treatment costs, see acne treatment cost.
Acne scar type questions
How many types of acne scars are there?
Three indented types: rolling, boxcar and icepick. Raised scars (hypertrophic or keloid) are a separate problem that needs an in-person evaluation, and flat red or brown marks aren't true scars at all.
What's the difference between boxcar and rolling scars?
The edges. Rolling scars are broad, shallow waves with soft, sloping sides and are tethered underneath; boxcar scars have steep, clearly defined walls around a flat floor.
Can I have more than one type?
Yes. Most people have a mix of rolling, boxcar and icepick scars, and that is why one treatment seldom takes care of everything.
Not sure which scars you have? Have them assessed
Book a $50 consultation at Neoderma in Anaheim. Your scars are identified in person and matched to treatment, and you get a transparent estimate before any treatment.
Physician-led medical spa · 4.9 on Google (650+ reviews) · Serving Anaheim since 2001
$50 consultation at Neoderma in Anaheim, CA, credited toward treatment if you proceed within two weeks · Open Mon–Sat
Neoderma's team assesses your skin and matches the treatment to what is actually there, and you get a transparent estimate before any treatment.
Booking opens Neoderma's short request form: under “By skin concern”, pick Acne & Breakouts or Acne Scars & Texture. Their team contacts you to confirm the time and the $50 consultation.