Boxcar Scars vs Chickenpox Scars

Round or oval depressed scars with relatively distinct edges. Permanent surface changes remaining after some chickenpox lesions heal.

Research updated 2026-10-23

Educational illustration of healed broad indented scars with defined edges on the left cheek, with the face turned to the person’s right on medium skin.

AI-generated educational illustration: Few small round depressed chickenpox scars on an adult cheek, healed skin, no active blisters or acne pustules. Not a clinical photograph.

Key differences What is it?What it looks like Diagrams When it starts Triggers Daily Care Treatment Outlook Complications When to get help Questions

Key differences

The same eight facts on every condition comparison.

Usual age

After inflamed acne

After chickenpox

Where

Cheeks and temples

Where blisters were

Main sign

Round dents with sharp edges

Small round pitted scars

Itch or pain

Contagious

Long term

Permanent without treatment

Scars

Is a scar

Who gets it

People who had inflamed acne

After scratched chickenpox

What is it?

Boxcar Scars

Chickenpox Scars

What is it?

What it is
Round or oval depressed scars with relatively distinct edges.

What it is
Permanent surface changes remaining after some chickenpox lesions heal.

What it looks like

Boxcar Scars

A close-up of a cheek with multiple shallow round and angular pits with distinct edges.

Boxcar Scars Small depressions create a sharply textured surface across the cheek.

Chickenpox Scars

A cheek with scattered small round indented scars.

Chickenpox Scars Several rounded depressions interrupt the otherwise smooth cheek surface.

Skin tones

Educational illustration of healed broad indented scars with defined edges on the left cheek, with the face turned to the person’s right on light skin.

Educational illustration of healed broad indented scars with defined edges on the left cheek, with the face turned to the person’s right on brown skin.

Educational illustration of healed broad indented scars with defined edges on the left cheek, with the face turned to the person’s right on deep skin.

Educational illustration of several healed round indented pockmarks on the left cheek, with the face turned to the person’s right on light skin.

Educational illustration of several healed round indented pockmarks on the left cheek, with the face turned to the person’s right on medium skin.

Educational illustration of several healed round indented pockmarks on the left cheek, with the face turned to the person’s right on brown skin.

Educational illustration of several healed round indented pockmarks on the left cheek, with the face turned to the person’s right on deep skin.

In the skin

Inflammation destroys localized supporting tissue beneath the surface. Healing leaves a depression with more defined edges than a broad rolling scar.

Deeper inflammation or secondary injury damages the skin during a chickenpox lesion. Uneven repair can leave a depressed area with reduced dermal support.

When it usually starts

010203040506070+

Boxcar Scars. Develops after relevant injury, inflammation or tissue change; age depends on the cause.

Chickenpox Scars. Develops after relevant injury, inflammation or tissue change; age depends on the cause.

Causes and triggers

Causes

Local tissue loss after inflammation leaves an edged depression.

Deeper inflammation or secondary injury disrupts normal healing.

Risk factors

Prior skin inflammation or injury, Individual healing tendency

Trigger

● Boxcar Scars

● Chickenpox Scars

No established short-term flare trigger

Not a typical trigger

Daily Care

Boxcar Scars

Chickenpox Scars

Daily care

Habits that help

Use broad-spectrum SPF 30 or higher on healed exposed skin
Sun protection helps limit persistent color changes around scars.
Keep healed skin comfortable with gentle cleansing and moisturizer
These measures support the skin barrier but cannot reliably lift established depressions.
Control active acne or inflammation before elective scar procedures
Ongoing lesions can create new scars even while older ones are being treated.
Use photographs in consistent light to track change
Scars change slowly; compare over months rather than repeatedly inspecting each day.

Avoid

Avoid: Picking new spots, crusts or healing wounds
Repeated injury increases the chance of further marks and scarring.
Avoid: Home needling, deep peels or cutting scar tissue
These can worsen scarring or cause infection, especially before a wound has fully healed.

Habits that help

Use broad-spectrum SPF 30 or higher on healed exposed skin
Sun protection helps limit persistent color changes around scars.
Keep healed skin comfortable with gentle cleansing and moisturizer
These measures support the skin barrier but cannot reliably lift established depressions.
Control active acne or inflammation before elective scar procedures
Ongoing lesions can create new scars even while older ones are being treated.
Use photographs in consistent light to track change
Scars change slowly; compare over months rather than repeatedly inspecting each day.
Discuss scar-type assessment
A dermatologist may combine resurfacing or focal procedures based on depth and scar shape.

Avoid

Avoid: Picking new spots, crusts or healing wounds
Repeated injury increases the chance of further marks and scarring.
Avoid: Home needling, deep peels or cutting scar tissue
These can worsen scarring or cause infection, especially before a wound has fully healed.

Treatment differences

Evidence labels come from each condition’s own treatment list.

Treatment

● Boxcar Scars

● Chickenpox Scars

Treatment approach

—

Scar treatment is optional and should match the depth and shape of the depressions. A dermatologist may consider resurfacing or focal procedures after discussing the risks and likely degree of improvement.

Procedures

Depth-specific scar treatment

Listed

Selected scars may benefit from resurfacing or punch techniques; depth and skin tone guide the choice.

None listed

Outlook

Long term

Boxcar scars generally persist, although their appearance can improve with appropriately selected procedures. Scar depth and edge shape influence treatment, and complete removal is unlikely.

Established chickenpox scars can soften in appearance but may remain permanent. Scar-directed procedures may help selected depressions, with results depending on depth, skin and treatment choice.