Ice Pick Scars vs Boxcar Scars

Narrow deep atrophic scars, commonly left by acne. Round or oval depressed scars with relatively distinct edges.

Research updated 2026-10-23

Existing representative image of Ice Pick Scars.

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.

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

Where

Cheeks

Cheeks and temples

Main sign

Narrow, deep pits

Round dents with sharp edges

Itch or pain

Contagious

Long term

Permanent without treatment

Scars

Is a scar

Who gets it

People who had inflamed acne

What is it?

Ice Pick Scars

Boxcar Scars

What is it?

What it is
Narrow deep atrophic scars, commonly left by acne.

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

What it looks like

Ice Pick Scars

A close-up of a cheek with many narrow pinpoint and small angular pits.

Ice Pick Scars Small, deep-looking depressions punctuate the skin surface.

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.

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.

In the skin

Deep localized inflammation damages supporting skin tissue. Healing leaves a narrow, deep tract-like depression in the surface.

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

When it usually starts

010203040506070+

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

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

Causes and triggers

Causes

Deep local tissue injury leaves a narrow tract-like depression.

Local tissue loss after inflammation leaves an edged depression.

Risk factors

Prior skin inflammation or injury, Individual healing tendency

Trigger

● Ice Pick Scars

● Boxcar Scars

No established short-term flare trigger

Not a typical trigger

Daily Care

Ice Pick Scars

Boxcar 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.

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

● Ice Pick Scars

● Boxcar Scars

Procedures

None listed

Depth-specific scar treatment

Listed

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

Outlook

Long term

Narrow deep scars usually persist without scar-directed treatment. Selected focal procedures can improve them, but several sessions may be needed and complete clearance is unlikely.

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.