Rolling, Boxcar and Ice-Pick Acne Scars: Understanding the Different Types of Pitted Scarring

If you've noticed small depressions or pits left behind after acne has healed, you may have developed atrophic acne scars. These are the most common type of acne scars and are caused by the loss of collagen during the skin's healing process.

Although many people simply describe them as "pitted scars", there are actually three main types:

• Rolling scars.
• Boxcar scars.
• Ice-pick scars.

Learning to recognise these different scar types can help you better understand your skin and appreciate why preventing further scarring is so important.

What are atrophic acne scars?

Atrophic scars develop when inflammation damages the deeper layers of the skin and there is insufficient collagen produced during healing.

Instead of returning to its original smooth surface, the skin heals with small depressions or indentations.

These scars represent a change in the skin's texture rather than its colour.

Unlike flat acne marks such as Post-Inflammatory Hyperpigmentation (PIH) or Post-Inflammatory Erythema (PIE), pitted scars do not simply fade away with time.

Rolling scars

Rolling scars are broad, shallow depressions with soft, sloping edges.

Rather than having clearly defined borders, they blend gradually into the surrounding skin, creating a gently undulating or wave-like appearance.

They develop when fibrous bands beneath the skin pull the surface downwards, tethering it to deeper tissue.

Rolling scars are often:

• Wide.
• Shallow.
• Soft-edged.
• More noticeable under side lighting.

Because of their gradual contours, they can become more visible depending on the angle of light across the face.

Boxcar scars

Boxcar scars are another form of atrophic scar but have a very different appearance.

They are:

• Round or oval.
• Clearly defined.
• More sharply edged.
• Resemble small craters.

Unlike rolling scars, the edges are much more distinct and often appear almost vertical.

Boxcar scars commonly develop on the:

• Cheeks.
• Temples.

Some are relatively shallow, while others extend deeper into the skin.

Ice-pick scars

Ice-pick scars are usually the narrowest but deepest type of acne scar.

They appear like tiny puncture marks extending down into the skin.

Characteristics include:

• Small surface opening.
• Narrow shape.
• Deep penetration.
• Sharp appearance.

Although they may look small, their depth often makes them the most noticeable type of pitted scar.

They are frequently found on the cheeks.

Why is it helpful to identify your scar type?

Every scar type develops slightly differently.

Understanding the type of scarring you have helps provide realistic expectations and supports informed discussions during a professional assessment.

Many people actually have a combination of:

• Rolling scars.
• Boxcar scars.
• Ice-pick scars.

Rather than just one type.

Recognising this variation helps explain why acne scars can look so different from one person to another.

Can more scars be prevented?

Yes.

The appearance of any pitted scar is an important reminder that active acne should be treated promptly.

The best opportunity to reduce future scarring is while acne is still active.

Helpful preventative measures include:

• Treating inflammatory acne early.
• Avoiding picking or squeezing spots.
• Following a consistent skincare routine.
• Seeking assessment if acne is becoming deep, painful or cystic.

Once true scars have formed, preventing additional scars becomes far more valuable than waiting for new ones to develop.

Frequently Asked Questions

How do I know which acne scar I have?

Rolling scars are broad with soft edges, boxcar scars have sharply defined borders, and ice-pick scars are narrow, deep puncture-like depressions. Many people have a combination of all three.

Which type of acne scar is deepest?

Ice-pick scars are generally the deepest type of atrophic acne scar, extending further into the skin despite their small surface opening.

Can acne scars disappear naturally?

Unlike flat acne marks, true pitted scars involve structural changes within the skin and generally do not disappear on their own.

Why do my scars look worse in certain lighting?

Side lighting creates shadows that make rolling and other pitted scars appear more obvious.

Can I stop new acne scars from forming?

Yes. Early treatment of inflammatory acne and avoiding picking or squeezing spots are among the most effective ways to reduce future scarring.

Reviewed by Dr Tara Treacy, GP with a special interest in dermatology (IMC 411337).

Last reviewed: 16/07/2026.

General information only. It does not replace an individual medical assessment.