Wednesday, October 8th, 2025

Which Treatment for Which Scar?

Q: What is the best treatment for rolling scars?

Rolling scars respond best to subcision, which releases fibrotic bands tethering the skin. Doctors often pair it with Secret RF microneedling or CO₂ laser for collagen stimulation and smoother texture.

Q: Can boxcar scars be treated without laser?

Yes, mild boxcar scars can be treated with subcision and Rejuran S to stimulate collagen. Deeper scars may still benefit from fractional CO₂ laser resurfacing.

Q: What treats ice-pick scars best?

The most effective method for ice-pick scars is TCA CROSS combined with fractional CO₂ laser to reconstruct deep pits and refine pores. Rejuran S can be added to enhance recovery.

Best Treatment for Rolling, Boxcar & Ice-Pick Scars in Singapore

A Doctor’s Matrix for Rolling, Boxcar & Ice-Pick Scars

When it comes to acne scar correction, not all scars respond to the same treatment. The right approach depends on the type, depth, and skin condition.

Below, we outline a medical-based decision matrix to help you understand which procedure works best for rolling, boxcar, and ice-pick scars — and when combination therapy delivers the most visible results.

💡 If you want a full breakdown of every technique, you can compare acne scar removal options for an overview of methods and downtime.

Understanding the 3 Main Types of Acne Scars

Before treatment selection, identifying your scar morphology is key.

Scar Type	First-Line Treatment	Recommended Combination	Why It Works
Rolling Scars	Subcision	Subcision + Secret RF Microneedling	Releases fibrotic tethers and boosts collagen for smoother contours.
Boxcar Scars	Fractional CO₂ Laser	CO₂ Laser + Rejuran S	Softens sharp edges and regenerates dermal collagen for better texture.
Ice-Pick Scars	Fractional CO₂ Laser / TCA CROSS (doctor-guided)	TCA CROSS + CO₂ Laser + Rejuran S	Targets deep pits, reconstructs collagen and refines pores.

Doctor’s Treatment Matrix: Which Works Best for Each Scar Type

Scar Type	First-Line Treatment	Recommended Combination	Why It Works
Rolling Scars	Subcision	Subcision + Secret RF Microneedling	Releases fibrotic tethers and boosts collagen for smoother contours.
Boxcar Scars	Fractional CO₂ Laser	CO₂ Laser + Rejuran S	Softens sharp edges and regenerates dermal collagen for better texture.
Ice-Pick Scars	Fractional CO₂ Laser / TCA CROSS (doctor-guided)	TCA CROSS + CO₂ Laser + Rejuran S	Targets deep pits, reconstructs collagen and refines pores.

Why Combination Treatments Matters

Acne scars often appear in mixed patterns — meaning one patient can have rolling, boxcar, and ice-pick scars simultaneously.

Combination therapy tailors multiple modalities to treat different depths in one session, improving both texture uniformity and collagen regeneration.

Examples of doctor-recommended pairings:

Subcision + CO₂ Laser → releases tethers then resurfaces texture.
Secret RF + Rejuran S → stimulates collagen and enhances dermal healing.
TCA CROSS + CO₂ Laser → smooths deep pits and tightens pores.

FAQs

What is the best treatment for rolling scars?

Rolling scars respond best to subcision, which mechanically releases the fibrotic bands tethering the skin. For enhanced collagen stimulation, doctors often pair it with Secret RF microneedling or a CO₂ laser session.

Can boxcar scars be treated without laser?

Yes, moderate boxcar scars can be improved with subcision and collagen-stimulating injectables like PDRN S. However, deeper scars usually need fractional CO₂ laser resurfacing for more visible textural refinement.

What treats ice-pick scars best?

Ice-pick scars are the most resistant type. The gold-standard protocol is TCA CROSS (a targeted chemical reconstruction) followed by fractional CO₂ laser to smooth the surrounding skin. Rejuran S can then boost dermal repair.

Doctor’s Insight

Concern	Key Doctor Consideration	Typical Number of Sessions	Result Expectation
Rolling Scars	Depth and presence of fibrotic strands	2 – 4 Subcision + RF	Gradual texture levelling
Boxcar Scars	Edge definition and skin laxity	2 – 3 CO₂ Laser	Visible smoothness and uniform tone
Ice-Pick Scars	Depth > 2 mm, pore involvement	3 – 5 TCA CROSS / CO₂ Laser	Reduced depth, pore tightening

Key Takeaways

The best treatment depends on scar type, not a one-size-fits-all method.
Subcision leads for rolling scars; CO₂ laser for boxcar; TCA CROSS + CO₂ for ice-pick.
Combination therapy enhances collagen rebuilding and overall tone.
Always start with an in-clinic scar analysis to map your scar pattern and design a personalised matrix.