There are various forms of acne scars, and each one needs a distinct course of treatment. Acne scar treatment is a medical art that calls for exceptional talent and the application of the appropriate techniques. All different types of acne scars cannot be treated using the same technique. One of the most crucial aspects in the revision of an acne scar is choosing the appropriate type of acne scar. Pockmarks or craters are other names for boxcar scars. Although they are not physically harmful, when they appear on the face in particular, they can lead to discomfort and low self-esteem.
What are boxcar scars?
An example of an acne scar is a boxcar scar. They fall under the category of an atrophic scar, the most prevalent kind of acne scar. Around 20 to 30 percent of atrophic scars are boxcar scars. Ice pick scars and rolling scars are some of the other atrophic scar forms.
Boxcar scars resemble a depression or crater in your skin that is round or oval in shape. The scars are often bigger than ice pick scars but not as wide as rolling scars, with sharp vertical edges.
What causes acne scars?
Acne outbreaks that go deep into the skin harm both the surface tissue and the tissue below. The body makes an effort to repair this harm when the acne clears up.
The body creates collagen throughout the healing process, which is a material that supports the skin. A scar results from the body producing either too little or too much collagen.
Your body’s ability to produce collagen determines the form of scar.
Boxcar scars can be produced by any kind of acne. Scars from acne can occur as a result of several risk factors, including:
Having acne that is severe or inflammatory
Having ancestors who were prone to acne scars
Having long-term untreated inflammatory acne
Boxcar acne scars: do they fade?
Boxcar scars might lighten, but they won’t disappear entirely by themselves. Treatment, however, can typically reduce the appearance of boxcar scars by 50% to 75%. They might no longer be evident after treatment.
Treatment for boxcar scars
The best course of action for treating boxcar scars will depend on a number of things, including your skin type, the location of the scarring, how deep the scars are, and how red they are.
The first step in boxcar scar treatment is a dermatological consultation to assess the nature and severity of the scar and create a personalised treatment plan.
Here, a specialised instrument is utilised to remove the top layers of skin using friction. The boxcar scar gets shallower as more layers of skin are removed. This procedure can alter the skin’s colour and texture and is typically less efficient than other scar removal techniques at removing deeper scarring. For the best results, 2 to 3 treatments are frequently necessary.
In order to lessen the depth of a scar, this cutting-edge procedure uses radio-frequency technology and microneedling. In order to encourage healing and collagen creation, the dermatologist uses tiny needles to make tiny wounds in the scarred area. It encourages the development of new skin cells to improve the texture of the skin visibly while reducing scarring.
Camirand, who employed tattoo gun needles to decrease the scars, was the first to study post-surgical scars. Since then, practically all kinds of surgical scars have been treated with microneedling, which has proven to be helpful. In a study of 16 patients, conducted by Aust et al., microneedling was found to be successful in decreasing even burn scars by up to 80%. The collagen-elastin matrix in the dermis is supposed to normalise after a year. Post-traumatic scars and varicella scars respond well to microneedling.
Another method of skin resurfacing that can lessen the visibility of mild to moderate boxcar scars is laser resurfacing. There are two varieties.
Ablative laser therapy: In this procedure, a small patch of skin is removed from the area around the scar and is replaced by a fresh, smooth patch of skin.
Non-ablative laser procedure: During this procedure, lasers encourage the synthesis of collagen to help enhance the scar’s appearance without removing any skin.
All types of atrophic acne scars, with the exception of deep icepick scars, may be treated well with ablative and nonablative fractional lasers. When compared to one surgery alone, a combination of methods (such as subcision or filler injections along with fractional resurfacing) will frequently produce better results. Moreover, atrophic acne scars have been successfully treated with nonablative large-spot lasers.
Chemical peels are a moderate exfoliation method that uses various combinations of plant extracts. Based on the patient’s scar kind and severity, the dermatologist will choose the best peel. The peel gets rid of the scar tissue to show fresh, healthy skin.
Skin injections called fillers contain ingredients that give the skin a plump appearance. By manually pushing the skin above it upward, this treatment works by injecting a substance into the skin.
TCA CROSS (Chemical Reconstruction of Skin Scars)
Trichloroacetic acid (TCA), a strong acid, is injected into scars during this procedure in high quantities, ranging from 70% to 100%. The acid causes a minor inflammatory reaction in the skin and causes the formation of new collagen, which lessens the depth of the scar. To obtain the greatest results, multiple treatments are frequently necessary.
Ice-pick and narrow boxcar scars are treated with the CROSS method. To remove the epithelial wall and encourage dermal reconstruction, a high-strength trichloroacetic acid (TCA) peel solution is applied to the base of these scars.
The following two procedures are available:
Punch excision: This procedure involves eliminating individual scars to leave behind a new, less noticeable scar. This is one method for lessening the visibility of deep boxcar scars.
Subcision: This technique involves a doctor inserting a needle under the skin and moving it around to separate the skin from the scar tissue. Once the skin heals, the body then starts to generate collagen. For shallower boxcar scars, subcision is preferable.
Preventing Boxcar Scars:
Use a mild, oil-free moisturiser after twice-daily face washing with a gentle cleanser.
Avoid the urge to pop, pick, or squeeze breakouts.
Apply sunscreen every day with an SPF of 30 or higher to stop the discoloration and aggravation of your scars.
As soon as you see acne, get it treated.
Incorporate vitamin A-rich foods
Use lotions and serums that are high in vitamin C.
Stay away from makeup items that could clog your pores. There are many ways to lessen the visibility of boxcar scars. Boxcar scars require specialised care before the proper medical intervention at the proper time. The ideal course of action is to see a dermatologist as soon as you experience painful acne flare-ups.