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Ice-Pick · Boxcar · Rolling · Tailored Protocol

Acne Scar Treatment —
Three Scars, Three Answers

Atelier Aesthetics · Medical Director: Dr. Sin Yong · Updated 6 Oct 2026

Atrophic acne scars are not one condition. Ice-pick, boxcar and rolling scars have different geometry, sit at different depths and respond to different interventions. Treating them with a single laser is the most common reason acne scar treatment disappoints.

A rolling scar is held down from underneath. Resurfacing the top of it changes nothing.

Dr. Sin Yong · Medical Director, Atelier Aesthetics

Specifications

Ice pick
Under 2 mm at the surface, extending deep into dermis
TCA CROSS
High-concentration trichloroacetic acid, applied focally
Subcision
Mechanical release of fibrous tethers before resurfacing
Programme
Assessed across sessions spaced by healing intervals
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This page explains the condition. For how it is treated at Atelier, see acne scar treatment.

Morphology

Identify Before You Treat

Narrow & Deep
Ice-Pick Scars
Sharply walled tracts extending deep into the dermis, often narrower than 2mm at the surface. Too narrow and too deep for resurfacing alone — TCA CROSS reaches the base where laser cannot.
Defined Edges
Boxcar Scars
Wider, flat-based depressions with sharp vertical walls. Respond to multi-depth ablative resurfacing that softens the wall edge and stimulates dermal fill from the floor.
Tethered
Rolling Scars
Broad, shallow undulations caused by fibrous bands anchoring skin to deeper tissue. Subcision releases the tether first — without it, surface treatment achieves nothing lasting.

Sequence

Order Matters

01
Release the tether
Subcision frees rolling scars from the fibrous bands holding them down. Nothing above this step works until it is done.
02
Reach the ice-pick base
TCA CROSS applied focally into each narrow tract, raising the floor through controlled collagen deposition.
03
Resurface at depth
DEKA Tetra Pro multi-depth CO2 softens boxcar walls and drives dermal remodelling across the field.
04
Refine and protect
Surface refinement plus strict photoprotection — in Asian skin, post-inflammatory pigmentation is the main risk to an otherwise good result.

FAQ

Acne Scars — Common Questions

Ask a Question
Atrophic scars divide into ice-pick (narrow, deep, sharply walled), boxcar (wider, flat-based, defined edges) and rolling (broad, shallow, tethered from beneath). Each responds to a different intervention, which is why a single laser applied to all of them underdelivers.
Rolling scars are tethered to deeper tissue by fibrous bands. Until those bands are released, resurfacing the surface does nothing — the tether pulls the skin back down. Subcision cuts them mechanically.
A high-concentration trichloroacetic acid applied precisely into the base of an ice-pick scar, provoking controlled collagen deposition that raises the floor. It reaches a depth and narrowness that laser cannot.
No, and any clinic promising that is misleading you. Substantial improvement — often 60–80% across a full programme — is realistic. Complete erasure is not.
A full programme typically runs across several sessions spaced by healing intervals. The number depends on scar morphology, depth and skin type, and is set after assessment rather than sold as a package.
Acne Scar Treatment at Atelier Aesthetics — CityLink Mall, Singapore
Acne Scar Treatment · Atelier Aesthetics, CityLink Mall

References

  1. Ministry of Health, Singapore

More on this topic

Atelier Aesthetics

Scars assessed —
before they are treated.

1 Raffles Link, #B1-28, CityLink Mall, Singapore 039393 · +65 8023 7170

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