Is it possible to fill in or eliminate a pitted/boxcar acne scar?

I have a pitted/boxcar acne scar an inch or so below my eye (on my cheek). I've been using Retin A and have been taking doxycycline hyclate for a few months now. I feel I have become more insecure since this scar formed and would like to get rid of it as soon as possible. I have read about bellafill but I'm only 19, but is there anything similar that I'm able to receive now? Or is there another treatment that could work? Thank you!!!!

Doctor Answers 8

Pit Scars Can Respond To TCA CROSS; Box Scars To Subcision with/without Filler

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A photo would certainly have been helpful. Under the circumstances, I can only respond in general terms. First, a pit scar is different from a boxcar scar. The former is a thin, very narrow tract scar in the skin. The latter is usually larger and depressed (indented, atrophic) has well defined vertical ridges, like palisades, surrounding the depression.
Pit scars can be removed with a small punch and closed with stitches. An even simpler approach is to use a very potent acid applied deep into the pit to close it off, a procedure known as The TCA CROSS Technique. Originally 90-100% TCA was used, hence the name. However, more recently high potency phenol has been used successfully in this fashion, as well. 
Boxcar scars need first to be elevated. Subcision works well for breaking up the tethering bonds of scar tissue below the surface responsible for pulling the surface down and creating the depression. Once this is done, filler may be added to achieve further elevation and smoothing, and if necessary (often not), microneedling may be used (in this case just locally with an instrument known as a  Dermastamp) to obtain better surface blendingin color and texture  of the treated scars with the surrounding normal skin.
For additional information on any of the above, you can check out the archives of and be sure to consult with a board certified aesthetic physician with expertise and experience in all forms of scar treatments. Good luck to you.

New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

Acne scars

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Acne scars are treated differently depending on their appearance and structure. A variety of treatments can be performed to remodel the scar from energy-based lasers and radiofrequency devices to mechanical disruption of the scar with microneedling which can treat most scars. Specifically, deep wide scars such as boxcar and rolling-type can be released and filled in with subcision and fillers (Bellafill) and ice-pick (thin, deep) scars are best treated by excising them completely. Bellafill is FDA approved for patients over 21 years old, and use in an adult 18-21 years old would be considered off-label use but not contraindicated. For the best treatment options, it is important to visit an expert for an in-person examination. Hope this helps!
Johnson C. Lee MD Plastic Surgery

Johnson C. Lee, MD
Beverly Hills Physician
5.0 out of 5 stars 17 reviews

Acne Scarring -- Requires a Combination of Fractional Laser Resurfacing, Fillers Like Bellafill, Subcision and Eclipse Micropen

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Acne treatment requires a combination approach. Fillers like Bellafill or Sculptra or Radiesse for broad "boxcar" or "rolling" scars. Eclipse Micropen for all types of scars and improvement in texture and tone. Lasers such as co2 / erbium laser resurfacing or Fraxel/Clear+Brilliant or radiofrequency such as Skinginify or Viva to improve the scars and give long term collagen production. I suggest consulting with a board certified dermatologist for further assessment. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Acne scar treatments

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Thank you for your question. There are many types of acne scarring - rolling, boxcar scars and ice pick scars. These types are amenable to many different types of treatment. Any of the modalities that injure the skin with subsequent collagen formation such as fractionated laser, dermroller, resurfacing lasers, deep peels and etc.. may help your condition. Fillers are a good option, specifically Bellafill®, a permanent filler. Bellafil® is FDA approved in treating acne scars. The right modality for you depends on your skin type, expectations, patience, downtime and cost. I highly recommend you consult with a board certified physician to discuss treatment options that best suit your needs.

Reuel Aspacio, MD, FAAD
Las Vegas Dermatologist
5.0 out of 5 stars 6 reviews


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A series of pro-fractional treatments would be beneficial in decreasing the appearance of scars. The pro-fractional treatment ablates the skin forcing new skin to grow and generates collagen. Depending on the severity of your scars, a series of 5-7 treatments should give you sufficient results. Applying Alastin post-procedure will decrease any inflammation and help the skin heal quicker.

Kian Karimi, MD, FACS
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 73 reviews

Options for Hidef Acne Scar Protocol

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Our Hidef Acne Scar Protocol includes sublative RF, fractional lasers, Yag laser, skin tightening, subcision, fillers, and TCA Cross. Best, Dr. KaramanoukianLos Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Boxcar Acne scarring treatment

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I would try Infini for about 3 rounds. It give great results for all skin types and is a permanent result. This can be combined with PRP and subcision for better results. Bellafill is an option, but it is mainly used for distensible rolling acne scars. 

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

Scar and Fillers

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It would be best to post a photo to ascertain the best treatment for you.  Bellafill is a permanent filler for the scar.  However, there are other safe fillers that work extremely well such as Restylane.  Please consult an expert for the best cometic advice. Lasers such as Fraxel and eMatrix complement these injections.  Best, Dr. Green

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.