They may be shallow (0.1–0.5 mm) or deep (≥0.5 mm) and are most often 1.5 to 4.0 mm in diameter. Icepick: narrow (2 mm), punctiform, and deep scars are known as icepick scars.
The three layers
Scars form in response to burns, infected cuts, acne, injuries and surgical procedures. To understand why our bodies create scars, it's helpful to first learn about the skin's three distinct layers.
They often look like small oval holes, similar to a chicken pox scar. Because of these characteristics they are the most difficult acne scars to treat. As the deeper under the skin they go the harder it is to heal them.
Deep scars often require skin surgery and resurfacing. Dermatologists use fillers to safely and effectively plump depressed acne scars. A dermatologist may fill acne scars with collagen, the patient's own fat, or another substance. Many fillers give us temporary results, which last between 6 and 18 months.
What causes acne scars? Depressed acne scars: If the body produces too little collagen, depressions or pits form as the skin heals. Raised acne scars: Sometimes the body produces too much collagen as it tries to heal the skin and underlying tissue.
While some scars are permanent, acne scars and other small blemishes aren't impossible to reduce and fade away. There are several types of acne scars, but they can be split into three categories: atrophic, hypertrophic, and keloid.
“Chemical peels, micro-needling radiofrequency and intradermal radiofrequency, fractional minimally ablative CO2 laser and dermal fillers are some of the recommended treatments for long-term reduction of acne scars,” she adds.
It's natural to wonder, “Do indented scars fill in over time?” Unfortunately, these scars won't disappear on their own. Atrophic scars rarely go away completely, but with the help of a dermatology provider, you may be able to successfully reduce their appearance.
Advanced acne scars can take six months or more to fade, while mild to moderate scars may only require four to six weeks to heal. The type of treatment used to minimize your scars will affect your overall results, so be sure to consult with expert dermatologists, such as our team.
In general, most acne scars will not go away by themselves or even with at-home treatments with chemical exfoliants like lactic or glycolic acid. For true acne scar removal, you will need acne scars treatments to achieve even-toned skin with a smooth texture.
Depressed or pitted acne scars are the most common. They are the result of inflammatory acne, or papulopustular acne. Papulopustular acne are lesions that consist of red blemishes, pimples, papules and pustules (zits) and larger swollen lesions (nodules).
Mild acne causes less irritated whiteheads or blackheads with or without a few red bumps or pustules. Most of the time, the light red or brown marks left behind by healed acne clear up over time on their own. But severe acne, especially cystic acne, is likely to leave permanent scarring as it heals.
Hypertrophic or raised acne scars. These scars are most common with chest and back acne. They stand above the surface of the surrounding skin and are caused by too much collagen during healing.
Scars that are left alone become far more costly to treat later since the number of treatments required increase. Older skin needs much more stimulation to produce enough new collagen to smooth out scars.
When assessing scars, it is important to check whether they are tethered. This can be done by stretching the skin; if the scar flattens, it is not tethered. Tethering implies a fibrotic connection into the lower dermis, which requires additional treatment.
Grade 4: This grade of acne scar is defined as severe disease whereby the acne scars are not flattened by stretching the skin. It includes deep divots, severe boxcar scars, ice pick scars, and hypertrophic/keloid scarring.
While acne scars can improve in appearance, they might not disappear entirely. They also tend to require professional help to resurface the skin. Harth explains that “home remedies and natural products sound appealing, but unfortunately have minimal value in acne scars and dark spots treatment…
Depending on how deep the scar is (what it is from), your own healing tendencies, and location of the scar all make a difference in the final outcome. A month is still a short period of time and your scar will continue to improve in appearance; likely filling in as well.
Moderate to severe cases of acne can result in scars that cause discoloration and indentations in the skin. In most cases, acne scars do improve over time without treatment. That's particularly true of discoloration. Indentations may be more stubborn and less prone to disappearing on their own.
Silicone gel sheeting
If you have a scar on the face or other exposed area, silicone sticks with SPF are the ideal solution. If you wish to conceal your scar, applying silicone gel sheeting in natural skin color will completely cover the scar site while allowing it to blend in with the surrounding tissue.
Soft-tissue fillers are a common treatment specifically for rolling atrophic acne scars. They are used to level or raise the indented scars to match the normal layer of skin. Fillers are injected under the scar and provide almost immediate results.
Depending on the location of the scar, acne scars can appear more severe as you grow older because of collagen depletion in the skin. Depressed acne scars or atrophic acne scarring will usually look worse as your skin loses natural volume as part of the natural aging process.
Dermal fillers: Dermal fillers such as JUVÉDERM™ Injectable Gel and Restylane® can be used to add volume to recessed areas of the skin, such as indented scars. Although results are temporary, treatments can safely be repeated as necessary.
An acne scar is a change in texture in your skin. Usually, it's depressed. It's not a brown spot. Discoloration is temporary, but texture changes are permanent.
Pockmarks, which are also called pick marks or acne scars, are blemishes with a concave shape that can look like holes or indentations in the skin. They occur when the deeper layers of the skin become damaged. As these deeper layers heal, extra collagen is produced.