Some scars can have a sunken or pitted appearance. This kind of scarring occurs when underlying structures supporting the skin (for example, fat or muscle) are lost. Some surgical scars have this appearance, as do some scars from acne. Scars also can appear as stretched skin.
In time, some collagen breaks down at the site of the wound and the blood supply reduces. The scar gradually becomes smoother and softer. Although scars are permanent, they can fade over a period of up to 2 years. It's unlikely they'll fade any more after this time.
Depressed (atrophic): These sunken scars often result from chickenpox or acne. They look like rounded pits or small indentations in the skin. Also called ice pick scars, they develop most often on the face. Acne scars may become more noticeable as you age because the skin loses collagen and elasticity over time.
An atrophic scar develops when the skin cannot regenerate tissue correctly. Unlike keloids and hypertrophic scars, atrophic scars are indented in appearance due to healing that occurs below the expected layer of skin.
“Usually the scars will heal rather quickly - within the course of a few weeks to one or two months - but you may not see final results for up to a year. Individual factors also influence how quickly your body is able to recover from a wound.” In older patients, or where the skin is more lax, scars settle more rapidly.
Atrophic scars are typically the result of acne. These scars are concave, dipping lower than the surface of the skin. Their depth can vary. There are several scar revision options available to treat these marks.
Lasers may be used to smooth a scar, remove the abnormal color of a scar, or flatten a scar. Most laser therapy for keloid scars is done in conjunction with other treatments, including injections of steroids, use of special dressings, and the use of bandages.
Soft tissue fillers.
Injecting collagen, fat or other substances under the skin can plump the skin over indented scars. The goal is to make the scars less noticeable. Results are temporary, so repeat treatments are needed to retain the effect. This method has little risk of changes in skin color.
Subcision is a procedure for treating scars that are indented. A needle is directed into the skin to break up the fibers that attach the scar to below-the-surface tissue, raising it back to the elevation of surrounding skin. It also promotes healing by creating new connective tissue that repairs and smooths the skin.
Depressed scars can be improved by removing the scar surgically – usually in the office. Skin fillers can also be used to improve most depressed scars in an easy, immediate, and quick way. Advanced lasers or dermabrasion can also be used to treat skin areas with depressed scars, such as in acne scarring cases.
For some pitted scars, laser surgery (laser resurfacing) is used to try to make the scar flatter. This involves using a laser to remove the top layers of skin, which stimulates collagen production in the deeper layers.
While no topical treatments have been shown to improve atrophic scars, silicone gel can be used as the original pimple or chicken pox blister is healing. Silicone gel is recommended by scar experts to prevent abnormal scarring.
There are three distinct, sequential phases of repair leading to the formation of a fibrotic scar: (1) inflammation, (2) new tissue formation, and (3) remodeling.
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.
Acne scars can be sunken (depressed) due to the loss of tissue. They may look like ice pick pits. They can be rolling, creating a wavy texture in the skin or they may also be boxlike. These are sometimes called boxcar acne scars and are often on the face.
Soft Tissue Fillers (Collagen, Hyaluronic Acid, or Fat Injections) Various injectable substances are available to elevate indented soft scars. The amount of material injected will vary with the size and firmness of the scar. Bovine or human collagen may be used.
Vitamin C helps treat acne scarring both below the skin and on the surface. Your skin's epidermis — its top layer — contains high levels of vitamin C, which plays an essential role in protecting it and producing new skin. Vitamin C's anti-inflammatory properties also help reduce redness and swelling.
Massaging your scars is important. It keeps the tissue around the incision loose so it doesn't “stick” to the tissue underneath. Wait until after your skin has healed before you start massaging your scar. Your skin will be healed when the edges of the scar are well closed with no gaps, and have no drainage.
A lack of collagen can lead to atrophic scarring, those indented scars left behind after acne. Supplementing your body with high-quality marine collagen will help it to work at repairing the skin from the inside, minimising the appearance of depressed scars for a smoother complexion.
Go for a matte foundation because it will absorb the light and soften the appearance of your scar. They won't attract any attention to the area. Concealer is a great product to use to cover any scar. Its high pigmentation covers any discoloration and matches it to your natural skin tone.
Over time, raised scars tend to flatten, but flattening can take months or years. A raised scar is most likely to form on the chest, upper back, or shoulder area, but it can appear anywhere on your skin. Some raised scars itch or feel painful.
Laser treatment cannot get rid of a scar.
Laser treatment can: Prevent a raised scar from forming after surgery. Reduce scar pain and itch.
Exfoliating can fade scars and make them smoother and less noticeable. But if you'd like to remove your scars, you may need treatment such as laser therapy.