Atrophic scars occur when your skin is unable to regenerate sufficient collagen and results in an indentation. These skin indentations can result from traumatic, acne, surgical, or chickenpox scars. While some scars may undergo some level of fading, atrophic scars are particularly stubborn and don't resolve over time.
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.
The filler of choice for filling indented scars is generally a biostimulator to lay down a new layer of fresh collagenous tissue that will continue stimulating your body to create new collagen. Radiesse® and Sculptra® are examples of fillers used to treat acne and other depressed scars.
Atrophic Scars
They are depressed, sunken and often have a pitted appearance. Atrophic scars happen when the body does not make enough collagen while healing, which causes the loss of tissue. Acne, chickenpox or injuries involving loss of skin tissue are the usual causes of these scars.
The best scar treatment for your atrophic scar depends on the severity of your indentation. Scar revision surgery is for the most severe scars. Subcision and microneedling can both treat acne scars, postoperative scars, and chickenpox scars.
Hypertrophic scars that result from burn wounds are more difficult to treat. Superficial burn wounds usually heal without forming hypertrophic scars. Deep burn wounds are harder to treat. Many dermatologic and plastic surgeons treat these by removing the burned area and then using a skin graft.
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.
Mederma PM Cream can be used on atrophic scars such as acne and chicken pox scars. Mederma® PM Cream may help to smooth and soften the edges of the pox mark but it will not cause the indented area to fill in. By smoothing the edges, the mark may become less noticeable.
For best results, you should perform scar massage for at least 10 minutes, twice a day, for six months. You should only stop sooner than that if the scar starts showing signs of infection or you experience intolerable discomfort.
In some cases, insurance carriers will cover scar revision procedures, especially if the scar is causing a functional limitation. In other cases, insurance carriers will not cover scar revision procedures.
Atrophic scars are the most common type of acne scarring and account for about 80-90% of all acne scarring. Atrophic scars are categorized into 3 types by their morphology: icepick, rolling, or boxcar.
Moisturize Atrophic Scars
This will help to keep your skin hydrated making it appear less dry and rough around the scar. Try using a non-comedogenic moisturizer, like Vaseline® Jelly – it won't clog your pores and is appropriate for use on sensitive areas, like the face.
A scar may fade so much that you can barely see it, but it never completely goes away. Some scars cause problems months or years later. As nerve endings grow back, the scar may become painful or itchy. Skin cancer can develop in scars, especially in burn scars.
Retinol is also found in many acne scar treatment products because it promotes new skin cell growth and helps even out skin texture and skin tone — all of which can help reduce the appearance of newer, red acne scars and older scars.
Mederma gel is designed to tackle a range of scar types including acne scars, burn scars, injury and surgical scars, old scars and more. It contains Cepalin® botanical extract, for old and new scars.
Cortisone injections.
These types of injections can help soften and then shrink hard scars. Keloids and hypertrophic scars often soften after intralesional steroid injections.
CO2 lasers like Erbium YAG can help treat atrophic scars. Non-ablative lasers don't remove skin tissue but work to stimulate new collagen formation and tighten the skin, which causes the atrophic scar to rise to the surface and produce a smoother-looking appearance.
Atrophic depressed facial scars can be effectively treated with hyaluronic acid fillers with esthetically satisfactory clinical outcome with a low risk or complications.
While silicone strips may not be able to fill the indentation, they can help to improve the texture and colour of atrophic scars. Burn Scars: These are scars resulting from skin damage caused by burns. They can be raised or indented, and may cover large areas of skin.
The available treatment modalities for atrophic scarring available in literature are ablative fractional laser therapy (6), non-ablative laser therapy (16), dermabrasion (2), chemical peel therapy (5), surgical techniques such as subcision, autologous fat transfer and injectables (5) and combination therapies (7) ...
You should carry on massaging your scars for at least three to six months after your surgery or injury. What happens if I do not do anything? Your scar could become hard and inflexible or adhesions may form. Scars that cross a joint could stop you being able to bend or straighten the joint (a contracture).
After a scar is first formed, the body continues to touch up its work where it can - which is why scars fade slightly over the years when left alone. But scar tissue does not get replaced by this process2, which means that most scars, when left to heal naturally, will never fully disappear.