Atrophic scars are pitted or indented scars that occur when your skin heals below the normal layer of skin due to a lack of regenerative tissue. Think of a pothole in the road that isn't filled all the way up—that's what the imbalanced skin of an atrophic scar is like.
What Are Atrophic Scars? 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.
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.
Atrophic scars: This type of scar is generally the result of losing muscle or fat from an of the body, causing the skin to sink. Acne scarring or surgical scars are examples of these.
An atrophic scar takes the form of a sunken recess in the skin, which has a pitted appearance. These are caused when underlying structures supporting the skin, such as fat or muscle, are lost.
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.
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.
And vitamin C is a key player when it comes to creating collagen. Even though collagen and wounds are usually discussed in the context of repairing fresh injuries, since collagen helps make healthy tissue, it can impact older scars as well and improve their appearance.
Atrophic scars are indents in the skin where a wound occurred. Instead of a flat or raised scar, there are pock marks or dips in the skin. Acne is a common cause of atrophic scars, but other skin infections and wounds can also create indents in the skin.
What Is Abnormal Scarring? When skin is cut or injured, the body heals itself by forming scar tissue. If the body makes too much scar tissue, abnormal scarring results. “Hypertrophic scars” are usually raised, red fibrous lesions, and keloid scars extend beyond the edges of the original cut or wound.
While some scars may undergo some level of fading, atrophic scars are particularly stubborn and don't resolve over time. Atrophic scar treatment helps fill in the indentation and fade the appearance of your previous wound for a smooth, balanced appearance.
Depressed scar
Sunken scars can become more noticeable as you age. This happens when the skin relaxes and sags, causing the depressions to become more noticeable. You're more likely to develop depressed scars after chickenpox or severe acne clears.
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.
Scar tissue may become hard and raised. Massage is a way of softening and flattening scars and reducing the adhesions between the different layers of the tissue, making the scar tissue more flexible. It can also help alleviate any itching and over-sensitivity of the scar.
Scar Process
It will take six to 18 months for the scar to have its final appearance. Your scar should gradually soften and fade over these six to 18 months, but will look pink initially (photo B). Some scars never fade. If your scar stays pink after 12 to 18 months please call to discuss options.
Indentation scarring – more common with severe acne, occurs when the top layer of skin doesn't fully heal and regenerate — leaving an indentation in the skin.
Atrophic scars.
These are indented scars that happen when your skin heals below the normal layer of skin due to a lack of tissue. They're common in cases of severe acne or chickenpox.
Whether they're from childhood accidents, surgery or illness, some scars will fade over time but it's unlikely they'll completely disappear by themselves. If you're looking to reduce their appearance, you'll need to look into scar treatment. Keloids and sunken acne scars are least likely to fade.
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.
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).
The three phases to healing are the inflammatory stage, the proliferative stage and the remodelling stage. The inflammatory stage begins immediately and lasts a few days. During this time, the bleeding stops and white blood cells come to the site and fight any infection.