What does an atrophic scar look like?

Author: Ms. Roxanne Will PhD  |  Last update: Saturday, August 16, 2025

Atrophic scars are the opposite of hypertrophic scars. They are depressed, sunken and often have a pitted appearance.

How do you know if a scar is atrophic?

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.

Do atrophic scars fill in?

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.

What is the difference between atrophic scarring and normal scarring?

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.

Can indented scars be fixed?

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.

Depressed or Atrophic Scars

How do you plump up indented scars?

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.

Does mederma work on atrophic scars?

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.

What does abnormal scarring look like?

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.

What makes atrophic scars worse?

Cutaneous injuries as small as 0.5mm can trigger excess fibrotic tissue deposition or destruction of the natural tissue scaffold. 1 Scar appearance can further visibly change over time, worsened by factors such as high-tension.

How do you reduce the appearance of atrophic scars?

A few of the treatments we provide for scarring include:
  1. Fillers. Dermal fillers are products injected into your skin to reduce the appearance of atrophic acne scars. ...
  2. Microneedling. In this treatment, Dr. ...
  3. Laser skin resurfacing. ...
  4. Dermabrasion. ...
  5. Chemical peel.

Does Vaseline help atrophic scars?

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.

Should you massage atrophic scars?

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.

How deep is an atrophic scar?

They are , typically 1.5-4 mm wide and may be shallow (< 0.5mm) or deep (> 0.5mm). Rolling scars, which account for 15-25% of atrophic acne scars, have an undulating appearance with a gently sloping border. They are typically wider (usually ≥ 4-5 mm) than they are deep.

When is it too late to massage scar tissue?

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.

How do you know if you have skin atrophy?

The skin atrophy in hyperadrenocorticism mainly involves the dermis, with the result that the skin is thin and easily wrinkled. This can be noticed when determining the thickness, flexibility, and turgor of the skin.

What does an unstable scar look like?

Unstable scars are distinguished by their lack of resolution. Unlike stable scars that fade and flatten over 12–18 months, unstable scars may remain raised, red, itchy, or painful indefinitely. They can also spread or change over time, leading to functional limitations or psychological distress.

What does a healthy scar look like?

For about six weeks after surgery the scar becomes red, firm and hard. This is the body's way of making a very strong and solid scar. Over the next four months the scar will soften and lose the redness. This is the normal process of scarring.

What are examples of atrophic scars?

Several types of atrophic scars exist, including ice pick, boxcar and rolling scars. Ice pick scars are small, deep pits resembling an ice pick's holes. Boxcar scars have a well-defined edge and are more expansive and shallower than ice pick scars. Rolling scars are wide and shallow, with a wave-like appearance.

Why are my scars indented?

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.

How long do atrophic scars last?

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.

When should you not use Mederma?

It's important to wait until the wound has closed and any stitches have been removed. Mederma should also not be used for severe burns, animal bites or puncture wounds.

What is the best scar gel for old scars?

Mederma is the best it's truly does fade and heal new scars and fade old scars to your original skin tone.

What shrinks scar tissue?

Cortisone injections.

These types of injections can help soften and then shrink hard scars. Keloids and hypertrophic scars often soften after intralesional steroid injections.

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