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.
They may be tight if they were placed in a sub-optimal position. Equally they may become tight because it is a fundamental property of scar tissue that it tends to contract over time. If the scar does contract, it may result in dimpling of the overlying 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.
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.
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.
Injectable treatments may also be used. Dermal filler can be used to fill depressed or concave scars. Depending on the injectable substance used and your particular scar conditions, results may last from three months to several years. Therapy must be repeated to maintain results.
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.
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.
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.
Prevent scars while the wound is healing
Gently cleanse the area with soap and water and apply Aquaphor or Vaseline with a bandage daily. Maintaining a moist wound surface is key, rather than crusted, dry scabs. Avoid topical, over-the-counter antibiotic ointments, such as Neosporin, if you've never used them before.
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.
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.
Pitted acne scars are hollow indents in the skin left behind by inflammatory acne. These scars develop due to the sudden loss of collagen during the skin's healing process. As cell regeneration occurs, it may not be enough to fully repair the damage. This causes depressions to form in the skin.
Atrophic scars look like little indents or dimples in the skin and may be further classified as icepick (deep and narrow), rolling (broad with sloping edges) or boxcar scars (broad with sharp edges). On the other side of the spectrum, hypertrophic scars are thickened raised acne scars.
Keloids are an overgrowth of scar tissue at the site of a healed skin injury. They often create a thick, puckered effect simulating a tumor. Keloids may be reduced in size by freezing (cryotherapy), external pressure, corticosteroid injections, laser treatments, radiation, or surgical removal.
Keloid and hypertrophic scars are common types of scarring that can occur as a result of the acne healing process. They appear as raised lesions of scar tissue on the skin and are a result of the overgrowth of fibrous tissue in the region where the acne lesion had developed.
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.
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).
Injectable fillers are able to replenish the indentation, producing a smooth complexion. However, even for these types of scars, laser skin therapy is the best option because of its ability to treat indented scars by using heat to resurface the top layer of skin and produce a smoother, more even complexion.
Atrophic scars are pitted or sunken scars. They occur when the body doesn't produce enough collagen during the healing process, resulting in a loss of tissue that leaves an indentation in the skin.
Pockmarks are concave scars that result from damage to the deeper skin layers from acne, trauma, or infection. They're sometimes used as a general term for atrophic acne scars (icepick scars, rolling scars, and boxcar scars). Pockmarks don't disappear on their own, but there are treatments to reduce their appearance.
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.