A depressed scar sits below the surface of the skin, giving a sunken look. Depressed scars can look more noticeable over time as our skin ages. Another type of scar is a keloid scar. This scar is raised above the surface of the skin.
Unlike hypertrophic acne scars, depressed scars are permanent. They caused by the loss of collagen during the healing process. This may be due to replacement of collagen fibers with fibrotic tissue, or a combination of both. In any event, they affect the well-being of those with them.
Types of scars
If your body doesn't produce enough collagen, you can end up with the opposite — a depressed scar. Depressed scars, also called atrophic, boxcar, icepick, and rolling scars, are more commonly found on the face as a result of acne.
Depressed scars are quite common scars resulting from acne, skin trauma, accidents, and previous surgery. 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.
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.
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.
Do acne scars go away on their own? Reddish or brownish acne marks left behind by acne lesions usually fade eventually, but it can take a year or longer. Mild or moderate scarring may also fade over time, but in general, unless acne scars are treated—especially severe scarring—they're permanent.
Injection treatments
On the other hand, filler injections are used to fill depressed scars. Collagen and synthetic agents are injected into or under the scar tissue, producing immediate results.
Well, a scar can heal within 12 to 18 weeks in most cases. However, how long your specific scar will take to heal depends on various factors, including size, depth, type of scar, and proper wound care. While scars aren't visually appealing, they're a natural part of the healing process and require patience.
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.
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.
Raised scars are most commonly found in taut skin areas on the body and, depending on the location, can impede movement. A depressed scar sits below the surface of the skin, giving a sunken look. Depressed scars can look more noticeable over time as our skin ages. Another type of scar is a keloid scar.
To qualify for disability compensation, you must have at least one scar that is unstable, painful, or both. In a nutshell, the VA's disability rating criteria for scars is based on multiple factors: Pain. Stability.
Medicated Creams or Gels
Over-the-counter skin medications such as creams or gels can help. If your scar is itchy or sensitive, antihistamine cream may stop the itch while helping your scar heal. Corticosteroid cream can help prevent scarring and has been shown to reduce the appearance of scars over time.
Apply a water based cream, such as aqueous cream or E45 hand cream to the scar. Use the pads of your fingers to massage the scar and tissue around the scar.
Bio-Oil helps to improve the appearance of new or old scars; whether from surgery, accidents, burns, insect bites, scratches or conditions such as acne or chickenpox. Although younger scars will have a greater chance of improvement, studies have shown that older scars also benefit from regular use of Bio-Oil.
Scar massage: At approximately 2-3 weeks after wound closure, scar massage can be performed. Scar massage is one of the most effective ways to soften a scar and improve the appearance. It helps to promote collagen remodeling, decrease itching, and increase the flexibility of the scar.
Some medicated creams, such as those containing azelaic acid or hydroxyl acids, might help too. 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.
Fillers: Your dermatologist may recommend fillers to treat deep-pitted scars. These fillers fill the scarred tissues and lift them to the level of the surrounding skin. They contain substances such as hyaluronic acid to add volume to the depressed scars with minimal discomfort.
What makes acne scarring worse? Your own DNA plays a role in your scars! Your genes determine how well your skin heals, the amount of collagen produced and the depth of the acne lesions also controls the severity of the scars. However, you can make the scarring worse by smoking, squeezing the acne and picking at it.
In comparison to the pictures of those with clear skin, those with acne scars were less likely to be considered attractive, confident, happy, healthy and successful, and more likely to be perceived as insecure and shy (all p < 0.05; Table 1).