Can You Get Rid of Deep-Pitted Acne Scars?
Deep pitted acne scars are the result of severe or cystic acne. As your skin cells regenerate, some of your tissue is lost, which over time will leave scarring, dimples, and depressions in your skin.
Authors
Dr. Marnie E. Fisher & Dr. Elena Poulos
Dr. Fisher, Dr. Poulos, and the dermatologists at Kingsway Dermatology & Cosmetic Centre have a combined 20 to 25 years of experience each of providing both medical, surgical and cosmetic care for acne and acne scarring.
Dr. Fisher and Dr. Poulos are your expert dermatologists here at Kingsway Dermatology & Cosmetic Centre, who have spent decades of their lives working with all kinds of skin types to bring patients satisfaction with the skin they’re in.
Atrophic
Atrophic scars are shallow and have healed underneath the top layer of the skin, leaving a depression caused by collapsed and condensed collagen. The subclassifications of atrophic scars are:
Ice pick – deep, narrow, pitted scars that resemble holes in the skin
Rolling – sloping edges which make the skin look wavy and uneven
Boxcar – larger than ice pick scars with sharply defined edges that look like craters
Atrophic superficial – typically ivory in color with a flat, wrinkled appearance resembling a small stretch mark
Hypertrophic and Keloid
Hypertrophic and keloid scars are raised versions of healed skin with a white, pink, or dusky coloration. They’re often tender, itchy, and feel waxy. Hypertrophic scars stabilize at the site of the original pimple and remain slightly raised. Keloid scars begin to spread through newly made bundles of tightly wound collagen beyond the origin of the original pimple. High-risk areas for these scars include the jawline, back of the neck, center chest, and shoulders.
For both types of scars, it’s common to have an overproduction of collagen. The gold standard of treatment for these remains Kenalog (steroid) injections that break down excess collagen, producing softer, flatter, and less symptomatic scars. These injections are generally performed in a series over time.
Post-inflammatory Hyperpigmentation
Also known in abbreviated form as PIH, this is not exactly a scar, but a discolored spot or area that is the result of squeezing and picking of the acne itself. The healing process blurs the top layer from the underlying layer of the skin, and pigmentation cells become trapped among collagen fibers. Older blood vessels remain at the site of healing, giving it a darker appearance.
Treatments for Deep Pitted Acne Scars
A combination of treatments is often required, because patients have more than one type of deeply pitted scarring. Many treatments can help in treating several types of scarring too! PIH can be improved with laser genesis, chemical peels, and micro needling. Ice-pick and boxcar scars can be treated with fractionated ablative laser, microneedling, subcision, and filler injections.
Stage 1 Treatment
As multiple treatments may be required, it is best to treat deeply pitted scars in stages. An initial stage of treatment may include:
Stage 2 Treatment
Stage 2 treatment options are viable once you have completed the first stage and can take your skin to the next level in terms of evenness, tone, smoothness, and texture.
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