Acne is a common skin condition affecting many people. Severe inflammatory acne is the cause of rolling acne scars that are characterized by depressed skin attached to a scar band extending into the deeper tissue. This leads to superficial shadowing and a rolling or undulating appearance to the overlying skin.
Skin scars are a natural part of the healing process following burns, surgeries, or injuries.
Acne and Rolling Scars
Post-acne scarring can significantly impact your quality of life, especially for young individuals. It’s essential to properly assess the severity of scarring and consider appropriate treatments. Medical professionals classify scars into three main types: atrophic, hypertrophic, and keloidal.
- Keloid scars are an overgrowth of tissue that extends beyond the wound’s edges. Keloids are caused by too much collagen production at the wound site.
- Hypertrophic scars have excessive collagen deposits, resulting in raised areas on the skin, though they are not as severe as keloidal scars.
- Atrophic scars are indented and occur when the skin fails to produce enough new tissue, leading to uneven scarring.
Atrophic acne scars are the most common type of acne scars and are classified into three main types: icepick, boxcar, and rolling scars.
Causes of Rolling Scars
Rolling scars are caused by bands of scar tissue that form beneath the skin, leading to a rolling and uneven appearance on the skin’s surface. These scars develop due to dermal tethering to the subcutis tissue and typically measure about 4 to 5 millimetres in width. They create an undulating or wavy texture, often resembling the letter “M.”
Understanding the different types of acne scars and their causes is crucial for effective treatment and management.
Treatment of Rolling Scars
Rolling scars can be a significant source of stress, but effective management is possible. In some cases, home remedies may help, but if they are ineffective, consulting skin experts for surgical treatment may be necessary. The success of these treatments depends on several factors:
- Your age
- Your overall health and medical history
- The type of scar
- Your response to various medications and therapies
Treating post-acne scars can be challenging and often requires a combination of techniques tailored to the different types of scars. Generally, deeper scars are more difficult to treat effectively.
With the right treatment, you can significantly reduce the appearance of scars caused by acne.
Treatment Options
- Chemical Peels: This quick outpatient procedure is effective for treating acne scarring. Rolling scars often respond well to mild and medium-depth peels, which can include trichloro-acetic acid, alpha hydroxy acids, salicylic acid, and Jessner’s solution.
- Ablative Laser Resurfacing: Several traditional ablative lasers are used to treat acne scars, e.g., 10,600 nm carbon dioxide (CO2) lasers and 2940 nm pulsed Er:YAG lasers. Such a laser creates many microscopic treatment zones to activate new collagen formation and re-epithelialization
- Subcision: This simple surgical technique uses a special needle to release the sub-dermal bands responsible for rolling scars. By “releasing” the tethered scar, new collagen can form beneath, which helps lift and smooth the skin’s surface. Deeper and more noticeable rolling scars often see dramatic improvements after subcision.
- Micro-Needling: This minimally invasive technique is initially designed for skin rejuvenation. A micro-needling device equipped with needles, tips, or pins gently exfoliates the skin. It’s safe and can be combined with other surgical procedures for enhanced results.
- Fractional Radiofrequency: The use of microneedle radiofrequency is based on the ability to selectively heat the tissue at a specific depth. The device also uses micro-needles through which a beam of radio waves is emitted directly into the tissue. Additionally, the needles only heat up at their tips, which allows precise control of the depth at which the tissue is heated.
- Platelet-rich plasma (PRP): PRP is an autologous blood-derived product enriched in platelets, growth factors, and chemo/cytokines delivered in a volume of plasma. PRP has the potential to deliver a high concentration of growth factors to the target tissues
- Dermal Fillers: This treatment involves injecting hyaluronic acid-based “fillers” under the skin. By providing support underneath the scar, it effectively lifts the depressed rolling scars and makes the skin smoother.
Additional Treatment Options
- Combined therapy
- Punch techniques
- Autologous fat transfer
- Topical creams
The ultimate goal of seeking treatment for your acne scars is to improve the skin’s appearance rather than achieve complete scar disappearance. Choosing the right procedure for your skin type is the first step towards achieving healthier, smoother skin.