I Have Deep-Pitted Scars from Acne: Can You Help?

You expect acne to disappear once the breakouts stop. Unfortunately, your skin has different plans. Deep indentations, uneven texture, or lingering marks can remain long after the acne itself has cleared.

At Dermatology Specialists of Atlanta, board-certified dermatologist Kathleen J. Smith, MD, and our team regularly help patients who feel frustrated by acne scars that seem permanent. The good news is that several effective treatments can improve the appearance of your scars and help restore smoother, healthier-looking skin.

The first step is understanding what type of acne scar you have, because different scars respond best to different treatments.

What causes acne scars in the first place?

Acne scars form when inflammation from a breakout damages your skin’s deeper layers. As your skin heals, your body produces collagen to repair the injury. If your skin produces too little collagen, it can heal with depressions or pits. If too much collagen forms, raised scars can develop.

Deep or long-lasting acne, especially cystic acne, is more likely to cause scarring. Picking or squeezing pimples can also increase the risk.

Deep-pitted scars: The most common concern

Deep-pitted scars, often called atrophic acne scarring, look like indentations in your skin because the underlying tissue has lost volume.

There are three main types of pitted acne scars:

Ice pick scars

Ice pick scars are narrow, deep scars that extend into your skin. They often look like tiny holes or punctures.

These scars are the deepest and can be tough to treat with surface treatments alone. We typically recommend procedures that stimulate collagen production to gradually improve their appearance.

Boxcar scars

Boxcar scars are wider indentations with well-defined edges. They can resemble shallow craters in the skin and often appear on the cheeks or temples.

Because they affect a larger surface area, treatments that stimulate collagen and smooth the skin’s texture are often the best bet for improving these scars.

Rolling scars

Rolling scars create a wavy or uneven skin surface. These scars form when fibrous bands beneath your skin pull the surface downward, creating gentle depressions.

Treatments that release these bands and stimulate collagen can help smooth the skin over time.

Other types of acne scars

Not all acne scars are pitted. Some people develop raised scars, known as hypertrophic scars or keloids, where excess collagen forms during healing.

Others may notice lingering discoloration after acne heals. These marks, called post-inflammatory hyperpigmentation, are not technically scars but can still affect the appearance of your skin.

Each type of scar requires a different treatment approach.

How we treat acne scars at Dermatology Specialists of Atlanta

Before choosing from our suite of scar-reducing treatments, we evaluate the condition of your skin and talk about your goals so we can create a plan tailored specifically to you, which could include one or more of the following:

• Chemical peels
• Laser treatments
• Intense pulsed light (IPL)
• Treatments that target pigmentation left behind by acne

Chemical peels remove damaged outer layers of skin and encourage the growth of new, smoother skin. 

Laser treatments work deeper within the skin to stimulate collagen production. This process helps gradually fill in depressed scars and improve overall skin texture.

IPL treatments use pulses of light to target redness and pigmentation that often remain after acne heals.

You may benefit from a combination of treatments to address multiple types of scarring at the same time.

What kind of results you can expect

Acne scars usually improve gradually rather than disappearing overnight. Most treatments work by encouraging the skin to produce new collagen and renew itself over time.

With the right treatment plan, many patients see noticeable improvements in the smoothness and clarity of their skin.

Just as important, treating acne scars can also restore confidence. Many patients tell us they feel more comfortable without makeup and more confident in their appearance after treatment.

You don’t have to live with acne scars

If deep-pitted acne scars are affecting how you feel about your skin, help is available.

Call Dermatology Specialists of Atlanta in Decatur, Georgia, or book an appointment online today to learn which treatments may be right for you and take the first step toward smoother, more confident skin.