Pitted Scars Are Permanent Without Special Treatment, Experts Say

Pitted scars, known medically as atrophic scars, are permanent changes to skin structure that do not resolve without specific treatment. Many believe these scars can be treated with skincare products, but they actually form when the body fails to produce enough collagen during healing. This collagen deficiency prevents damaged tissue from fully repairing, leading to lasting indentations.

Dr. Hamidah Mohd. Salleh, CEO of Klinik Lovina, explained that pitted scars develop when the collagen produced is insufficient to fill damaged skin areas. "When there is a wound or inflammation, the body produces collagen to repair the area. But if there isn't enough collagen, the skin heals with indentations, forming atrophic scars," she told Utusan Malaysia. She identified cystic acne as a primary cause because its inflammation affects deep dermal layers, damaging skin structure. Other causes include chickenpox, folliculitis, boils, accidents, surgery, or injuries affecting deeper skin layers.

Dr. Hamidah also highlighted that picking at active acne significantly increases the risk of developing pitted scars. "When acne is picked while still active, the inflammation can go deeper and cause tissue damage that ultimately leaves permanent scars," she stated. Factors like prolonged acne without treatment, genetic predisposition to scarring, and smoking also raise the risk, as they slow down skin healing.

Pitted scars vary in type, including ice pick, boxcar, and rolling scars, each with distinct shapes, depths, and treatment methods. "Each scar type requires a different treatment approach. Therefore, a doctor's examination is crucial to identify the scar type before appropriate treatment can be administered," she advised. Treatment selection depends on the scar's type, depth, and duration, meaning each patient needs a personalized plan. Aesthetic treatments include chemical peels, TCA CROSS, microneedling, dermapen, CO2 laser, subcision, fillers, and skin boosters to stimulate new collagen. However, most patients, especially those with older scars, require a combination of treatments because these are harder to heal than newer scars. "The earlier treatment begins, the better the results. Newer scars are easier to treat," she concluded.