There are several options available to treat atrophic scars. It is important to note that popular treatments used for raised hypertrophic or keloidal scars like steroid injections and dermabrasion are not considered effective for atrophic scars. Rather than shrinking down scars, appropriate treatment for atrophic scars usually focus on raising the scar to meet the skin’s surface level.
Laser skin resurfacing, where high-energy light is used to remodel damaged or scarred skin, can help lessen the appearance of atrophic scars. Depending on the type of laser used and the severity of the scarring, patients who undergo this therapy can usually resume normal daily activity within a week, but their skin may remain pink for several weeks. Sometimes just one treatment is all that is needed to reach the desired effect.
Soft tissue fillers are another option for patients. Depending on the size and firmness of the depressed scar, collagen, hyaluronic acid or fat is injected into the scar to fill it out and raise it up to more closely match the skin’s surface. While the improvement is immediate, it is not permanent and collagen injections in particular often need to be repeated. Chemical peels may also prove useful for superficial atrophic scars since chemically burning off the top layer of skin helps smooth depressed scars and even out skin color.
For certain deeper pitted scars like ice-pick scars, surgical removal or “punch excision” is an effective treatment. In this procedure, a small hole is cut into the skin to remove the scar and then stitches are placed over it for five to seven days. Though the excision itself leaves behind a scar, it is less visible than a depressed scar and the skin appears smoother.
Reviewed by: Michael Fuller, MD