While acne blemishes are a pain to deal with, at least they are only temporary. However, they can leave behind marks in the form of acne scars which are always permanent without treatment.
There are 4 basic types of acne scars: Ice-pick, boxcar, rolling, and hypertrophic scars.
In this article we’ll take a look at rolling acne scars. We’ll start with defining what they are, talking about what causes them, and finally we’ll look at what your treatment options are for getting rid of them.
What Are Rolling Acne Scars?
Rolling acne scars are one of the four types of scars left behind by acne.
They are a type of scar known as a depressed scar, meaning that the skin is indented or lowered, rather than raised. With rolling scars, the skin has a wave-like or “rolling” appearance; hence the name.
These undulations in the skin are not discolored, and are only visible because of the change in skin texture.
For a better idea of what they look like, see below for pictures of rolling acne scars.
Rolling Acne Scar Pictures
Rolling scars on a man’s left cheek
Severe rolling acne scars
What Causes Rolling Acne Scars?
Rolling acne scars are formed when bands of fibrous scar tissue form between the outer layers of skin (epidermis) and deeper skin tissues. These bands of scar tissue pull the surface of the skin down, which is what gives it the wave-like or rolling appearance where some parts are more depressed than others.
Rolling Acne Scar Treatment Options
Without treatment, acne scars will always be permanent.
Fortunately, there are a number of treatment options for rolling acne scars which can either significantly reduce their appearance, or completely eliminate them.
Subcutaneous Incision (Subscision)
A scar treatment known as subcutaneous incision, or subscision, is probably the best treatment option for rolling acne scars.
I mentioned earlier that rolling acne scars are cause by bands of tissue pulling the outer layers of skin down towards deeper skin tissue. With subscision treatment, these fibrous bands is tissue are severed, allowing the skin to return to it’s normal “flat” state.
Results are typically immediate, with the appearance of the scars reduced by approximately 50%. Of the patients who have subscision performed on rolling acne scars, 90% claim to be satisfied with the results.
Chemical Peels
Tricholoracetic acid (TCA) chemical peels are useful in the treatment of some acne scars.
With rolling scars, a peel from a 20-30% concentration of TCA can moderately reduce the appearance of the scars.
A dermatologist would be able to administer a chemical peel, however if you have rolling acne scars it is recommended that you first look into subscision, as it is typically a more effective treatment.
Dermabrasion
Dermabrasion is a procedure which abrasively removes the top layer of skin, forcing it to regrow and it often repairs some of the damaged scar tissue as it regenerates itself.
Dermabrasion is very appropriate for rolling acne scars, and often produces satisfactory results. It is also useful for reducing the appearance of post-inflammatory hyperpigmentation (red marks) caused by acne.
As with all of the treatment options so far, a dermatologist will be able to administer dermabrasion for your acne scars.
Laser Resurfacing
Using an ablative laser, the top layers of skin can be removed, and even deeper layers of skin are heated by the laser. This forces the skin to regrow, healing itself in the process.
This is similar to the way dermabrasion works, however it is a more drastic procedure which may require significant downtime for your skin to heal.
Laser resurfacing can be very effective for treating rolling acne scars, however you may still want to consider subscision as your first treatment option.
Skin Fillers (Augmentation)
With this type of treatment, a dermatologist will inject a filler into the skin, which replaces the lost collagen that caused the scar in the first place. The filler can be collagen, hyaluronic acid, PMMA (polymethylmethacrylate), or the patient’s own body fat.
The major downside to treating acne scars with fillers is that other than PMMA, they are all temporary. Most fillers will last for 3-6 months before your body absorbs the material and another treatment is needed.
Like most of the other treatment options, it is best to consider skin fillers for rolling acne scars only after you have had subscision, which is the best treatment for this type of scar. If the rolling skin hasn’t completely flattened after the subscision, then filler may be an excellent option to further reduce their appearance.
