Can pitted scars be treated? Causes and effective treatment for pitted scars

Uneven indentations and pitted scars on the skin are often the result of deep skin damage, making it difficult to restore a smooth surface. Can pitted scars be treated? What causes them, and how to treat pitted scars effectively? In this article, HBIO Clinic explores the causes of pitted scars and various solutions that help you achieve smoother, more even-toned skin.

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What are pitted scars?

Pitted scars are small depressions or pits on the skin’s surface that often appear when the collagen in the skin is damaged after an inflammatory acne, pimple, or other injury heals imperfectly. When the skin is damaged, the body tries to produce collagen to regenerate the skin, but sometimes this process doesn’t work properly, resulting in the formation of uneven, depressed scars.

Pitted scars often have different shapes, from small, deep depressions to scars with sharp or square edges, creating small holes in the skin. Pitted scars can appear on any area of the skin, but are most common on the face, especially the cheeks, forehead, and chin.

Treating pitted scars can be difficult and time-consuming, however, with modern treatments such as microneedling, lasers, or filler injections, you can completely improve your skin condition and minimize the appearance of pitted scars.

Read now: What Causes Acne Scars? Discover 8 Most Effective Acne Scar Treatment Methods

Common types of pitted scars

To ensure effective treatment for pitted scars, dermatologists classify them based on shape to determine the right approach. Below are the most common types:

Ice-pick scars

Characteristics: Small but deep, resembling punctures made by sharp objects.
Structure: Depth greater than 0.5mm, narrow opening, bottom of scar not visible.
Cause: Typically results from untreated acne and loss of collagen in the dermis.

This is the most difficult type to treat and is often mistaken for enlarged pores.

Boxcar scars

Characteristics: Broad, sharply defined edges with clearly visible base.
Size: Ranges from 1.5–4mm in width; round, oval, or triangular.
Cause: Often caused by severe inflammatory acne or improper acne extraction. Also seen in post-chickenpox skin.
Note: One of the most noticeable pitted scars, significantly affecting aesthetics.

Rolling scars

Characteristics: Shallow, wide scars with uneven surface and no sharp edges.
Structure: Subdermal fibrous bands pull the skin inward, causing a wave-like appearance.
Cause: Formed by fibrotic tissue that pulls the skin downward.
Appearance: Often found on thick skin such as the lower cheeks or chin, contributing to an aged and sagging look.

Mixed pitted scars

Characteristics: A combination of all types above—ice-pick, boxcar, and rolling.
Cause: Acne lesions heal inconsistently, leading to mixed scar shapes depending on inflammation severity and skin type.
Note: Difficult to treat without proper techniques due to the complexity of the skin surface.

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What causes pitted scars?

Pitted scars form when the skin is damaged and doesn’t regenerate evenly, leading to irregular skin texture. Common causes include:

Acne: The most frequent cause. Untreated or improperly handled inflammatory acne can damage collagen structures.
Improper acne extraction: Using non-sterile tools or squeezing pimples can spread bacteria and worsen inflammation, causing scars.
Deep skin trauma: Burns, injuries, or wounds that don’t heal well often result in permanent pitted scarring.
Skin conditions: Diseases like chickenpox, dermatitis, or psoriasis can deeply damage skin layers, leading to pitted scars.
Genetics: Individuals with poor collagen production or scar-prone skin are more likely to develop pitted scars.
Skin aging: As collagen declines with age, the skin becomes thinner and more prone to uneven healing.
Chronic inflammation: Long-lasting skin inflammation can damage tissue and form sunken scars.

Cure for pitted scars: 4 effective methods

Can pitted scars be treated? Yes—with the right method and consistency. Here are four common options:

Natural remedies

Ingredients like centella asiatica, aloe vera, turmeric, or green tea powder contain antioxidants and vitamins that promote collagen regeneration. These are best for mild acne scars, requiring long-term commitment.

Chemical Peels

A treatment for acne scars using chemical solutions to remove dead skin cells and promote smoother, even-toned skin. Types include:

Superficial peel: Removes only the outermost layer to brighten and reduce spots.
Medium peel: Reaches the dermis, improving moderate scars and texture.
Deep peel: Penetrates deeper layers to restructure skin and treat severe pitted scars.

How Chemical Peels Work in Treating Pockmarks

The chemicals in the peeling solutions will remove dead skin cells, clean pores and reduce inflammation that causes acne. By regenerating new skin, this method helps to fade pockmarks, especially small and shallow scars.

Stimulate collagen regeneration: After the dead skin layer is removed, new skin cells will be produced quickly. This stimulates the production of collagen and elastin, helping to regenerate the skin surface, filling in pockmarks.

Fade scars: When new skin cells form, a smoother layer of skin will replace the damaged skin layers, fading scars. As a result, the skin will become more even-toned and firmer.

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Creating pseudo-injuries (Needling, Micro-needling)

Needling and micro-needling are methods that use small needles to create mild injuries on the skin surface, stimulating collagen production to help fill in pitted scars. Needle rolling affects the skin layer more deeply, bringing obvious effects but can cause pain. Micro-needling is less invasive, suitable for skin with mild or moderate scars.

Filler Injections

Filler injections are a non-surgical cosmetic procedure that helps fill and improve pitted scars on the skin. Fillers are fillers, usually hyaluronic acid or other materials, that are injected into sunken or pitted areas of the skin to resurface the skin, making it smoother and more even-toned.

Read now: How long does it take for acne scars to fade? Signs, causes, and treatment methods.

How it works

When injecting Filler into the area of skin with pitted scars, the filler will fill in the indentations and stimulate collagen production, helping to fill in the scars and regenerate the skin surface. After injection, the skin will become softer and smoother.

Benefits of Filler Injection in the treatment of pitted scars

Improve skin structure: Filler fills in scars, making the skin even and smooth
Increase collagen production: Filler stimulates the body to produce collagen, making the skin firmer.
No surgery required: This is a non-invasive method, less painful and has a quick recovery time.
Fast results: After injection, you will see immediate results, pitted scars are filled and clearly faded.

Each treatment method has its own advantages and limitations, so you need to consult your doctor to choose the method that is suitable for your pitted scar condition.

In short, treating pitted scars is completely possible if you apply the right method and persevere. Although the treatment process may take time, with the right choice of therapies and proper skin care, you can completely minimize the appearance of pitted scars, bringing smooth, even-toned skin. Remember, consulting with dermatologists will help you choose the right method and achieve the best results in treating pitted scars. So contact HBIO Clinic to receive the best free consultation!

Read now: What Causes Acne Scars? Discover 8 Most Effective Acne Scar Treatment Methods