Rolling Acne Scars
Acne is one of the most common skin conditions, affecting as many as 50 million Americans throughout their lifetimes, according to the American Academy of Dermatology. Unfortunately, acne lesions can linger on the skin’s surface even after the initial breakout has cleared, leaving acne scars. Acne scars can take many forms, but the most common are atrophic acne scars, which appear as depressions dotted across the skin’s surface. These depressed scars form from severe acne breakouts that do not heal properly; specifically, the body produces insufficient collagen, resulting in indentations across the affected area. Rolling acne scars are a type of atrophic acne scar characterized by depressions with a sloping border, giving the skin a wavy, rolling texture. While rolling acne scars are permanent, meaning they will not fade on their own over time, their appearance can be reduced or eliminated with a combination of cosmetic treatments available at Dr. Michele Green’s New York City dermatology practice.
For atrophic acne scars, including rolling scars, a combination approach is typically needed to heal and erase them fully: first, address the depressions that affect skin texture, and second, address any discoloration or redness resulting from scarring. At Dr. Green’s Upper East Side New York City dermatology office, a wide range of treatment options is available to eliminate all signs of rolling acne scars for patients of all skin types. To address the indentation in the top layer of skin, Dr. Green may use subcision with dermal fillers, punch excision, chemical peels, Fraxel fractional laser treatment, eMatrix non-ablative laser resurfacing, microneedling, and microdermabrasion. To help eliminate hyperpigmentation and discoloration, Dr. Green may also use VBeam laser therapy or chemical peels with glycolic acid, salicylic acid, or trichloroacetic acid (TCA), depending on your acne scars and skin type. With so many options available, it is best to consult an expert, board-certified dermatologist, such as Dr. Green.
Dr. Michele Green is an acclaimed, board-certified dermatologist with over 25 years of experience. Recognized for her expertise, she serves a diverse clientele, including some of the most discerning individuals seeking non-invasive treatment options, particularly for acne scars. In her approach to facial rejuvenation, Dr. Green adopts a holistic methodology, emphasizing a less-is-more philosophy that enhances her patients’ natural beauty. Each treatment plan is meticulously tailored, combining in-office procedures, personalized topical treatments, and specialized skincare products to align with each patient’s unique needs and goals. Her commitment to excellence and patient care has earned her numerous accolades, and she is consistently recognized by prestigious publications, including New York Magazine, Super Doctors, The New York Times, and Castle Connolly, as one of New York’s leading dermatologists. During your consultation in her inviting boutique dermatology office located in Manhattan’s Upper East Side, you will devise a comprehensive treatment strategy to achieve a clear, smooth, and healthy complexion.
What are rolling acne scars?
Rolling acne scars are characterized by indentations that create a rolling or wavy appearance on the skin’s surface, with sloping edges that measure a few millimeters wide. Caused by inflammatory acne that inhibits wound healing, rolling scars form when collagen production is insufficient after an acne breakout. Inflammatory acne occurs when pores on the skin’s surface are clogged not only by sebum and dead skin cells but also by bacteria, leading to infection beneath the skin. Depending on your body’s unique wound-healing process, this bacteria-infected acne, known as inflammatory acne or acne cysts, can lead to the formation of acne scars, and the deeper the infection, the more likely scarring will occur. Once scarring occurs, acne scars are permanent unless addressed through a cosmetic procedure.
What do rolling acne scars look like?
Rolling acne scars are a type of atrophic acne scar characterized by depressions or indentations on the skin’s surface. Unlike other atrophic scars, such as boxcar and icepick scars, rolling scars have sloping borders rather than sharp or angular edges. This gives the skin a wavy appearance, and these scars typically develop in areas with thicker skin, such as the jawline or lower face. Rolling acne scars form when fibrous bands tether the dermis, the outer layers of the skin, to the underlying subcutaneous tissue. This connection pulls on the epidermis, resulting in a rippling effect. The size of rolling acne scars can vary based on how the acne lesion heals over time, and they often cover a larger surface area than the original acne lesion or cyst. They typically result from damage to the deeper layers of the skin, leading to a loss of structural support and contributing to the rolling effect on the surface.
What are the different types of acne scars?
Acne scars form from inflammatory acne, which damages the skin and prevents lesions from healing properly. Two main types of acne scars can form: atrophic and hypertrophic. Atrophic scars are characterized by depressions or indentations in the skin’s surface, caused by insufficient new collagen produced during the healing process. They can be further broken down into three main types: boxcar, icepick, and rolling scars.
Boxcar scars form when acne-induced inflammation destroys collagen fibers in the affected area, leading to a loss of tissue support and skin depression. Typically oval or rounded, boxcar scars vary in size and depth depending on the severity of the initial acne breakout. Boxcar scars are typically wider than icepick scars and have sharper edges than rolling scars.
Icepick scars are named for the deep, narrow indentations resulting from severe inflammation of cystic or nodular acne, which resemble a skin being pierced with a thin, sharp object, like an icepick. The third main type of atrophic scar is the rolling scar, which results in a rolling or wavy skin appearance and is caused by insufficient collagen production during the wound-healing process.
Hypertrophic scars are raised scars that form when excess collagen is produced during the natural healing process after injury. Typically, hypertrophic scars expand to a larger surface area than the initial lesion or injury. The main type of hypertrophic scar is the keloid, a raised, thickened scar that appears lumpy over the affected area. Some patients are more genetically predisposed to keloid scars, which a medical professional should only treat like Dr. Green.
Acne scars are often accompanied by post-inflammatory hyperpigmentation, a skin discoloration that occurs in the surrounding skin after a severe acne breakout. Post-inflammatory hyperpigmentation is often treated separately with the VBeam laser to reduce redness in atrophic or hypertrophic scars.
What causes rolling acne scars?
Rolling acne scars primarily result from previous acne breakouts that damage the skin’s structure. When acne forms, it can cause inflammation and subsequent collagen breakdown in the affected area. As the skin heals, it may not regain its original texture, leaving depressions or rolling scars. These scars are characterized by soft, wave-like edges that cast shadows on the skin’s surface, giving it an uneven appearance. Factors such as the severity of acne, genetic predisposition to scarring, and individual skin-healing processes can contribute to the development of rolling acne scars.
What type of acne causes rolling acne scars?
Acne is an extremely common skin condition that affects up to 50 million Americans at some point. Of those 50 million, 40% will develop acne scars after an active breakout. Acne breakouts occur when sebum, the oil on the skin’s surface, and other debris, such as dead skin cells, clog the pores. In severe cases, bacteria can become trapped in the pores, leading to inflammatory acne, nodular acne, pustules, and cysts. Inflammatory acne can damage the skin and impede wound healing, leading to acne scars. The deeper the infection, the more likely the lesions are to scar. Picking or popping pimples can increase the risk of developing acne scars, such as rolling scars, by spreading infection or forcing debris deeper into the pores. Smoking can also be a risk factor for developing acne scars, such as rolling scars, by constricting blood vessels, reducing oxygen and nutrient delivery to the skin, and breaking down collagen, hindering the skin’s recovery process.
How to treat rolling acne scars
Rolling acne scars do not go away on their own; however, patients can reduce their appearance with cosmetic treatments available at Dr. Green’s dermatology office. When treating rolling acne scars, Dr. Green typically recommends a combination approach to address the skin’s indentation and any post-inflammatory hyperpigmentation (discoloration) resulting from scarring. Many treatment modalities can be used, including microneedling, chemical peels, laser treatment, chemical reconstruction of skin scars, dermabrasion, subcision, and punch grafting. With so many options available, Dr. Green will begin the treatment session with a consultation to recommend a series of treatments that are safest for your skin type and most effective at eliminating rolling scars.
Treatment of Acne Scars
Rolling acne scars can be treated with several forms of laser therapy to promote collagen remodeling. Each laser treatment uses a different energy source to help erase the appearance of rolling acne scars on the skin’s surface, providing patients with clear, smooth, even-colored skin.
Microneedling for rolling scars
Microneedling, also known as collagen-induction therapy, is an effective treatment for improving skin tone and texture and reducing the appearance of rolling acne scar depressions. The non-invasive treatment uses tiny, surgical-grade needles to create controlled micro-injuries in the skin’s layers, triggering the body’s natural wound-healing response and increasing the production of the structural proteins collagen and elastin. When performed in areas with rolling acne scars, microneedling stimulates new collagen production that fills in surface indentations, resulting in smooth, even-textured skin. Microneedling can also be paired with platelet-rich plasma (PRP) injections to enhance treatment outcomes further. To increase patient comfort, a topical numbing cream is applied before the treatment begins, and no downtime is required afterward. It is recommended that you consult a board-certified dermatologist to ensure proper technique and the use of medical-grade devices, and to avoid worsening existing scars or creating new ones.
Derma-rolling for acne scars
A derma roller is a handheld device that uses the same principle as Microneedling: it has many tiny needles that puncture the skin’s surface to create small, controlled micro-injuries, boosting collagen production in the treatment area and resulting in smoother, clearer skin. Touted as a home remedy for acne scars and other skin irregularities, some derma rollers have been FDA-cleared to help improve skin color and texture. However, home devices are not nearly as powerful as the treatments available at Dr. Green’s dermatology office. Scheduling Microneedling with Dr. Green can deliver more noticeable results. Furthermore, patients using a derma roller at home should use it correctly. Patients should avoid using derma rollers if they are experiencing an active herpes outbreak, have an autoimmune disorder or a weakened immune system, take blood thinners or prescription medication for acne, or suffer from bleeding disorders. The best way to achieve good treatment results is to visit an expert dermatologist, such as Dr. Green, rather than trying treatments at home.
Chemical peels for rolling scars
Chemical peels are an effective treatment for rolling scars, designed to exfoliate the skin and promote skin cell turnover for a smoother, more even texture. There are many types of chemical peels, each with different exfoliating agents and strengths: mild, medium, and deep. For rolling acne scars, Dr. Green recommends a mild or medium peel composed of one of the following exfoliating agents: glycolic acid, trichloroacetic acid, or salicylic acid. Glycolic acid chemical peels, which are mild alpha-hydroxy acid peels, are often used for active acne breakouts to clear breakouts and prevent the formation of acne scars in the first place. When applied to the skin, glycolic acid unclogs pores by removing excess sebum, dead skin cells, and other debris, exfoliating the skin and reducing current breakouts and the appearance of acne scars. A mild peel, glycolic acid is safe for lighter and darker skin types.
TCA Cross Technique
TCA CROSS (Trichloroacetic Acid Chemical Reconstruction of Skin Scars) is an advanced dermatological treatment designed to address rolling, boxcar, and icepick acne scars. This technique uses a high concentration of trichloroacetic acid, typically 70%-100%. The procedure involves carefully applying the acid directly to the base of the scars with a fine instrument. This precise method enables targeted treatment and induces a controlled chemical injury, thereby prompting the skin’s natural healing processes. As a result, the body stimulates collagen production, which is essential for improving skin texture and reducing the appearance of scars over time.
Phenol CROSS
Phenol CROSS (Chemical Reconstruction of Skin Scarring) is an advanced, highly effective treatment for deep icepick and certain types of rolling acne scars. The procedure uses high-concentration phenol solutions, typically 80% to 100%. The phenol penetrates the skin and stimulates collagen production, promoting skin regeneration and improving the overall texture and appearance of scarring. While Phenol CROSS is particularly beneficial for deep scars, rolling scars often require a more comprehensive treatment strategy to achieve optimal results. This may include subcision, a technique that involves inserting a needle beneath the skin to break fibrotic bands that tether the skin to deeper tissues. Following subcision, additional treatments, such as dermal fillers or laser therapy, can further enhance skin smoothness and resilience, leading to better outcomes.
When choosing a chemical peel to treat your rolling acne scars, consult a board-certified dermatologist, such as Dr. Green. When applied correctly by an expert, the treatment is associated with only mild side effects, such as redness or dryness at the treatment site. However, improper application can lead to more significant side effects, including hyperpigmentation. With many options available, Dr. Green helps patients determine which chemical peel is best for them.
Fraxel laser resurfacing
The Fraxel laser is a non-ablative fractional laser that precisely resurfaces the skin and is most effective for atrophic scars, such as rolling acne scars. When applied to the treatment area, the laser’s fractional beam creates micro-injuries that trigger the body’s natural production of collagen and elastin. As new collagen forms, the skin’s depressions are filled in, resulting in smooth, even skin. To treat rolling acne scars, Dr. Green recommends scheduling between three and five sessions, each spaced a month apart, to achieve optimal results.
eMatrix laser for treating acne scars
The eMatrix laser uses radiofrequency technology to treat rolling acne scars and reduce fine lines, wrinkles, stretch marks, and enlarged pores. FDA-approved, eMatrnd e damage-effective non-ablative treatment that delivers results comparable to those of ablative laser treatments. However, unlike ablative treatments, which are associated with significant downtime and recovery, the eMatrix radiofrequency laser resurfaces the skin without downtime. When applied to the treatment area, the eMatrix laser emits radiofrequency energy to stimulate collagen production and promote smooth, even-textured skin. For optimal results, Dr. Green recommends scheduling four to six eMatrix treatment sessions, with continued improvement over the three to six months after treatment.
VBeam laser for rolling acne scar treatment
A common side effect of acne scarring is post-inflammatory hyperpigmentation (redness). Acne scars often remain red or dark, and this discoloration can be treated with VBeam laser therapy. The VBeam pulsed-light laser is the ideal treatment for hyperpigmentation and redness, including acne scars, rosacea, varicose veins, stretch marks, and surgical scars. When applied to the treatment area, the VBeam laser emits pulses of light that are converted into heat and absorbed by red-pigmented tissue, destroying the pigmentation while leaving the surrounding tissue unaffected. With patented cooling technology, no topical anesthetic is needed for high patient comfort, and there is no downtime after the treatment.
CO2 laser
The CO2 laser is an ablative laser that is particularly effective in treating acne scars by removing the damaged top layer of skin and promoting the growth of new, healthier skin beneath. One advantage of this treatment is its ability to improve scar texture and appearance significantly. However, the procedure entails significant downtime, as the skin may take several days to heal. During this recovery period, patients often experience redness, swelling, and peeling, similar to a moderate-to-severe sunburn. Additionally, there’s a risk of hyperpigmentation, especially in individuals with darker skin tones, where patches of darker skin can appear in the surrounding skin. To mitigate risks and ensure optimal results, it is highly recommended to consult a board-certified dermatologist who can assess your skin type and condition, discuss the benefits and risks, and determine whether CO2 laser treatment is the most suitable option for your acne scars.
Erbium YAG laser
The Erbium YAG is another fractional ablative laser designed for laser resurfacing and skin rejuvenation. The ablative nature of the laser removes the outer layer of skin, triggering the natural healing process and promoting skin cell turnover, revealing healthy, clear, and tight skin as the treated area heals. Light energy can also penetrate deep into the dermis, boosting collagen production and treating skin conditions from the inside out. Compared with other ablative lasers, such as the carbon dioxide laser, the Erbium YAG requires less recovery time and carries a lower risk of side effects. The Er: YAG laser may not be appropriate for everyone, so it is always best to consult an expert dermatologist, such as Dr. Michele Green, before undergoing any laser treatment.
Subcision with Dermal Fillers
Subcision is an ideal procedure for treating rolling acne scars, in which the epidermal layer is tethered to the subcutaneous tissue, creating an indentation on the skin’s surface. Subcision involves inserting tiny needles beneath the skin at the scar site. Once the needles are in place, Dr. Green uses the point to break the tethers binding the bottom of the scar to the subcutaneous tissue, thereby releasing tension. Typically, Dr. Green pairs subcision with injections of hyaluronic acid dermal fillers, such as Restylane or Juvederm, or the poly-L-lactic acid filler Sculptra, which is particularly effective for collagen induction in deeper scars. Dermal fillers help restore lost volume to depressions on the skin’s surface, while subcision untethers the fibrous bands that pull down on the epidermis.
What is the best treatment for rolling acne scars?
Rolling acne scars are difficult to treat and often require a combination approach to achieve the best results. They are frequently characterized by depressions along the skin’s surface and redness or discoloration. To improve skin texture and achieve smooth, even skin, Dr. Green often recommends the Fraxel laser, eMatrix laser, chemical peels, microneedling, or, if the scars are tethered, subcision paired with dermal fillers. Dr. Green may choose the V-Beam laser or chemical peels to address hyperpigmentation. No single treatment is necessarily “best”; rather, it is important to choose the treatment or series of treatments that will best suit you, depending on the width and depth of your scarring and your skin type. Fortunately, Dr. Green is an expert at treating patients of all skin types and developing the best treatment regimen for each patient’s unique needs.
What is the worst thing about rolling acne scars?
Rolling acne scars can develop after severe inflammatory acne, creating a rippling, wavy appearance on the skin. These scars are permanent and will not go away on their own, often making patients feel self-conscious long after the initial breakout has faded. Fortunately, many treatment options are available at Dr. Green’s New York City dermatology office, so you no longer have to live with uneven, discolored skin. Schedule your initial consultation with Dr. Green to determine which treatments best meet your needs.
Are rolling acne scars permanent?
Rolling acne scars are considered permanent because of the underlying structural changes they create in the skin. They form when collagen fibers in the dermis become tethered to underlying tissues, creating a dimpling effect on the skin’s surface. Unlike other types of acne scars, which may fade over time, rolling scars typically do not improve on their own. Professional treatment is often necessary to effectively address and minimize their appearance. Treatments such as subcision use a needle to release fibrous bands that anchor scar tissue, resulting in smoother skin texture. Microneedling, another popular option, uses fine needles to create micro-injuries in the skin, stimulating collagen production and improving skin elasticity. Additionally, laser therapies can target the scarred areas to promote skin regeneration and surface smoothing. While these treatments can significantly enhance the appearance of rolling acne scars, it is important to consult a board-certified dermatologist, such as Dr. Green, to determine the most suitable approach for your skin type and scar severity.
How to treat rolling acne scars at home?
When dealing with rolling acne scars, it’s essential to consult a board-certified dermatologist, such as Dr. Michele Green, for professional treatment options. While at-home microneedling devices and derma rollers are available, they are generally not recommended for treating rolling scars. These devices often fail to penetrate the skin deep enough to effectively stimulate collagen production, which is crucial for skin repair and regeneration. Moreover, using at-home tools increases the risk of complications, such as scarring or infection, particularly if the technique is not performed correctly. An experienced professional can tailor a treatment plan to your skin type and the severity of your scars, ensuring safer, more effective results. Therefore, seeking professional guidance is the best approach to achieve optimal skin health and improve the appearance of rolling acne scars.
Frequently Asked Questions about Rolling Acne Scar Removal
How can you tell if your acne scars are tethered?
Some forms of depressed acne scars are tethered, meaning the bottom of the scar is attached by fibrous bands to the subcutaneous tissue beneath the skin’s surface, resulting in a depression on the skin’s surface. Rolling acne scars can often be tethered, in which case subcision is often the best course of action to break the fibrous bands causing the indentation on the skin’s surface. During your initial consultation with Dr. Green, she will examine the treatment area and determine whether the rolling acne scars are tethered and require subcision.
Can rolling acne scars go away on their own?
Most types of acne scars are permanent once formed. Rolling acne scars that form after an inflammatory acne breakout may fade slightly over time, but will not fully go away on their own. Fortunately, many treatment options are available to reduce the appearance of acne scars at a board-certified dermatologist’s office. With a wide range of cosmetic procedures available to treat rolling acne scars, the best first step is to consult an expert, such as Dr. Green. During your initial consultation, Dr. Green will examine the treatment area to determine the combination of treatments that best meets your needs.
Are rolling scars easy to treat?
Rolling acne scars are shallow and soft, caused by fibrous bands of tissue pulling down the skin’s surface. These scars can create a wave-like effect, making the skin appear less smooth. Fortunately, rolling scars tend to respond well to a variety of treatments, including laser therapy, microneedling, and dermal fillers, which can help break down the fibrous tissue and improve skin texture. However, it is always recommended to consult a board-certified dermatologist, who can assess the severity of the scars and develop a personalized treatment plan tailored to the individual’s skin type and concerns. This professional guidance helps patients achieve the best possible results and address potential complications effectively.
How to cover rolling acne scars?
Covering rolling acne scars can be challenging because of their uneven texture and the shadows they cast. Unlike other types of acne scars, rolling scars have a slightly depressed, wavy surface that can make them more prominent under certain lighting. To achieve a smoother makeup application, start with a solid skincare foundation. Ensure your skin is clean and well-moisturized, which helps makeup adhere better and minimize the appearance of scars. Use a silicone-based primer to fill in uneven texture and create a smoother canvas. Next, choose a high-coverage foundation that conceals imperfections. For added coverage, apply a thicker, concealer-like product to scarred areas. While it may be difficult to cover rolling acne scars with makeup, it is best to consult a board-certified dermatologist to explore treatment options that can help smooth the skin’s surface.
Does jade rolling help with acne scars?
Jade rolling is a facial massage technique that uses a jade stone to roll across the skin gently. This practice is believed to promote lymphatic drainage, which can help reduce puffiness, improve overall skin tone, and enhance blood circulation. While jade rolling may provide a soothing experience and contribute to a healthier-looking complexion, it does not directly heal or remove acne scars. Instead, its primary benefits are temporary, such as reducing inflammation and enhancing the absorption of skincare products. Some users report visible improvements in skin texture and reduced redness with regular use. Still, those seeking to address acne scars specifically may need to explore more targeted treatments, such as chemical peels, microneedling, or laser therapy. Overall, incorporating jade rolling into a skincare routine can be a relaxing ritual that complements other skincare methods. Still, it should not be relied upon as a sole treatment for acne scars.
Can rolling acne scars be removed?
Rolling acne scars are a common consequence of acne, characterized by a wave-like appearance on the skin. While completely removing these scars is challenging because they result from a loss of collagen and skin elasticity in the affected areas, various treatments can significantly improve their appearance. Techniques such as microneedling, chemical peels, and laser therapy can stimulate collagen production and promote skin regeneration, which may help flatten and soften the scars over time. Additionally, subcision, a minor surgical procedure, detaches the scar from the underlying tissue to improve skin texture. Ultimately, while rolling acne scars may not be eliminated, these treatments can lead to noticeable improvements, enhancing the skin’s overall appearance and boosting confidence. Consulting with a board-certified dermatologist can help determine the most appropriate approach tailored to individual skin types and scar conditions.
How to treat rolling acne scars naturally?
While there is no definitive natural remedy to eliminate rolling acne scars, a variety of non-invasive cosmetic treatments can significantly improve their appearance. To effectively reduce the risk of developing rolling acne scars, it is essential first to manage and treat the underlying acne. Active acne breakouts can cause inflammation and damage to the skin, which in turn can lead to scarring as the skin attempts to heal. If you are currently experiencing active acne, it is strongly recommended that you consult a board-certified dermatologist. A skilled dermatologist can conduct a thorough evaluation of your skin and develop a personalized treatment plan tailored to your specific needs. This plan may include oral medications, topical treatments, or lifestyle modifications to help control your acne. Once the underlying acne has been effectively managed, you can consider cosmetic treatments to improve the appearance of rolling scars.
How do I get started on treating acne scars today?
Acne is a common skin condition that can lead to various types of scarring. Acne scars can be an even more challenging concern to treat than the breakouts themselves and, for many, may cause feelings of self-consciousness or low self-esteem. Fortunately, board-certified dermatologist, Dr. Michele Green, offers a range of non-invasive treatment options to reduce the appearance of acne scars and achieve clear, smooth, healthy skin that lasts. Depending on your skin type and the types of acne scars present, the treatment options recommended by Dr. Green may include microneedling, chemical peels, subcision with dermal fillers, and laser treatments, among others.
Dr. Michele Green, based in New York City, is an internationally renowned board-certified dermatologist with over two and a half decades of experience providing the best non-invasive treatment options, including medical acne treatment and cosmetic acne scar treatment. Castle Connolly, Super Doctors, New York Magazine, and the New York Times consistently identify Dr. Green as one of NYC’s best dermatologists for her dedication to patients and expertise. Dr. Green takes a holistic approach to skin rejuvenation, customizing each patient’s treatment plan to best address their specific needs and overall aesthetic goals. When you consult with Dr. Green at her private each patient’s treatment plan to best address dermatology office in Manhattan’s Upper East Side, she will work with you to develop a personalized treatment plan that incorporates a combination of cosmetic treatment options and specially formulated skincare products best suited to your skin condition and goals so that you look and feel like the very best version of yourself. To schedule a consultation with Dr. Green and get started with your treatment plan for healthy, radiant, beautiful skin that lasts, call the NYC-based office at 212-535-3088 or contact us online today.