Rolling scars are a type of indentation on the skin, often resulting from acne. These atrophic scars involve a loss of tissue.
Defining Rolling Scars
Rolling scars appear as wave-like depressions across the skin’s surface, creating an uneven and undulating texture. They are typically wider than other acne scars, with a rounded, irregular shape and soft edges. Under certain lighting, these scars cast shadows, emphasizing the skin’s unevenness and making it appear less smooth.
How Rolling Scars Form
Rolling scars form beneath the skin during the healing of severe acne lesions. Deep inflammation, characteristic of cystic or nodular acne, disrupts collagen and elastin fibers in the dermis. This damage prevents the skin from healing smoothly, leading to an irregular distribution of fibrous tissue.
Fibrous bands develop between the subcutaneous fat layer and the dermis, pulling the skin surface downwards. These tethering bands create the characteristic wave-like depressions. The loss of underlying volume and the pulling action of these fibrous structures contribute to the depressed appearance.
Factors influencing scar development include genetic predisposition, the body’s immune response to inflammation, hormonal fluctuations, and age. The severity and duration of untreated acne significantly increase the likelihood of rolling scar development.
Treatment Approaches for Rolling Scars
Professional procedures for rolling scars aim to stimulate new collagen production and release underlying fibrous bands.
- Laser therapy uses focused light energy to target scarred tissue. Fractional lasers create microscopic columns of injury, prompting new collagen production and skin resurfacing.
- Radiofrequency microneedling combines microneedling with radiofrequency energy. Tiny needles create micro-injuries, while radiofrequency heats deeper dermis layers. This stimulates collagen and elastin synthesis, plumping depressed areas and improving texture.
- Chemical peels apply a chemical solution to exfoliate outer skin layers. Deeper peels reach the dermis, encouraging cellular turnover and collagen remodeling. This smooths the skin and reduces shallow rolling scars.
- Dermal fillers, such as hyaluronic acid, are injected directly into depressed scars. They add volume, lifting the indentation to be more level with surrounding skin. Results are temporary but provide quick contour improvement.
- Subcision is a minor surgical procedure. A needle is inserted under the skin to mechanically break fibrous bands tethering the scar. Releasing these bands allows the skin to lift, and the space fills with new collagen, improving appearance.
- Fat grafting harvests a person’s own fat and injects it into scarred regions. The transferred fat fills depressions and contains growth factors that improve skin quality and texture. This provides natural, longer-lasting volume restoration.
- Cryotherapy involves controlled freezing of scarred tissues. This causes targeted cells to undergo necrosis, leading to their removal and allowing new, healthier tissue to emerge.
Preventing Rolling Scars
Preventing rolling scars focuses on effective, timely management of active acne. Controlling inflammation and preventing severe breakouts reduces scarring risk. A consistent skincare routine, tailored to skin type and acne severity, helps manage existing blemishes and prevent new ones.
Using appropriate skincare products that do not irritate skin or exacerbate acne is beneficial. Lifestyle factors, such as maintaining a balanced diet and managing stress, contribute to overall skin health and can lessen acne severity.
Seeking professional advice for persistent or severe acne is a proactive measure. Dermatologists provide prescriptions, in-office treatments, and guidance to prevent acne from progressing to deep, inflammatory lesions and subsequent rolling scars. Early intervention is a strong defense against developing these lasting skin changes.