What should you know about depressed scar revision?

A depressed, atrophic or indented scar sits below the surrounding skin. It may form after inflammation damages deeper skin structures, including after acne or chickenpox. Rolling scars often have gently sloping edges, while boxcar scars have more defined borders and ice-pick scars are narrow and deep. A clinician examines the scar pattern, texture, colour and any active skin disease before recommending revision.

Revision usually improves the way light falls across the surface rather than recreating unscarred skin. Different scars on the same face may need different approaches, and several treatments may be combined over separate visits. Skin tone, tendency to form raised scars, medicines, recent tanning and expectations all affect planning.

First control active acne or other inflammation so new scars are less likely while older scars are being treated. Microneedling creates controlled tiny injuries that encourage remodelling and may suit some shallow, broad depressions. Laser treatment changes the surface or deeper tissue with light energy; the choice depends on scar depth and skin characteristics.

Subcision uses a small instrument beneath selected scars to release fibrous bands that pull the surface downward. Dermal fillers can temporarily restore volume in suitable depressions. Your clinician may discuss downtime, sun protection, pigment changes, infection, bruising, swelling and the possibility that more than one session will be needed. Do not pick the area while it heals, and follow the exact aftercare provided.

Arrange a dermatology assessment if a scar is changing, becoming painful, bleeding, crusted or repeatedly inflamed, or if you are unsure whether the mark is a scar. After a procedure, contact the treating clinic promptly for spreading redness, increasing warmth, pus, fever, severe pain, unexpected skin colour change or swelling affecting vision or breathing. Urgent care is appropriate for breathing difficulty or rapidly worsening facial swelling.

Ask which scar types are present, whether active acne must be treated first, what improvement is realistic for your skin, how many visits may be considered, and what downtime and aftercare each option involves. Tell the clinician about previous pigment changes, raised scars, cold sores, allergies, medicines and recent sun exposure.