Rolling scars are common, and they form as acne heals. Various treatments may reduce their appearance, and many do so by promoting the production of collagen.
Rolling scars are pits in the skin with sloped sides. This scarring is more common in areas where the skin is thick, such as the lower cheeks and jawline.
Below, we explore the range of treatment options, most of which require a professional to perform them.
Rolling scars are pits or indentations in the skin, and they often have sloped sides. Each of these pits may be wider than 4–5 millimeters. They give the skin an uneven appearance and can be difficult to conceal.
People with rolling scars may also have other types of acne scars, including discolored or raised marks.
A dermatologist may classify acne scars according to their visibility:
- Mild scars are those that are not visible from distances of more than 50 centimeters (cm) or that a person can cover with makeup or the shadow of a beard.
- Moderate scars are visible at distances of greater than 50 cm but flatten when a person stretches the affected area of skin.
- Severe scars are visible from more than 50 cm away and do not flatten when a person stretches the skin.
According to a 2017 analysis in the Journal of Drugs in Dermatology, risk factors for rolling scars may include:
- severe acne, such as acne that causes cysts or deep wounds in the skin
- acne that has been present for some time before treatment
- acne that relapses after treatment
- male sex
Can they heal on their own?
Rolling scars may become less pronounced with time once the acne has completely healed. However, they do not go away on their own.
Microdermabrasion and derma rollers may reduce the appearance of acne scars, and a person can use these methods at home.
Microdermabrasion involves removing the top layer of skin to help promote healing. Home dermabrasion kits deeply exfoliate the skin and may reduce the appearance of scars over time.
Derma rollers use tiny needles to create wounds in the skin, in a process called microneedling. This treatment may promote healing, reducing the appearance of acne scars. The Food and Drug Administration (FDA) have approved a handful of these tools for use.
However, a person may be more likely to see reductions in the appearance of rolling scars if they receive professional treatment, such as:
- Microdermabrasion: A professional uses more powerful chemicals than those available for home use.
- Microneedling: This may promote collagen production and heal scarring.
- Chemical peels: This treatment also aims to remove the top layer of skin, and it, too, may support the production of collagen, giving the skin a more even appearance.
- Dermal fillers: A professional can regularly inject collagen and other materials to fill dents in the skin.
- Surgical treatments: Procedures such as punch excision or grafting, for example, aim to create a flatter, smoother skin surface.
- Chemical reconstruction: This involves injecting a potent acid into the area, creating inflammation that prompts the production of collagen. Most people need multiple treatments.
- Laser therapy: Depending on the type, this may either remove the top layer of skin, promoting healing and reducing the appearance of scars, or use heat to encourage the production of collagen.
There is no evidence that creams, vitamins, or other remedies can treat rolling scars.
Anyone considering using a derma roller should check that it has FDA certification. The FDA also recommend:
- avoiding using the tool if there is an infection or a herpes outbreak in the area
- following the instructions carefully on how often to use the tool and how to sanitize it
- avoiding the use of harsh products, such as chemical exfoliants, immediately after using a derma roller
- ensuring that the derma roller is suitable for use and never using a broken or damaged one
These devices may not be safe for people who:
- have a weakened immune system
- have hepatitis or HIV
- have clotting or bleeding disorders
- take blood thinners
- have eczema or an autoimmune disorder
- take prescription acne medication
Anyone who has severe or painful acne that does not respond to home treatment should consult a doctor. It is also important to do this if acne stops responding to treatment, or if home acne treatments irritate the skin or cause more scarring.
If the skin is very discolored or warm, or there are other signs of infection, it is important to seek medical guidance immediately.
Rolling scars are not dangerous, but they may affect self-esteem. A person should see a doctor if they are unhappy with the appearance of their scars or home treatments do not work.
Rolling scars are pits or indentations in the skin that form as a result of acne. Healthcare professionals typically classify their severity based on their visibility.
Various procedures can reduce the visibility of rolling scars, but it is important to consult a dermatologist before deciding on a treatment strategy. Some treatment options may not be suitable for everyone.