How To Heal Rolling Scars

Not all acne scars are created equally - They come in many shapes, sizes, colors and textures (pitted or raised).

Rolling scars are a type of scar that usually forms after an acne breakout.  They look like indented acne scars with a sloped edge.  Do rolling scars heal on their own? How do I treat rolling scars? These questions may pop into your mind when you hear about this term - so don't worry.  This article will talk about ways to heal and reduce the look of rolling scars. 

What Are Rolling Scars?

Rolling scars look like indentations on the skin with sloped edges. Rolling scars can give skin an uneven texture appearance and typically occur from skin damage after acne.

Rolling scars are shallow scars in terms of depth and can be around 4 millimeters wide. 

These types of scars are typically found on the lower cheeks and jaw, where the skin is thicker. Their indents have sloping edges that make the skin look uneven and wavy. Rolling scars are common and they form as acne heals.

What Causes Rolling Scars?

Rolling scars often form as acne heals.  More severe acne such as nodular or cystic acne have a higher risk of rolling scars forming afterwards. 

Typically it's the inflammation in skin that's the main culprit for rolling scars forming. The deeper or longer lasting the inflammation, the more likely your skin will leave a scar upon healing.

Other risk factors could be habitual picking of acne, as this can further push the inflammation deeper and cause more damage to skin. 

Habitual smoking can also possibly lead to development of rolling scars as it slows the healing and increases risk of scarring in general.

Do Rolling Scars Heal On Their Own?

Rolling scars aren't going to go away on their own unfortunately, but they can become less visible as it heals. 

Treatment Options For Rolling Scars

There are at least 7 options that you can use for treating rolling scars. Most of these treatments will require a professional to provide the treatment for you.  It is best to consult a dermatologist or trusted skin specialist for recommendations before trying any of the options as you may need a combination of different therapies.  

Here are 6 treatments for rolling scars:

• Microneedling
• Chemical peels
• Dermal fillers
• Surgical treatments
• Chemical reconstruction
• Laser therapy
• Subcision

Microneedling 

This treatment option enhances or promotes collagen production and heals scarring. Microneedling tools comprise small needles that gently penetrate the skin and create micro wounds on the skin to stimulate collagen. If using at home we recommend not go over 0.5mm as that is the minimum length for encouraging collagen synthesis which can help improve rolling scars.  Follow all instructions for sanitizing and aftercare if you'd like to try it at home and if you want to go for a stronger treatment, you can supplement with in office microneedling which uses longer needles. 

Chemical Peels 

This type of treatment option aims to remove the top layer of the skin and supports the production of collagen, which gives the skin a more even appearance. Chemical peels usually involve use of glycolic acid or salicylic acid.  Chemical peels can be done at home with lower concentrations, however these may not have much effect on rolling scars.  Deeper peels can be done in office or by a professional.

Dermal Fillers

Done by a professional by injecting collagen and other materials to fill in the dents of the skin. Dermal fillers however are not permanent but results can last up to 9 months depending on the filler type used.

Surgical Treatments

 Surgical treatment options include punch excision and grafting. Punch excision involves use of a circular tool to cut out the scar of the skin then stitches the wound shut for the skin to form a new, flat scar. Grafting, on the other hand, involves removing a scar then filling it with another skin that was taken from another part of the body (e.g. back of the ear). Both of these treatments help in creating a flatter, smoother skin surface.

Chemical Reconstruction

A treatment option where a potent acid like TCA is pressed into the base of each scar by a professional. The scar gets broken down and the healing response it create can elevate the scar.  Typically 3-6 treatments are needed to see results.

Laser Therapy

This treatment option may either remove the top layer of skin, to promote healing and reduce the appearance of scars, or even use heat to encourage production of collagen. 

Subcision

This treatment option is also known as subcutaneous incisionless surgery, which is considered to be a simple and safe office surgery procedure for treating depressed acne scars. It involves a small needle that is inserted into individual scars and it's moved back and forth to cut away at the scar tissue so the depressed scars can rise up and the downtime is about a week.  

How Can I Prevent Rolling Scars?

There is no surefire way to completely stop rolling scars, but you can prevent it by managing acne as soon as it shows up.  Keep inflammation down by applying anti-inflammatory skincare ingredients like aloe vera  as well as a diet that is low in high inflammatory foods like processed foods, high sugar, trans fats, or alcohol. 

To sum up, don't feel bad if you have rolling scars. Acne scars are common and there can be a lot of ways to treat rolling scars.  While rolling scars won't be able to disappear fully, they can be reduced significantly.  

References:

Acne Scars: Pathogenesis, Classification and Treatment https://www.hindawi.com/journals/drp/2010/893080/

How To Treat Rolling, Boxcar and Icepick Acne Scars" by Zoe Weiner from Teen Vogue; https://www.teenvogue.com/story/how-to-treat-rolling-ice-pick-boxcar-acne-scars

"Acne Scars" from Cleveland Clinic; https://my.clevelandclinic.org/health/diseases/21222-acne-scars