Atrophic scar: what it is and how it relates to HOF
Quick facts
- Definition
- Depressed scar, below the level of the surrounding skin, caused by tissue loss in the dermis.
- Common cause
- Inflammatory acne; also chickenpox and trauma.
- Shapes
- Ice pick, boxcar and rolling.
- Contrast
- Hypertrophic scars and keloids are raised, the opposite of atrophic scars.
An atrophic scar is a sunken scar that sits below the level of the surrounding skin. It forms when inflammation destroys part of the dermis and repair does not replace all of the lost collagen. On the face, the most frequent cause is inflammatory acne, but chickenpox and trauma can also leave this type of mark.
What shapes are there?
| Shape | Appearance |
|---|---|
| Ice pick | Narrow and deep, like a puncture from an ice pick |
| Boxcar | Box-shaped, with well-defined edges |
| Rolling | Wavy, with soft edges, caused by tissue tethering below |
Recognizing the shape helps in choosing the approach. Hypertrophic scars and keloids are the opposite: raised, from excess tissue.
What does aesthetics usually discuss?
The most cited approaches work on tissue repair: microneedling, release of adhesions through subcision, lasers and collagen biostimulators, which activate fibroblasts and promote neocollagenesis. Dermal filler can lift a specific depression. The choice, the number of sessions and the combination are decisions for the qualified professional, after an assessment.
What if the skin is dark or very sensitive?
The risk of post-inflammatory hyperpigmentation weighs more in higher phototypes and belongs in the plan. Informing the patient about this risk is part of consent.
In Harmy
Harmy projects volume changes in the marked areas and does not simulate skin texture or scars. In the projection, the skin in the photo stays as it is, and the app does not retouch or smooth the skin.
Frequently asked questions
What is an atrophic scar?
It is a sunken scar that sits below the level of the neighboring skin because of lost collagen and tissue. The most common type on the face comes from acne.
Can acne scars be treated?
There are approaches that may improve their appearance, such as microneedling, subcision and biostimulators. Results vary and usually take more than one session.