Rolling acne scars are shallow, wide depressions in the skin that give it a wavy, uneven look, mainly caused by collagen loss from deep acne inflammation. These scars form when severe pimples damage the skin’s deeper layers, leading to less collagen production and fibrous bands that tether the skin down.
Acne starts as red, inflamed spots, but when it goes deep, it harms the collagen that keeps skin firm and smooth. Collagen is like the skin’s support structure, made of proteins that fill space and hold everything together. During bad acne, inflammation destroys this structure, so the skin heals with gaps instead of fullness. The body then creates tough scar tissue bands under the surface. These bands pull the skin downward, making rolling scars that slope gently at the edges and feel soft to touch. You often see them on cheeks and temples, and they can come with dark spots from old breakouts.
Picking or squeezing pimples makes things worse by causing more damage and pulling skin unevenly. Without enough collagen, the skin stays indented, changing its texture to rough and bumpy. This collagen loss is key, as normal healing would rebuild the lost support, but here it falls short.
Treatments focus on fixing the tethers and boosting collagen. Subcision uses a small needle to cut those fibrous bands under the skin, letting it lift up naturally. It’s great for rolling scars since they are softer than other types. After subcision, doctors often add fillers like hyaluronic acid to plump the area right away, giving quick smoothness that lasts months.
To rebuild collagen long-term, microneedling with radiofrequency works well. Tiny needles poke the skin, and heat from radiofrequency energy goes deep to spark new collagen growth. This tightens and fills scars over a few sessions, with mild redness for a day or two. Laser resurfacing smooths the surface and helps collagen remodel, blending scars into normal skin. Other options like chemical peels or PRP with microneedling improve texture and tone for milder cases.
Preventing more scars means controlling acne early with anti-inflammatory steps, like steroid shots for bad spots, and avoiding picking. Over time, consistent treatments can make skin much smoother by restoring lost collagen.
Sources
https://sozoclinic.sg/acne-scars/rolling/
https://shi.org/acne-scars/fillers-and-filler-injections/
https://www.london-dermatology-centre.co.uk/blog/rolling-vs-boxcar-acne-scars/
https://rightdosenow.com/acne-scars-removal/
https://syraaesthetics.com/treatments/acne-scar-treatment-nyc/
https://rejuvadermatology.com/conditions/acne-scars-in-venice-fl/
https://www.influennz.com/blog/rolling-scars-treatment/
https://www.mesoestetic.com/blog/acne-scars/
