What Causes Acne That Leaves Indentations
Acne that leaves indentations, also called pitted or atrophic scars, happens when your skin doesn’t heal properly after severe breakouts. Understanding why this occurs can help you prevent these lasting marks.
How Severe Acne Damages Your Skin
When you have deep inflammatory acne like cysts or nodules, the breakout goes far below the skin’s surface. This type of acne creates significant inflammation and damage to the deeper layers of your skin, particularly an area called the dermis. The dermis contains collagen, a protein that gives your skin its structure and strength. When severe acne inflames this layer, it destroys collagen and other tissue around the breakout.
The Healing Process Goes Wrong
After the acne heals, your body tries to repair the damage by producing new collagen. However, the repair doesn’t always work perfectly. In many cases, your body produces too little collagen to fill in the damaged area completely. When there isn’t enough collagen to support the skin above it, the skin sinks inward, creating a depression or indentation. This is how pitted scars form.
Think of it like patching a wall. If you use uneven plaster to fill a hole, some spots will be level with the wall while others will be lower. Your skin heals the same way. The collagen gets deposited unevenly, leaving some areas sunken and indented.
Why Some People Get These Scars More Than Others
Several factors make you more likely to develop indented acne scars. If you have a family history of scarring, your skin may naturally have a harder time healing properly. Some people’s bodies simply don’t produce enough collagen during the healing process, making them more prone to these marks.
The severity and duration of your acne also matters. The longer acne goes untreated, the more inflammation builds up and the deeper the damage goes. Deep cystic acne is much more likely to leave indentations than mild breakouts because it damages more tissue.
Your skin type and location also play a role. Areas like your back and chest have higher concentrations of oil glands and thicker skin, which means acne tends to be deeper and more severe there. When acne is deeper, the scars are often deeper too.
What You Do to Your Skin Matters
Picking, squeezing, or scratching acne lesions dramatically increases your chances of getting indented scars. When you manipulate a breakout, you drive bacteria deeper into the skin and increase inflammation. This causes more tissue damage and makes scarring much worse.
Even after acne heals, sun exposure can interfere with your skin’s natural repair process. UV radiation degrades collagen and can make post-acne marks darker and more persistent, extending the time it takes for them to fade.
The Bottom Line
Indented acne scars form when severe inflammatory acne damages your skin’s deeper layers and your body doesn’t produce enough collagen to fill in the damage completely. Genetics, acne severity, how long acne goes untreated, and what you do to your skin all influence whether you’ll develop these lasting marks. Treating acne early and avoiding picking at breakouts are your best defenses against ending up with indented scars.
Sources
https://sozoclinic.sg/acne-scars/pitted/
https://www.london-dermatology-centre.co.uk/blog/acne-scarring-back-chest-treatment/
https://liniaskinclinic.com/ice-pick-scars/
https://cocomedicalspa.com/uneven-skin-texture-and-acne-scars-treated-with-chemical-peels/
https://slmdskincare.com/blogs/learn/the-5-kinds-of-acne-scars-how-to-treat-each-type
https://www.studiomedspa.com/dermal-fillers-for-acne-scars-what-you-need-to-know
