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Pitted scars cause skin aging, making patients feel old before their age, losing confidence in front of the crowd. So what are pitted scars , is there a treatment? Causes, signs and how to classify pitted scars? The following article will share information with patients about common pitted scars, helping to diagnose correctly and treat more effectively.

What are pitted scars?

Pitted scars are skin conditions that appear deep indentations of uneven size and shape on the surface of the skin, so they are also known as concave scars . When the fibroblast organization in the dermis is damaged, broken, does not produce collagen and elastin, it loses the ability to regenerate the skin, cannot fill the wound, so when the wound heals, it leaves indentations on the skin.

Although this condition does not cause itching, discomfort, does not affect health, but pitted spots on the skin (especially in the face) make patients lack confidence.

Classification of the most common types of pitted scars today

In order to apply effective measures to treat pitted scars, suitable for each disease case, dermatologists - skin cosmetologists will classify the most common types of pitted scars today by shape as follows:

1. Sharp bottom leg scars

Sharp basal scars are shaped like sharp objects that penetrate deep into the skin structure. Scars are usually wider than 2mm and deeper than 0.5mm, making the skin surface spotty, less smooth, .. These scars are mainly secondary results from not treating acne completely. This is one of the most difficult to treat pitted scars.

2. Square leg scars

Square foot scars often have vertical edges, wider than sharp basal scars. They resemble a large depression or common crater under the cheeks and jaw. Square leg scars are formed from squeezing pimples incorrectly or as a result of chickenpox.

3. Round bottom scars

To distinguish round-bottom scars from other types of pitted scars, the patient observes through the following characteristics: indentations with steep edges, undulating on the surface like a wavy shape, making the skin look less smooth. Round bottom scars, also known as wavy scars, are found more often on your lower cheeks and chin, where your skin is thicker.

4. Mixed pitted scars

At this time, the skin condition appears all forms of pitted scars with sharp bottoms, square legs, round bottoms, etc., making the skin less smooth. Because acne nodules after healing do not have the same rules for forming pitted scars. Depending on what type of acne it is, whether the inflammation is large or small and each person's body, after an acne episode, different types of pitted scars form. This type of mixed pitted scar is easy to see in people with previous pitted scars.

Causes of pitted scars

Pitted scars are known to originate from the types of acne caused, but there are still some other causes of wood scars such as:

1. Acne

Acne is one of the most common causes of pitted scars. Especially during puberty, acne often appears more.In addition, other types of acne such as blackheads, cysts , pustules, etc., if not handled in time, will clog pores, leading to skin damage. Severe cases of inflammatory acne still cause pitted scars, even when the acne heals on its own.

2. Chickenpox

Chickenpox is caused by the varicella zoster virus, with blisters all over the body, along with itching and discomfort.The disease usually heals in 3 to 4 weeks, the chickenpox nodules will dry out on their own and usually do not leave scars. However, in some cases, without careful and proper care, chickenpox spots still leave pitted scars.

The main causes of pitted scars from chickenpox: damaged skin from scratching the blisters too much, causing blisters to burst, severe disease with a skin infection that causes the blisters to turn into pustules, or It is easy to leave scars. The pitted scars from chickenpox grow scattered, not much concentrated and the surface is from 3 to 8mm wide.

3. Accident

An accident is something that we do not know in advance and cause direct damage to each person when encountered. Situations that cause skin dents or pitted scars such as burns, tripping and scratches, wounds after traffic accidents, etc. In this case, the treatment of pitted scars is quite difficult because they quite large in size.

4. Surgery

Although you do not want to have pitted scars on your skin, when you have surgery with cutlery, it will definitely leave scars, big or small. Laparoscopic appendectomy is a common occurrence of pitted scars.

5. Other causes

In addition to the above factors, pitted scars also come from improper skin care, folliculitis, skin abscesses, .. So when you have skin diseases, you should ask your doctor about the sequelae left behind and take care of them. skin properly to limit pitting scars.

Common signs of pitted scars

To recognize pitted scars is not a difficult problem, here are some common signs:

  • Pitted scars are indentations on the surface of the skin that form when damage has healed. Pitted scars are usually smaller than the wound size range and don't cause pain or discomfort, but leave your skin rough, dry, and rough.
  • During the period of acne, if you do not take care of it properly, it can easily lead to severe inflammatory acne. In this process, the inflammatory acne part is covered with pus and spills into the dermis to destroy skin cells. Lesions easily lead to an overproduction of the enzyme collagenase, an enzyme capable of breaking down collagen and reducing the amount of collagen below the skin's surface. After the acne lesions heal, pitted scars are created.
  • Depending on where the skin is damaged, pitted scars appear there. But common pitted scars appear on cheeks, chin caused by acne lesions. Besides, depending on the location of each person, the likelihood of pitting acne appearing is high or low. In people who have less scarring than others, when they have inflammatory acne, there is no need to worry about pitting scars.

Common pitted scar locations on facial skin

Skin occupies the entire body, so external influences often cause damage to the skin first. The skin on the face is most damaged because the skin is quite thin. Since then, pitted scars appear , in common locations such as:

1. On the face

The habit of using your hands to squeeze pimples, this is a bad thing because acne spots are more easily infected. Facial skin is smooth and thin, when you put your hands on your face, you inadvertently bring dirt and bacteria from your hands into contact with your skin. At this time, the facial skin protects itself by thickening to protect skin coverage.

The pores have acne bran, acne becomes deeper and easy to form pitted scars when acne is gone. This is a rather special case, the cause of pitted scars is not due to the loss of collagen but due to the thickening of the skin and the concave acne area.

Another part, in women, when the facial skin is exposed to many other cosmetics without carefully removing makeup, causing clogged pores. From there, form acne, the leading cause of pitted scars.

2. Above the nose

Blackheads, usually appear on the nose with tiny particles. Many people think that they are small so there is no risk of scarring. However, blackheads are the cause of pitted scars in many people, especially men. In addition to blackheads that appear on the nose, there are still bran acne that also cause pitting scars.

Classification of pitted scars on the face by degree

The condition of pitted scars is classified into 3 different levels.

  • Mild: Mild pitted scar is a condition that only when others come in close contact with them, they realize it or only feel it when they touch it. And on the face there are only a few slight dimples in some areas. This level can be covered with makeup or creams.
  • Moderate: The pitted scars appear densely on both cheeks. The skin surface now appears clearly visible indentations.
  • Severe: Pimples almost take over your face such as: cheeks, forehead, chin, .. with pitted scars deep down to the skin surface. Typically for severe pitted scars, you have a sharp or mixed bottom-shaped scar.

Can pitted scars fill up on their own?

Pitted scars cannot fill up on their own. Pitted scars are the healing process after the skin has been damaged. They form a partial scar to shield the skin from bacteria and other harmful agents. This is considered a permanent form of damage because the broken fibroblasts cannot produce any more collagen.

Pitted scars for a long time, the broken links are not as active as the original, become calloused and difficult to treat.

Can pitted scars be treated?

Have! With modern medicine today, treating pitted scars is not too difficult. However, the effectiveness of treatment depends on the condition of the pitted scar. In addition, patients need to go to reputable pit scar treatment facilities, examine and properly identify the condition, choose the appropriate method, post-treatment care, ..

Aged pitted scars when treated will take more time and are more difficult to achieve than new scars.

How do pitted scars affect life?

People with pitted scars lose confidence in public and become less attractive to the opposite sex. Pitted scars do not cause pain but affect spiritual life. When suffering from pitted scars, patients reduce their chances of finding a job, especially in the field of external appearance.

Diagnosing pitted scars

  • Skin examination: the doctor will examine the skin and use LED lights to check the skin condition and classify the skin.
  • Dermatoscopy: the skin examination is painless, takes place quickly, helping the doctor to optimize the diagnosis of skin conditions, the doctor will know the elasticity, structure, and type of skin deep inside to the dermis.

After examining and examining the skin, the doctor will diagnose the condition of pitted scars with 4 levels: macular, mild, moderate and severe.

  • The macula is a red but flat scar.
  • Light level: makeup can cover pitted scars.
  • Moderate level: clearly visible at close range, makeup does not cover.
  • Severe degree: when standing at a distance of 50cm, pitted scars are still clearly visible.

How to treat pitted scars

Currently, there are many different ways to treat pitted scars , including popular methods such as:

1. Natural ingredients

The ingredients gotu kola, aloe vera, fresh turmeric, green tea powder... collagen production and anti-oxidant.

With the above ingredients, just grind and apply gently on the scar, leave for about 15-20 minutes and rinse with water. If using fresh turmeric or green tea powder, you need to add honey, or squeeze a little lemon juice when using aloe vera.

The natural way to treat pitted scars is easy to do, you need to apply it for a long time to see the effect. However, this method is not effective in cases of severe pitted scars.

2. Chemical peels

Chemical peels (peel or biological peels) are based on the use of organic acids such as alpha hydroxy acid (AHA) or beta hydroxy acid (BHA) or trichloroacetic acid (TCA). epidermis, promote renewal, skin regeneration. The method of skin peels can overcome many skin problems such as: acne, pitted scars, dark spots, large pores ... at a much lower cost than other high-tech treatments such as: super abrasive, laser phototherm…

3. Create fake damage

Create fake lesions with 2 main methods: needle roller , microneedle.

Microneedling uses small needles to roll over the surface, causing small lesions to stimulate collagen production to improve skin conditions such as: melasma, scars, baldness, wrinkles.

Microneedle uses micro needles to act on the skin epidermis to replace the old layer of cells. Then, nutrients extracted from seaweed, fermented plants ... are injected deep inside the skin to nourish and regenerate the skin.

Microneedling is mainly in the epidermis layer of the skin, causing no pain, suitable for skin with mild or moderate pitted scars. Needle rolling causes more pain because the intervention is deeper than micro-needle, bringing a noticeable effect after each treatment.

4. Skin grinding

Doctors use a hand-held device called a dermabrasion, which creates friction to remove the outer layers of skin. This method is painless because it only affects the surface of the skin and one time it takes about 30-40 minutes.

There are 3 common types of microdermabrasion: hydraulic dermabrasion, which microdermabrasion with diamond crystals, and crystal dermabrasion. Because it only works on the surface, microdermabrasion needs you to persevere many times to bring the expected results.

5. Filler injection

Filler injection is chosen by many people with quick results after implementation. This method introduces fillers into the dermis or dermis at the site of pitted scars with the aim of raising the skin surface, supporting subcutaneous tissue and filling pitted scars. Fillers are usually liquid or gel, usually collagen, autologous fat similar to natural substances in the body.

Depending on the location, filler injections keep for 4-6 months, then dissolve and the skin returns to the state before the filler was injected. In addition, this method can have dangerous complications if the filler is of unknown origin, of poor quality or injected in the wrong way, causing the scar structure to change.

6. Laser Reconstruction

There are two types of laser skin resurfacing: fractional CO2 laser and non-invasive. Depending on the condition of the pitted scar or the nature of your skin, the dermatologist - esthetician determines which laser method is suitable.

Fractional CO2 laser therapy helps stimulate cell regeneration below the scar. Using laser light shines on pitted scars, burns the outermost layer of the scarred skin and stimulates new cell growth. After a while, the pitting is slightly reduced.

Ablative laser is a form of treatment that removes pitted skin with lasers. This invasive laser resurfacing takes weeks of care and recovery but results last for years, with no additional treatments required. However, this therapy has some risks such as changes in skin color, redness and swelling. In some cases, this method makes acne or scarring worse.

Notes to know after treating pitted scars

After the treatment of pitted scars, the skin becomes thin and sensitive. At that time, the skin has a number of other manifestations after treatment such as: red skin, self-sloughing skin and exposing young skin. This makes the patient afraid to care for fear of further harm, but the reactions will disappear if you know the right care. Some notes when treating pitted scars are as follows:

1. Follow the doctor's prescription

Dermatologist's advice – cosmetic skin care is very important after treating pitted scars. Patients should remember what the doctor tells them and take the full dose if prescribed, to avoid dangerous complications.

2. Proper skin care

  •  After 1-3 days of treatment, you should use cotton pads or gauze to avoid infection.
  • From 3 to 7 days, you can wash your face, but do not scrub or rub vigorously to damage the skin.
  • After 7 days, use a gentle cleanser.

Later, when the skin is perfected, you should use moisturizing products and use sunscreen when going out.

3. Avoid sun exposure

During the first week of treatment for pitted scars, you should limit going out and do not use sunscreen because at this time the skin is still thin and vulnerable. If you must go out, you should use sunscreen pills and a thick mask to help protect your skin. After 7 days, use sunscreen regularly even indoors.

Measures to prevent pitted scars

In order to not have a headache, lose confidence or waste time and money treating pitted scars , you need to create a skin care routine such as: 

1. Proper skin care when acne

When you have acne, you should not squeeze it with your hands, or intentionally remove the acne core, which can easily lead to infection. You need to remove makeup, wash your face thoroughly and use a stick to squeeze acne or wash your hands to get the acne feet under the skin. After squeezing acne, apply moisturizer to the skin. This way helps the skin have a certain moisture and reduces the risk of inflammation with the acne marks just removed.

2. Use sunscreen

Sunscreen should be used when going out to prevent dirt from sticking to the skin and harmful rays to the skin. If you don't go out and sit in a light location, you should still use sunscreen, because here the ultraviolet rays can still reach the skin.

3. Exfoliate

To treat existing acne and prevent further breakouts, it is important to keep pores open and support skin cell regeneration. Choose gentle exfoliators that contain ingredients: cleansers that contain AHAs (like glycolic acid), BHAs (like salicylic acid), and retinol are all helpful.

4. Take prescription medication

If your acne doesn't improve after a few months of acne treatment, see your doctor to adjust or review your prescription.

Treat pitted scars should eat, what to abstain?

During the treatment of pitted scars, eat carefully. In addition to paying attention to foods that provide nutrition to the skin, speeding up the recovery process should avoid some foods that can slow healing or cause allergic reactions such as spicy, greasy foods. …

1. Foods to eat

Diet and rest greatly affect the results of treatment. Foods that help increase wound healing such as: meat, fish, eggs, milk, broccoli, avocado, kiwi, .. In addition, foods rich in vitamins A, B, and E are often found in sweet potatoes. , lettuce, papaya, active seeds, ... help increase collagen. And drink enough 2 liters of water every day, a good measure to hydrate the skin.

2. Foods to Avoid

Foods made from glutinous rice such as banh chung, sticky rice, banh tet, etc. should be limited. Because they have the ability to cause inflammation and scarring. Although green vegetables have many vitamins that are good for health, water spinach, spinach, and amaranth make scarring more serious. And seafood with hard shells such as shrimp, crabs, crabs, snails, etc. are also not eaten. These types of seafood make scars wider, difficult to heal.

Specialist in Dermatology - Aesthetic Skin of Tam Anh General Hospital with leading doctors with long experience in the profession, helps to accurately diagnose pitted scars. With modern machinery and equipment, we offer the most effective treatment for pitted scars. Pitted scars appear indentations on the surface of the skin, making the skin prone to premature aging. There are many methods to treat pitted scars to help restore and regenerate the skin, making the skin stretchy and smooth. Patients should choose a reputable clinic and hospital with specialists in dermatology - skin cosmetology to examine, consult, and give a treatment plan's

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