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Noticed pick scars after pimple drains. Are these scars permanent? Tissue damage irreparable?

Dec 2013
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Answered by

Practicing since : 2002
Answered : 4168 Questions
Thanks for answering the earlier query Doctor. I was unable to rate your page yesterday and when I tried it today it wasnt possible. I have another query. Now that you are more or less aware of my skin type I should tell you that I have never had any permanent scarring on most of my face save a few spots here and there.

When a pimple inevitably drains and the scab falls off I have noticed certain very shallow pick scars on those spots. These werent particularly big pimples but they were inflamed with a white top and needed that white clog to be extracted. Now regarding the scars they have left behind. Are they permanent or do they heal and fill up over time. Is the tissue damage irreparable or will there be sufficient collagen build-up after in due time.
How much time would this take? The pitts are small - approx a milimeter in diameter but they are visible under proper sunlight. Will they heal?
Posted Sun, 30 Jun 2013 in Skin Hair and Nails
Answered by Dr. Sanjay Kumar Kanodia 9 hours later
Welcome again to the forum young fellow.

I can make out that the problem you are asking is for the scars after acne which we commonly designate as “Post acne Scar”.

As I said previously “Acne or pimples” are not that problematic thing but once these are healing they leave the most problematic sequel which are either marks or scars or both.

In yourself also I can make out by the query that shallow post acne scars are present. “Post acne Scar” per say have two problematic things: one is pigmentation and the other is atrophy or depth of the scar. The former is due to action and oer activity of color giving cells (called melanocytes) and the latter due to damage to collagen (the tissue which gives plumpness and texture to our skin).

Therefore the treatment advised is also related to both the things. Actually speaking, most of the topical creams have good effect in pigmentation but have slow effect in reducing the depth of scars. You are lucky enough o have shallow scars!! This is because by reducing slight pigmentation over the scars can also make the out look of scars on better side. With this, the slow but steady effect of the topical creams also helpful in rebuilding of collagen tissue.

For both slight pigmentation and shallow scarring, topical cream applications such as “retinoic acid” and or “glycolic acid” and or “azelaic acid” in different combinations and different concentrations will also be quite helpful under best dermatological guidance.

Other than this medical therapy there are certain procedures such as chemical peeling (chemical agents for controlled peeling of skin to reduce pigmentation and rebuilding collagen), scar reversion (method to lift up scar) and laser treatment (for deep scars by “Fraxel laser” only) is also quite helpful in different stages of treatment.

In my experience with a combination of various of the treatment modalities enumerated above, we can see visible results in 3-4 months and best results in next couple of months. I recommend you to follow one good "Cosmetic Dermatologist" with long term follow up and patience to see best results. So now you probably got some idea regarding the complete series of simple problem you are facing.

In between I would also recommend you to eat a lot of fruits in daily routine. I would especially recommend all seasonal fruits with special emphasis on citrus fruits (contains Vitamin C which is very essential for collagen rebuilding). Fruits contains good amount of vitamins, minerals and other essential nutrients which are quite essential for rebuilding collagen. As you are young man of 22 years only so in my experience the collagen rebuilding and remodeling with various above enumerated treatments would be very good in yourself making the things better and best faster.

Hope I have answered your query. If you have any further questions, I will be happy to help or if you do not have any clarifications, you can close the discussion and rate the answer.

Wish you good health and glowing skin.


Dr Sanjay Kumar Kanodia
(MD- Dermatology & STD)
Above answer was peer-reviewed by
Follow-up: Noticed pick scars after pimple drains. Are these scars permanent? Tissue damage irreparable? 13 hours later
And would these creams and solutions be effective in growing collagen where it would otherwise not happen ? Left on its own that is. Because there are a couple that I have noticed which have seen no change in even a month.

Could these go away and be replaced by normal skin. It just seems to take so long that it appears to not be changing one bit in terms of depth. Could Scar revision actually remove it completely? Isnt that like punch grafting which is impermanent and could make it look worse?
Answered by Dr. Sanjay Kumar Kanodia 37 minutes later

Welcome again to the forum.

Now according to your present query you are concerned towards collagen growth and hence improvement in the depth of the scars.

Dear young man, as I said earlier collagen regeneration is not a one day or one month process. It is a slow process which continues through out life. This is actually variable from person to person and also from one scar to other because of multiple factor.

The most important of which are- age of person and depth of scar. As you are young man of 22 years with probably shallow to medium scars, so there are best chances of regeneration of collagen and hence improvement in scar depth.

You can understand by simple things such as:

1.     Topical creams are effective for pigmentation and very superficial scars and also as maintenance therapy which can be used for multiple months and up to year period also.

2.     Chemical peeling of different types in different strengths and concentrations are effective for both superficial and medium depth scars.

3.     Scar reversion, punch grafting and Lasers are effective for deep scars. Amongst these three also punch grafting is least effective results because crudeness of this procedure and certain other limitations. While lasers have best effect because of its controlled ablation power.

So probably you got ample of idea regarding all the above facts. The best of the procedure to alter the depth of scar or directly to say improve the scar in today’s time is by Fraxel Laser in combination with topical treatment as maintenance. Even with these procedures it takes minimum of 3-4 sitting of laser in atleast 3-4 months to see visible and perceptible results.

In my own clinical experience, I have seen a visible, definite and very appreciable improvement with combination modalities of different treatment.

I hope you got all the answers regrading your queries and now can plan and mange the things accordingly.
Finally I request you to have patience and good follow up with the treating doctor.

With good health and glowing skin wishes to you.


Dr Sanjay Kumar Kanodia
(MD- Dermatology & STD)
Above answer was peer-reviewed by
Follow-up: Noticed pick scars after pimple drains. Are these scars permanent? Tissue damage irreparable? 2 hours later
Thanks. I shall do the same.
Answered by Dr. Sanjay Kumar Kanodia 35 minutes later
Dear young friend,

You are most welcome. We are thankful to you for using our forum.

Dr Sanjay Kumar Kanodia
(MD- Dermatology & STD)
Above answer was peer-reviewed by
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